This article is more than 5 years old. Information may no longer be current.
Influenza vaccination rates unchanged after ACIP withdraws LAIV recommendation
Click Here to Manage Email Alerts
Although the Advisory Committee on Immunization Practices no longer recommends the live-attenuated influenza vaccine, or LAIV, overall child influenza immunization rates remained unchanged between the 2015-2016 and 2016-2017 influenza seasons, according to a study published in Pediatrics.
In addition, researchers observed that children who had previously received an injectable influenza vaccine (IIV) were slightly more likely to return for immunizations the following year compared with children who had received LAIV.
The ACIP recommended against using LAIV in June 2016 after research showed it was less effective than the injectable vaccine in preventing the H1N1 strain of influenza. As a nasal spray, LAIV was a less painful and more convenient option for young children.
“A motivating concern for this study was that the withdrawal of the LAIV recommendation would lower childhood influenza immunization rates and that further interventions might be needed to promote the use of the injectable influenza vaccines among parents who in previous seasons had opted to use an LAIV,” Steve G. Robison, MPH, from the immunization program at the Oregon Heath Authority, and colleagues wrote.
The researchers compared child immunization rates from the 2012-2013 season with those from the 2016-2017 season using data from Oregon’s statewide immunization registry.
Children were additionally matched in groups and selected based on whether they received LAIV or an IIV in the 2015-2016 season. The researchers assessed whether these children returned for IIV in the 2016-2017 season.
For children aged 2 to 17 years, influenza immunization rates remained consistent across the 2015-2016 and 2016-2017 seasons. If a child between the ages of 3 and 10 years had previously received IIV, they were 1.03 times (95% CI, 1.02-1.04) more likely to receive IIV in the 2016-2017 season than children who were previously vaccinated with LAIV. Children aged 11 to 17 years who were previously immunized with IIV were 1.08 times (95% CI, 1.05 to –1.09) more likely than those who received an LAIV to return for immunization.
Research thus far has been somewhat inconsistent about whether the ACIP’s decision to recommend against LAIV has had an impact on vaccine uptake among children. In a recent study of almost 10,000 Penn State Pediatric patients, researchers saw a small but statistically significant drop — 1.6% — in end-of-season influenza vaccination rates after LAIV was no longer recommended by the CDC. – by Katherine Bortz
- References:
- Fogel B, Hicks S. Vaccine. 2017;doi:10.1016/j.vaccine.2017.07.067.
- Robison SG, et al. Pediatrics. 2017;doi:10.1542/peds.2017-0516.
Disclosures: The authors report no relevant financial disclosures.
Perspective
Back to Top
Ben N Fogel, MD MPH
The study by Robison and colleagues used the Oregon immunization registry to show that influenza vaccination rates remained stable after the 2016 ACIP recommendation not to offer LAIV. This is generally consistent with data that Steven D. Hicks, MD, and I recently published in Vaccine, as well as CDC data both of which show a minimal decrease in overall vaccination rates. These data should be reassuring to pediatricians who had worried about a large decrease in vaccination rates when the live-attenuated virus was not recommended.
These authors also found that patients who had received the live form of the vaccine in the 2015-2016 season were only slightly less likely to be vaccinated in the 2016-2017 season than those who had been previously vaccinated with the inactivated vaccine. This stands in contrast with our own data, which found meaningfully lower rates in 2016-2017 among patients who had previously received LAIV in 2015-2016.
This discrepancy could be due to the data sources used. Robison and colleagues, using Oregon registry data, found an overall vaccination rate in 2016-2017 of 32.6% compared with CDC reported rates in Oregon of 52%. Our own data used health system-level electronic medical record data and found an overall vaccination rate of 50.4% compared with CDC reported rates in Pennsylvania of 63.3%. These differences in results highlight the need for varied data sources in assessing seasonal changes in vaccination rates.
Click Here to Manage Email Alerts