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- ARTICLES:
Pedro A. Piedra, Manjusha J. Gaglani, Claudia A. Kozinetz, Gayla B. Herschler, Charles Fewlass, Dianne Harvey, Nadine Zimmerman, and W. Paul Glezen
- Trivalent Live Attenuated Intranasal Influenza Vaccine Administered During the 2003–2004 Influenza Type A (H3N2) Outbreak Provided Immediate, Direct, and Indirect Protection in Children
Pediatrics 2007; 120: e553-e564
[Abstract]
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eLetters published:
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Questioning the reliability of inactivated influenza vaccine effectiveness measure
- Alexander Goldstein
(14 August 2007)
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Questioning the reliability of inactivated influenza vaccine effectiveness measure [corrected]
- Alexander Goldstein
(15 August 2007)
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Questioning the reliability of inactivated influenza vaccine effectiveness measure |
14 August 2007 |
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Alexander Goldstein, Moscow, Russia sanofi pasteur
Send letter to journal:
Re: Questioning the reliability of inactivated influenza vaccine effectiveness measure
alexander.goldstein{at}sanofipasteur.com Alexander Goldstein
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I disagree with the authors of the paper in the method of assesement
of inactivated influenza vaccine (IIV) effectiveness. It is widely known
that immune response after administration of IIV peaks after first 2 weeks
after vaccination (Fukuda K. et al. Inactivated Influenza Vaccine. In:
Plotkin SA, Orenstein WA (eds). Vaccines. 4th ed., 2004). So cases of
influenza (clinically or laboratory-confirmed) occured during first 14
days after IIV vaccination usually are not included in the analysis of IIV
effectiveness becuse during that time recipients are not yet fully
protected or not protected at all. This factor is particularly important
in this study, because recipients of IIV were not healthy adults but
children, which had, in addition, chronic medical conditions (in which we
can propose slower kinetics of immune response). Furthermore, as noted by
the authors in the Discussion chapter, part of the children from the IIV
group were not vaccinated according to the recommended schedule as persons
<9 y.o., which have not been immunized against influenza previously,
should recieve 2 doses of the vaccine. Inclusion in the analysis cases of
influenza, which occured: 1) during first 14 days after receipt of IIV and
2) in not fully vaccinated children (the number of such cases is not
stated in the paper) would surely lead to underestimation of IIV
effectiveness and that occured in this sudy. As we can see in table 4, 7
of 14 laboratory-confirmed cases of influenza in IIV recipients occured
within 14 days after vaccination (6 of that 7 - durind 1st week after
vaccination). If they were not included in the analysis of IIV
effectiveness (table 3), the latter will be far from zero and amount 47%.
Such effectiveness, accounting for underlying chronic medical conditions
in vaccine recipients and influenza vaccine strain and circulating strain
mismatch, can be considered as satisfactory.
Conflict of Interest:
Employee of sanofi pasteur. |
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Questioning the reliability of inactivated influenza vaccine effectiveness measure [corrected] |
15 August 2007 |
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Alexander Goldstein, Moscow, Russia sanofi pasteur
Send letter to journal:
Re: Questioning the reliability of inactivated influenza vaccine effectiveness measure [corrected]
alexander.goldstein{at}sanofipasteur.com Alexander Goldstein
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I would like to edit my P3R. Corrected response should be the
following:
I disagree with the authors of the paper in the method of assesement
of inactivated influenza vaccine (IIV) effectiveness. It is widely known
that immune response after administration of IIV peaks after first 2 weeks
after vaccination (Fukuda K. et al. Inactivated Influenza Vaccine. In:
Plotkin SA, Orenstein WA (eds). Vaccines. 4th ed., 2004). So cases of
influenza (clinically or laboratory-confirmed) occured during first
14 days after IIV vaccination usually are not included in the analysis of
IIV effectiveness becuse during that time recipients are not yet fully
protected or not protected at all. This factor is particularly important
in this study, because recipients of IIV were not healthy adults but
children, which had, in addition, chronic medical conditions (in which we
can propose slower kinetics of immune response). Furthermore, as noted by
the authors in the Discussion chapter, part of the children from the IIV
group were not vaccinated according to the recommended schedule as persons
<9 y.o., which have not been immunized against influenza previously,
should recieve 2 doses of the vaccine. Inclusion in the analysis cases of
influenza, which occured: 1) during first 14 days after receipt of IIV and
2) in not fully vaccinated children (the number of such cases is not
stated in the paper) can lead to underestimation of IIV effectiveness.
This response represents only opinion of its author and do not
represent position of sanofi pasteur.
Conflict of Interest:
Employee of sanofi pasteur. |
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