No association between inactivated influenza vaccination and influenza viral load at diagnosis among young Japanese children: An observational study of the 2013/2014 through 2017/2018 influenza seasons

Author:

Mukai Emiko1ORCID,Fukushima Wakaba23,Morikawa Saeko4ORCID,Nakata Keiko4,Hiroi Satoshi4,Fujioka Masashi5,Matsushita Tohru6,Kubota Megumi7,Yagi Yoshina8,Takechi Tetsuhisa9,Takasaki Yoshio10,Shindo Shizuo11,Yamashita Yuji12,Yokoyama Takato13,Kiyomatsu Yumi14,Matsumoto Kazuhiro1,Maeda Akiko2,Kondo Kyoko15,Ito Kazuya16,Kase Tetsuo23,Ohfuji Satoko23,Hirota Yoshio17

Affiliation:

1. Department of Public Health Osaka City University Graduate School of Medicine Osaka Japan

2. Department of Public Health Osaka Metropolitan University Graduate School of Medicine Osaka Japan

3. Research Center for Infectious Disease Sciences Osaka Metropolitan University Graduate School of Medicine Osaka Japan

4. Department of Virology Osaka Institute of Public Health Osaka Japan

5. Fujioka Pediatric Clinic Tondabayashi Japan

6. Matsushita Kids' Clinic Kadoma Japan

7. Kubota Children's Clinic Osaka Japan

8. Yagi Pediatric Clinic Yao Japan

9. Takechi Clinic for Pediatrics and Internal Medicine Osaka Japan

10. Takasaki Pediatric Clinic Fukuoka Japan

11. Shindo Children's Clinic Fukuoka Japan

12. Yamashita Pediatric Clinic Itoshima Japan

13. Yokoyama Children's Clinic Kasuga Japan

14. Kiyomatsu Pediatric Clinic Fukuoka Japan

15. Management Bureau Osaka Metropolitan University Hospital Osaka Japan

16. Osaka Metropolitan University Graduate School of Nursing Osaka Japan

17. Clinical Epidemiology Research Center SOUSEIKAI Medical Group (Medical Co. LTA) Fukuoka Japan

Abstract

AbstractBackgroundThe association between inactivated influenza vaccination and viral load in young children remains unclear.MethodsDuring the 2013/2014 to 2017/2018 influenza seasons in Japan, children under 6 years of age with pre‐defined influenza‐like illness and influenza‐positive status by real‐time RT‐PCR were recruited at pediatric clinics for this observational study. Influenza viral load was measured for the most predominant subtype/lineage in each season. Using median dichotomized viral load as an outcome, a multilevel logistic regression model was applied to estimate the multivariable adjusted odds ratio (MOR) and 95% confidence interval (CI) for higher viral load.ResultsA total of 1,185 influenza‐positive children were analyzed. The median log10 viral load copy number (copies per milliliter) was 5.5 (interquartile range, 4.6 to 6.1) and did not differ by vaccination status: 5.5 for unvaccinated, 5.7 for one dose, and 5.5 for two doses (p = 0.67). The MOR of vaccinated (one or two doses) versus unvaccinated children was 1.19 (95% CI: 0.86–1.64). Other factors showing significant associations with higher viral load were positive results for A(H1N1)pdm09 and A(H3N2) in comparison with B/Yamagata. The respective MORs were 3.25 (95% CI: 2.28–4.64) and 1.81 (95% CI: 1.32–2.49). Significantly elevated MORs against higher viral load were also observed for higher body temperature at influenza diagnosis and shorter duration from fever onset to specimen collection.ConclusionNo association was observed between inactivated‐influenza vaccination and viral load at influenza‐positive diagnosis. Influenza subtype/lineage, body temperature, and time elapsed since fever onset were significantly associated with viral load.

Funder

Ministry of Health, Labour and Welfare

Publisher

Wiley

Subject

Infectious Diseases,Public Health, Environmental and Occupational Health,Pulmonary and Respiratory Medicine,Epidemiology

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