Assessing the Safety of Influenza Vaccination in Specific Populations

Children and the Elderly

Ali Rowhani-Rahbar; Nicola P Klein; Roger Baxter

Disclosures

Expert Rev Vaccines. 2012;11(8):973-984. 

In This Article

Abstract and Introduction

Abstract

Comprehensive monitoring of the safety of influenza vaccines remains a public health priority, particularly as immunization coverage increases across different age groups at the global level. In this review, the authors provide state-of-the-art knowledge on the safety of influenza immunization among children and the elderly. The authors review the safety information in each group separately for inactivated and live attenuated influenza vaccines. Adverse events of special concern including febrile seizure, narcolepsy, asthma and Guillain–Barré syndrome are covered under specific considerations. The authors discuss the current status of the field, particularly the use of new technologies for influenza vaccines and their potential safety profile.

Introduction

Annual influenza immunization is considered the chief public health strategy to reduce morbidity and mortality due to infection with the influenza virus. Influenza immunization is particularly critical among high-risk populations such as individuals with chronic diseases and the elderly.[1] These groups have traditionally constituted the main target group for influenza immunization. Nonetheless, owing to the recognition of the medical and socioeconomic impact of influenza infection on other groups, vaccine administration has become increasingly recommended for greater numbers of individuals in recent years. For instance, some health authorities around the world now include all healthy children and adolescents in their recommendations for annual influenza immunization.[2–5]

As immunization coverage increases globally across different age groups, comprehensive monitoring of the safety of influenza vaccines remains a public health priority. Over the past several decades, the safety of influenza vaccines has been examined in both randomized-controlled trials and observational studies. More recently, prospective near real-time active surveillance of the safety of these vaccines has been established in the USA.[6,7] This review provides state-of-the-art knowledge on the safety of inactivated influenza vaccines (IIVs) and live attenuated influenza vaccines (LAIVs) administered to two separate high-risk groups: children and the elderly. The authors use the term IIV throughout this review to collectively refer to all monovalent, bivalent and trivalent IIV. Adverse events of special concern including febrile seizure, narcolepsy, asthma and Guillain–Barré syndrome (GBS) are covered under specific considerations (Table 1). It is critical to note that the review of adverse events following immunization with influenza vaccines in this paper does not indicate that a causal relationship has necessarily been established. In the 'Expert commentary' section, the authors discuss the current status of the field, particularly the use of new technologies for influenza vaccines and their potential safety profile. Finally, the authors provide their viewpoint on how the field may evolve over the next few years in the 'Five-year view' section.

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