Quadrivalent Ann Arbor strain live-attenuated influenza vaccine

Figures & data

Figure 1. The percentage of circulating influenza B strains that were a lineage match (homologous lineage) or mismatch (heterologous lineage) with the B lineage included in the influenza vaccines by influenza season between 2001 and 2011 in the USA and Europe.

Lineage match/mismatch (A) in the USA and (B) in Europe. The B lineage contained in the vaccine is indicated below each season.

Adapted with permission from [4].

Figure 2. Comparative immunogenicity of quadrivalent live-attenuated influenza vaccine to trivalent live-attenuated influenza vaccine in children and adults.

(A) Geometric mean titer ratios (T/LAIV ÷ Q/LAIV) after vaccination by strain with two-sided 95% CI. Noninferiority was prespecified as an upper bound of the 95% CI of the ratio ≤1.5 (noninferiority margin, indicated by dotted line). (B) Geometric mean fold rise ratios (T/LAIV ÷ Q/LAIV) after vaccination by strain with two-sided 95% CI.

Q/LAIV: Quadrivalent live-attenuated influenza vaccine; T/LAIV: Trivalent live-attenuated influenza vaccine.

(A) Data taken from [40] and (B) data taken from [41].

Figure 3. Seroconversion/seroresponse to homologous and heterologous lineage B strains in adults and children.

(A) Response in adults and (B) in children. In all subjects and in the subset of subjects that included baseline serosusceptible adults or seronegative children, the proportion of subjects achieving a fourfold rise in hemagglutination inhibition (HAI) antibody titer from baseline in those receiving Q/LAIV and the T/LAIV containing the B lineage being assessed (homologous responses) was statistically significantly higher than the responses observed for those receiving T/LAIV that did not include the B lineage (heterologous responses).

†Serosusceptible = baseline HAI titer ≤8.

‡Seronegative = baseline HAI titer ≤4.

Q/LAIV: Quadrivalent live-attenuated influenza vaccine; T/LAIV: Trivalent live-attenuated influenza vaccine.

(A) Data taken from [40] and (B) data taken from [41].

Figure 4. Percentage of subjects reporting solicited symptoms 0–14 days after the first dose of study vaccine by symptom in adults and children.

(A) Percentage of subjects reporting solicited symptoms in adults and (B) percentage of subjects reporting solicited symptoms in children. Fever was defined as a temperature ≥38°C (100.4°F).

*p = 0.04 (Q/LAIV vs T/LAIV).

Q/LAIV: Quadrivalent live-attenuated influenza vaccine; T/LAIV: Trivalent live-attenuated influenza vaccine.

(A) Adapted with permission from [40] and (B) adapted with permission from [41].

Table 1. Vaccine strains contained in the quadrivalent live-attenuated influenza vaccine, trivalent live-attenuated influenza vaccine B/Yamagata and trivalent live-attenuated influenza vaccine B/Victoria vaccine formulations used in the adult and pediatric quadrivalent live-attenuated influenza vaccine studies.

Strain	Q/LAIV	T/LAIV-B/Yamagata	T/LAIV-B/Victoria
A/H1N1	A/South Dakota/6/2007	A/South Dakota/6/2007	A/South Dakota/6/2007
A/H3N2	A/Uruguay/716/2007	A/Uruguay/716/2007	A/Uruguay/716/2007
B/Yamagata	B/Florida/4/2006	B/Florida/4/2006
B/Victoria	B/Malaysia/2506/2004		B/Malaysia/2506/2004

Q/LAIV: Quadrivalent live-attenuated influenza vaccine; T/LAIV: Trivalent live-attenuated influenza vaccine.

Table 2. Fever, days 0–14 after dose 1 in subjects 2–8 years of age.

Fever	Q/LAIV (%) n = 1078	T/LAIV (%) n = 716	Rate difference (%)
≥38.0 to <38.5°C	2.6	2.0	0.6
≥38.5 to <39.0°C	2.3	1.4	0.9
≥39.0 to <39.5°C	1.3	0.6	0.7
≥39.5 to <40.0°C	0.3	0.3	0.0
≥40.0°C	0.1	0.0	0.1

Q/LAIV: Quadrivalent live-attenuated influenza vaccine; T/LAIV: Trivalent live-attenuated influenza vaccine.

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