Increased Risk of Noninfluenza Respiratory Virus Infections Associated With Receipt of Inactivated Influenza Vaccine
We randomized 115 children to trivalent inactivated influenza vaccine (TIV) or placebo. Over the following 9 months, TIV recipients had an increased risk of virologically-confirmed non-influenza infections (relative risk: 4.40; 95% confidence interval: 1.31-14.8). Being protected against influenza, TIV recipients may lack temporary non-specific immunity that protected against other respiratory viruses. …
There was no statistically significant difference in the risk of confirmed seasonal influenza infection between recipients of TIV or placebo, although the point estimate was consistent with protection in TIV recipients (relative risk [RR], 0.66; 95% confidence interval [CI], .13–3.27). TIV recipients had significantly lower risk of seasonal influenza infection based on serologic evidence (Supplementary Appendix). However, participants who received TIV had higher risk of ARI (acute respiratory infection) associated with confirmed noninfluenza respiratory virus infection (RR, 4.40; 95% CI, 1.31–14.8). Including 2 additional confirmed infections when participants did not report ARI, TIV recipients had higher risk of confirmed noninfluenza respiratory virus infection (RR, 3.46; 95% CI, 1.19–10.1). The majority of the noninfluenza respiratory virus detections were rhinoviruses and coxsackie/echoviruses, and the increased risk among TIV recipients was also statistically significant for these viruses (Table 3). Most respiratory virus detections occurred in March 2009, shortly after a period of peak seasonal influenza activity in February 2009 (Figure 1)….