The use of vaccines in children has perhaps never been more controversial than it is now, following the development and distribution of child vaccines for COVID-19. Flu vaccines have long been recommended in children. In those with asthma, the value of flu vaccines is complicated by both the impact of flu on asthma symptoms and the potential impact of the vaccines on those symptoms.

Flu often exacerbates wheezing, which has been highlighted as justification for vaccinating asthmatics against the flu. However, concerns have also been raised that quadrivalent live attenuated influenza vaccine (LAIV4) could also be associated with increased wheezing.

A study recently published in the journal Pediatrics investigated the safety of LAIV4 in children between the ages of 5 and 17 to determine if asthma exacerbations were more frequent when this type of flu vaccine was used compared to quadrivalent inactivated influenza vaccine (IIV4). Physicians and researchers studied 151 children diagnosed with asthma and randomly assigned the children to receive either LAIV4 or IIV4. All children were monitored for asthma symptoms for 42 days following their vaccination.

The results showed that 13% of the study participants experienced asthma exacerbation during the 42 days after vaccination. Importantly, though, there was no significant difference in these asthma exacerbations in those who received LAIV4 and those who received IIV4. There was also no difference in the frequency of asthma-related symptoms or peak expiratory flow rate in the two groups. The vaccine reactogenicity was similar across the groups as well. These new data suggest that LAIV4 are as safe as IIV4 in asthmatic children aged 5 to 17.

Reference

Sokolow AG, Stallings AP, Kercsmar C, et al. Safety of Live Attenuated Influenza Vaccine in Children With Asthma. Pediatrics. Published online March 28, 2022. doi:10.1542/PEDS.2021-055432