Mini Research Proposal: Effectiveness of Different Types of Vaccinations

by Tayba Aziz, Emilia Decaudin, Ann-Renee Rubia, and Manuel Sojan

Background

It is a well-known fact that flu vaccines can be effective when it comes to protecting an individual from influenza. According to the Center for Disease Control and Prevention (CDC), the vaccine reduces the risk of contracting the flu by about 50 to 60 percent. The flu vaccine also reduced children’s risk of admission into pediatric intensive care units by about 74 percent during the 2010–2012 flu season (J. Ferdinands et al., 2014). There have been numerous inquiries into what makes a vaccine more or less effective at combating the flu. The main factors researchers look at are the person’s age, his or her health, and how closely the vaccine resembles the strain of influenza it’s designed to protect against. However, in this investigation, a fourth factor will be examined: the type of vaccine used. The difference in effectiveness between live attenuated influenza vaccines (LAIV) and inactivated influenza vaccines (IIV) will be scrutinized.

Live attenuated vaccines are vaccines produced from disease-causing viruses or bacteria and are usually given in the form of a nasal spray. In a laboratory, the pathogens are weakened “by repeated culturing” (“Principles of Vaccination,” CDC). For instance, the vaccine for measles disease was produced from measles virus extracted from a child in 1954. According to the CDC, it took researchers about 10 years to create an attenuated form of the measles virus. The other type of vaccination, as mentioned in the previous paragraph, is the inactivated vaccine. To produce inactivated vaccine, bacteria and viruses are grown in culture media, and then inactivated with heat or chemicals. IIVs are usually carried out by intramuscular or deep subcutaneous injection. For adults and children aged 36 months or older, the injection is usually given in the deltoid muscle, while for those aged between 6 and 35 months, the preferred location for the injection is the anterolateral thigh flap (Sanofi Pasteur, 2017).

Research Question

Is the Inactivated Influenza Vaccine, administered through intramuscular injection, more effective than the Live Attenuated Influenza Vaccine (LAIV), administered intranasally, in preventing influenza when given to children (ages 5-17) in the United States?

Proposed Methods

Subject Enrollment

In order to collect data for our study, we would enlist the help of doctors from medical centers across the United States. We would ask for data from the doctors for children between the ages of 5 and 17 years old who have an up-to-date vaccination record/immunization record. The data should be collected during vaccination season, which is September to February. Before administration of the vaccination, informed parental consent must be obtained.

Data Collection

  • Survey

    Doctors should administer the vaccination for the influenza virus to the children either with the live attenuated vaccine (administered intranasally) or with the inactivated influenza vaccine (administered intramuscularly).  Both vaccinations should be the quadrivalent strain. After administering either vaccine, the doctors should give an optional survey for the parents to complete over the course of 4 weeks– observing and taking note of any symptoms experienced by the children such as pain, redness, swelling, etc., and rating the severity of each symptom (if experienced by the child). At the conclusion of 4 weeks, the children will return for a check-up and additional testing, at which point the completed survey will be returned.

  • Testing

    Nasal swabs should be performed and tested using a Rapid Influenza Test (RIT), which has a sensitivity of 81% and a specificity of 97% for influenza A, and a sensitivity of 65% and a specificity of 99% for Influenza B (the two most common forms of influenza). After completion of the RIT, we will compare the presence of the influenza virus between the groups of children who were either vaccinated through LAIV or IIV. This will allow us to test the effectiveness of each vaccine.

Below is a summary of the methods needed to collect data:

  • Access to medical centers across the United States.
  • Randomized study – to reduce bias and include a wide range of individuals from all backgrounds.
  • Give a survey to the parents/guardians asking about symptoms experienced by the children:
    • Survey Questions: Whether or not the children felt any of the following and rank each symptom from 1-5 based on severity:
      • Pain
      • Redness
      • Swelling
      • Headache
      • Nasuea
      • Fever
      • Vomiting
      • Diarrhea

Bibliography

Airey, J., Albano, F. R., Sawlwin, D. C., Jones, A. G., Formica, N., Matassa, V., & Leong, J. (2017). Immunogenicity and safety of a quadrivalent inactivated influenza virus vaccine compared with a comparator quadrivalent inactivated influenza vaccine in a pediatric population: A phase 3, randomized noninferiority study. Vaccine,35(20), 2745-2752. doi:10.1016/j.vaccine.2017.03.028

Does My Child Have the Flu? (n.d.). Retrieved September 17, 2017, from http://www.hopkinsmedicine.org/healthlibrary/conditions/pediatrics/influenza_flu_in_children_90,P02514

Ferdinands, J. M., Olsho, L. E. W., Agan, A. A., Bhat, N., Sullivan, R. M., Hall, M., … Randolph, A. G. (2014). Effectiveness of Influenza Vaccine Against Life-threatening RT-PCR-confirmed Influenza Illness in US Children, 2010–2012. The Journal of Infectious Diseases, 210(5), 674–683. https://doi.org/10.1093/infdis/jiu185

Inactivated Influenza Vaccine (Split Virion) BP. (n.d.). Retrieved September 17, 2017, from https://www.medicines.org.uk/emc/medicine/6207

Influenza (Flu). (2017, September 14). Retrieved September 17, 2017, from https://www.cdc.gov/flu/about/qa/vaccineeffect.htm

Mclean, H. Q., Caspard, H., Griffin, M. R., Poehling, K. A., Gaglani, M., Belongia, E. A., . . . Ambrose, C. S. (2017). Effectiveness of live attenuated influenza vaccine and inactivated influenza vaccine in children during the 2014–2015 season. Vaccine,35(20), 2685-2693. doi:10.1016/j.vaccine.2017.03.085

Valdin, H. L., & Bégué, R. E. (2017). Influenza vaccines effectiveness 2013–14 through 2015–16, a test-negative study in children. Vaccine, 35(33), 4088–4093. https://doi.org/10.1016/j.vaccine.2017.06.050