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Peer reviewedOpen accessInfluenza

Effects of attenuated influenza virus administration to young children on pneumococcal density and acquisition in UK families: a randomised controlled trial

The Lancet Microbe·

Jane Metz, George Qian, Begonia Morales-Aza, Jennifer Oliver, Elizabeth Oliver, Helen Rice, Kaltun Duale, Paul Heath, Saul Faust, Matthew Snape, Stephen Hughes, Laura Hole, Rebecca Mann, Fiona Shackley, Peter Rudd, Siân Ludman, Bradford Gessner, Leon Danon, Adam Finn

DOI
10.1016/j.lanmic.2026.101422
PMID
42612652
PMCID
OpenAlex
W7203668241
Study type
Randomised controlled trial
Publisher
Elsevier BV
Article type
journal-article
Integrity
current

Why this research matters now

The findings suggest LAIV-induced increases in pneumococcal density in vaccinated toddlers may transiently raise pneumococcal acquisition risk among household members, which has implications for transmission modelling at individual and population scales.

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Structured evidence summary

Research question

The study examined whether administration of LAIV to young children alters pneumococcal carriage density in those children and the likelihood of pneumococcal acquisition in their household contacts.

Study design

This was a randomised controlled trial conducted across ten UK sites (ISRCTN10720581), with 1:1 allocation of families to early or delayed LAIV groups. Laboratory and analytical staff were masked, while families and clinical staff were unmasked after randomisation.

Population and setting

Families with a 2-year-old index child eligible for a first NHS LAIV dose and at least two additional household contacts were enrolled in the UK. 405 households (1379 participants) were randomised; 96% of households completed the study.

Main findings

Compared with unvaccinated children, vaccinated index children had roughly 2.5-fold higher odds of increased pneumococcal density at day 14, and their household contacts had about 2.0-fold higher odds of acquiring pneumococcus. By day 28 these differences were no longer statistically significant. Three pregnancy/breastfeeding-related serious adverse events were reported and judged unrelated to the study.

Public-health relevance

The findings suggest LAIV-induced increases in pneumococcal density in vaccinated toddlers may transiently raise pneumococcal acquisition risk among household members, which has implications for transmission modelling at individual and population scales.

Important limitations

The abstract does not list explicit study limitations. This summary is limited to the supplied single-article abstract and metadata and requires the full paper for decision-grade interpretation.

GIDS interpretation

The paper addresses vaccine-related microbial transmission dynamics, classifying under influenza and vaccination topics, which supports its discoverability in literature searches on LAIV effects or pneumococcal carriage rather than confirming any live surveillance signal.

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Related GIDS surveillance

Literature context does not validate, explain, or change a surveillance signal. Exact and contextual relationships are shown separately.

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Evidence relationships

This article has 9 auditable classifier relationships to diseases, places, topics, and study design.

about diseaseaddresses topicaddresses topicevaluates interventionhas pathogen typestudied instudied population settingstudies populationuses study design