human
***TASK*** the task is to summarize an input biomedical literature in six sentences 
    ***INPUT*** the input is a biomedical literature 
    ***OUTPUT*** the output is the summary of an input biomedical literature in six sentences 
    ***DOCUMENTATION*** 
    ***EXAMPLES*** 
    Input: Production lots of a live influenza vaccine made of strains A/47/T ( N1H1 ) , A/47/6/2 ( H3N2 ) , and B/60/32 were used for vaccination of 3663 children aged from 5 to 14 years inoculated twice with monovaccines , a trivaccine made of the above strains , or placebo . Both mono- and polyvaccine were practically areactogenic . An average per cent of subjects with a significant rise in antibody titres to the respective three antigens was 60 % . The efficacy of the vaccination was 31.0 - 42.8 % for monopreparations and 36.3 % for the trivaccine . The studies showed the possibility and expedience of using for children the live influenza vaccine in the form of a polyvalent preparation including current influenza type A and B viruses In Russia for prevention of influenza in children , aged from 3 to 14 years , the children 's live influenza vaccine ( LIV ) , based upon A/Leningrad/134/47/57(H2N2 ) master strain ( LIVI ) is used . The need for double immunization appears to be one out of the faulties of this preparation . The study was aim ed to comparing the safety , immunogenic activity and prevention of influenza by  LIV for adults ( LIVII ) ( A/Leningrad/134/17/57(H2N2 master strain ) and LIVI in children aged from 7 to 17 years under similar administration schedule . The safety , the preventive efficacy , humoral and secretory immunity were studied . In total 2486 persons , including 539 children , twice inoculated with LIVI , 971 persons once inoculated with LIVII , and 840 treated by placebo were obserbed . From the data of the clinical observations during 7 days after immunization both vaccines appeared to be low reactogenic . The LIVII advantages in induction of the humoral and secretory antibodies in comparison with children 's vaccine had been revealed . Both vaccines were highly efficacious , the efficiency of both preparations was more pronounced after serologic correction of the diagnosis . The results obtained permit to recommend the single immunization by the variant of LIV at the base on A/Leningrad/134/17/57/(H2N2 ) master strain for prevention of influenza in school children Reactivity and immunogenicity of three inactivated , zonally purified , monovalent influenza A/swine virus vaccines were studied in children and adults . Each dose of vaccine contained either 400 chick cell-agglutinating ( CCA ) units/0.5 ml or 200 CCA units/0.25 ml . The vaccines contained either whole virus or ether-extracted , subunit virus with or without 1.5 mg of A1PO4/0.5 ml . Children younger than 10 years of age received a half dose . Substantial system reactions , including temperature increases of 2.2 F-4.9 F , were observed in all children who received whole-virus vaccines . In contrast , ether-extracted , subunit vaccines ( with or without A1PO4 ) were minimally pyrogenic in 185 subjects . Two doses of subunit vaccine in subjects younger than 25 years of age were immunologically equivalent to a single dose in older subjects . We concluded that two doses of ether-extracted , subunit virus vaccine with Hsw1N1 antigen , administered at least four weeks apart , are serologically effective for immunization of seronegative subjects of any age and that this dosage regimen should be used in young children in whom whole-virus vaccines are unacceptably reactive A cold-adapted ( ca ) influenza B reassortant virus vaccine that contained the six internal RNA segments from influenza B/Ann Arbor/1/66 ca virus and the neuraminidase and hemagglutinin genes from wild-type influenza B/Texas/1/84 virus was evaluated in children ranging in age from 8 months to 14 years . The children were vaccinated intranasally with doses ranging from 10(3.2 ) to 10(6.2 ) 50 % tissue culture infective doses ( TCID50 ) . Thirty children were seropositive , and 26 were seronegative . Thirty-three children participated as unvaccinated controls . The vaccine was well tolerated by both seronegative and seropositive children . The amount of virus required to infect 50 % of seronegative children was approximately 10(4.5 ) TCID50 . Vaccine viruses recovered from airway secretions retained temperature-sensitive and cold-adapted characteristics . The results of this study indicate that the vaccine virus , influenza B/Texas/84 ca reassortant virus , is attenuated , immunogenic , and phenotypically stable when given to young seronegative children Although current influenza vaccines have been shown to reduce influenza-related morbidity and mortality , there is a desire to develop more efficacious products . Vaccines which can induce CD8(+ ) cytotoxic T cell ( CTL ) responses in addition to strong antibody responses may be more effective in preventing disease since it has been demonstrated that CTL contribute to protective immunity , even against drift variants of influenza A viruses . The immunogenicity of two types of experimental influenza vaccines , which were based on immune stimulating complexes ( ISCOM ) , were evaluated and compared with a conventional non-adjuvanted inactivated split virion vaccine , after immunization of human volunteers . In this r and omized , double blind study , it was shown that the ISCOM vaccines altered the kinetics of the serum antibody response , result ing in more rapid titer rises against the vaccine strains . This accelerated antibody response coincided with enhanced in vitro proliferative T cell responses , which were observed shortly after vaccination . In addition , CTL responses were observed in a higher proportion of the vaccinees receiving an ISCOM vaccine , than in vaccinees receiving the conventional influenza vaccine CONTEXT A growing proportion of young children in the United States participate in day care , and these children are considered to be at high risk for influenza infection . Whether vaccinating day care children reduces household transmission of influenza is not known . OBJECTIVE To evaluate the effect of  vaccinating day care children  on reducing influenza-related morbidity among their household contacts . DESIGN Single-blind , r and omized controlled trial conducted during the 1996 - 1997 influenza season . SETTING Ten day care centers for children of US Navy personnel in San Diego , Calif. PARTICIPANTS A total of 149 day care attendees ( aged 24 - 60 months ) and their families were r and omized ; 127 children and their 328 household contacts received 2 vaccine doses and were included in the analysis . INTERVENTIONS Inactivated influenza vaccine was administered to 60 children with 162 household contacts , and hepatitis A vaccine as a control was administered to 67 age-matched children with 166 household contacts . MAIN OUTCOME MEASURES Information regarding febrile respiratory illnesses and related morbidity for household contacts of influenza-vaccinated vs control children ( subgrouped by influenza-vaccinated and unvaccinated contacts ) , obtained by telephone interviews with parents every 2 weeks from November 1996 through April 1997 . RESULTS Influenza-unvaccinated household contacts ( n = 120 ) of influenza-vaccinated day care children had 42 % fewer febrile respiratory illnesses ( P = .04 ) compared with unvaccinated household contacts of control children . Among school-aged household contacts ( aged 5 - 17 years ) , there was an 80 % reduction among contacts of vaccinated children ( n = 28 ) vs contacts of unvaccinated children ( n = 31 ) in febrile respiratory illnesses ( P = .01 ) , as well as reductions of more than 70 % in school days missed ( P = .02 ) , reported earaches ( P = .02 ) , physician visits ( P = .007 ) , physician-prescribed antibiotics ( P = .02 ) , and adults who missed work to take care of ill children ( P = .04 ) . CONCLUSIONS These results indicate that vaccinating day care children against influenza helps reduce influenza-related morbidity among their household contacts , particularly among school-aged contacts . Future studies should be conducted in civilian population s to assess the full effect of vaccinating day care children against influenza . JAMA . 2000;284:1677 - 1682 Objective . To determine the safety of cold-adapted trivalent intranasal influenza virus vaccine ( CAIV ) in children and adolescents . Study design . A r and omized , double blind , placebo-controlled safety trial in healthy children age 12 months to 17 years given CAIV ( FluMist ; MedImmune Vaccines , Inc. ) or placebo ( r and omization , 2:1 ) . Children < 9 years of age received a second dose of CAIV or placebo 28 to 42 days after the first dose . Enrolled children were then followed for 42 days after each vaccination for all medically attended events . Prespecified outcomes included 4 prespecified diagnostic groups and 170 observed individual diagnostic categories . The relative risk and the 2-sided 90 % confidence interval were calculated for each diagnostic group and individual category by clinical setting , dose and age . More than 1500 relative risk analyses were performed . Results . A total of 9689 evaluable children were enrolled in the study . Of the 4 prespecified diagnostic categories ( acute respiratory tract events , systemic bacterial infection , acute gastrointestinal tract events and rare events potentially associated with wild-type influenza ) , none was associated with vaccine . Of the biologically plausible individual diagnostic categories , 3 , acute gastrointestinal events , acute respiratory events and abdominal pain , had different analyses that demonstrated increased and decreased relative risks , making their association with the vaccine unlikely . For reactive airway disease a significant increased relative risk was observed in children 18 to 35 months of age with a relative risk of 4.06 ( 90 % confidence interval , 1.29 to 17.86 ) in this age group . The individual diagnostic categories of upper respiratory infection , musculoskeletal pain , otitis media with effusion and adenitis/adenopathy had at least one analysis that achieved a significant increased risk ratio . All of these events were infrequent . Conclusion . CAIV was generally safe in children and adolescents . The observation of an increased risk of asthma/reactive airway disease in children < 36 months of age is of potential concern . Further studies are planned to evaluate the risk of asthma/reactive airway disease after vaccine BACKGROUND Although influenza is usually a mild self-limiting disease it can cause serious complications in high risk groups . The economic costs of influenza are large due to the burden on the health system and absenteeism from work . There is evidence that the vaccine is underused in groups targeted for vaccination . OBJECTIVES To estimate : a ) the compliance rate with the influenza , vaccination in Israel during the winter seasons of 1998/1999 and 1999/2000 , b ) the role of health care personnel and the media in influencing compliance , and c ) the reasons for lack of compliance in the elderly . METHODS Two national population -based r and om telephone surveys of 1,500 households were performed during October 1999 and January 2000 to survey influenza vaccination  compliance prior to the winters of 1998/1999 and 1999/2000 respectively . Each survey was performed during four successive evenings . The response rate was 78.1 % for the first survey and 79.1 % for the second . RESULTS Vaccination compliance was similar in both surveys . The average rate of vaccination was 6 % for the population under 65 years and 50 % for the population of 65 years and above . The overall vaccination rate was around 10 % . The family physician was the main authority to recommend the vaccination , followed by the community nurse . Absence of recommendation and lack of faith in the efficacy of the vaccine were the main reasons for noncompliance . CONCLUSIONS Compliance rates with influenza vaccine in targeted groups in Israel remain relatively low . Health care personnel should be more involved in promoting the vaccine A double-blind r and omized study with bivalent influenza virus vaccines was conducted to compare the local and systemic reactions and immunogenicity of a whole-virus vaccine and a split-product vaccine in children .  Fevers of greater than 100 F were more frequent after vaccination with whole-virus than split-product vaccine especially in children one to four years old ( 69 % vs 22 % ; P less than 0.01 ) . Fevers of greater than or equal to 103 F did not occur in children who previously had been given influenza virus vaccine  , even in the absence of preexisting homologous serum antibody . The immune response to the A/Port Chalmers/1/73 antigen in the vaccine was similar after administration of either whole-virus or split-product vaccine . However , split-product vaccine induced significantly less hemagglutination-inhibiting antibody to B/Hong Kong/5/72 virus in children younger than 10 years who had not been previously immunized ; only 43 % developed detectable antibody vs. 100 % of those vaccinated with whole virus vaccine ( P less than 0.01 ) . These studies indicate that ( 1 ) in 
    Output:
    
agent
***TASK*** the task is to summarize an input biomedical literature in six sentences 
    ***INPUT*** the input is a biomedical literature 
    ***OUTPUT*** the output is the summary of an input biomedical literature in six sentences 
    ***DOCUMENTATION*** 
    ***EXAMPLES*** 
    Input: Production lots of a live influenza vaccine made of strains A/47/T ( N1H1 ) , A/47/6/2 ( H3N2 ) , and B/60/32 were used for vaccination of 3663 children aged from 5 to 14 years inoculated twice with monovaccines , a trivaccine made of the above strains , or placebo . Both mono- and polyvaccine were practically areactogenic . An average per cent of subjects with a significant rise in antibody titres to the respective three antigens was 60 % . The efficacy of the vaccination was 31.0 - 42.8 % for monopreparations and 36.3 % for the trivaccine . The studies showed the possibility and expedience of using for children the live influenza vaccine in the form of a polyvalent preparation including current influenza type A and B viruses In Russia for prevention of influenza in children , aged from 3 to 14 years , the children 's live influenza vaccine ( LIV ) , based upon A/Leningrad/134/47/57(H2N2 ) master strain ( LIVI ) is used . The need for double immunization appears to be one out of the faulties of this preparation . The study was aim ed to comparing the safety , immunogenic activity and prevention of influenza by  LIV for adults ( LIVII ) ( A/Leningrad/134/17/57(H2N2 master strain ) and LIVI in children aged from 7 to 17 years under similar administration schedule . The safety , the preventive efficacy , humoral and secretory immunity were studied . In total 2486 persons , including 539 children , twice inoculated with LIVI , 971 persons once inoculated with LIVII , and 840 treated by placebo were obserbed . From the data of the clinical observations during 7 days after immunization both vaccines appeared to be low reactogenic . The LIVII advantages in induction of the humoral and secretory antibodies in comparison with children 's vaccine had been revealed . Both vaccines were highly efficacious , the efficiency of both preparations was more pronounced after serologic correction of the diagnosis . The results obtained permit to recommend the single immunization by the variant of LIV at the base on A/Leningrad/134/17/57/(H2N2 ) master strain for prevention of influenza in school children Reactivity and immunogenicity of three inactivated , zonally purified , monovalent influenza A/swine virus vaccines were studied in children and adults . Each dose of vaccine contained either 400 chick cell-agglutinating ( CCA ) units/0.5 ml or 200 CCA units/0.25 ml . The vaccines contained either whole virus or ether-extracted , subunit virus with or without 1.5 mg of A1PO4/0.5 ml . Children younger than 10 years of age received a half dose . Substantial system reactions , including temperature increases of 2.2 F-4.9 F , were observed in all children who received whole-virus vaccines . In contrast , ether-extracted , subunit vaccines ( with or without A1PO4 ) were minimally pyrogenic in 185 subjects . Two doses of subunit vaccine in subjects younger than 25 years of age were immunologically equivalent to a single dose in older subjects . We concluded that two doses of ether-extracted , subunit virus vaccine with Hsw1N1 antigen , administered at least four weeks apart , are serologically effective for immunization of seronegative subjects of any age and that this dosage regimen should be used in young children in whom whole-virus vaccines are unacceptably reactive A cold-adapted ( ca ) influenza B reassortant virus vaccine that contained the six internal RNA segments from influenza B/Ann Arbor/1/66 ca virus and the neuraminidase and hemagglutinin genes from wild-type influenza B/Texas/1/84 virus was evaluated in children ranging in age from 8 months to 14 years . The children were vaccinated intranasally with doses ranging from 10(3.2 ) to 10(6.2 ) 50 % tissue culture infective doses ( TCID50 ) . Thirty children were seropositive , and 26 were seronegative . Thirty-three children participated as unvaccinated controls . The vaccine was well tolerated by both seronegative and seropositive children . The amount of virus required to infect 50 % of seronegative children was approximately 10(4.5 ) TCID50 . Vaccine viruses recovered from airway secretions retained temperature-sensitive and cold-adapted characteristics . The results of this study indicate that the vaccine virus , influenza B/Texas/84 ca reassortant virus , is attenuated , immunogenic , and phenotypically stable when given to young seronegative children Although current influenza vaccines have been shown to reduce influenza-related morbidity and mortality , there is a desire to develop more efficacious products . Vaccines which can induce CD8(+ ) cytotoxic T cell ( CTL ) responses in addition to strong antibody responses may be more effective in preventing disease since it has been demonstrated that CTL contribute to protective immunity , even against drift variants of influenza A viruses . The immunogenicity of two types of experimental influenza vaccines , which were based on immune stimulating complexes ( ISCOM ) , were evaluated and compared with a conventional non-adjuvanted inactivated split virion vaccine , after immunization of human volunteers . In this r and omized , double blind study , it was shown that the ISCOM vaccines altered the kinetics of the serum antibody response , result ing in more rapid titer rises against the vaccine strains . This accelerated antibody response coincided with enhanced in vitro proliferative T cell responses , which were observed shortly after vaccination . In addition , CTL responses were observed in a higher proportion of the vaccinees receiving an ISCOM vaccine , than in vaccinees receiving the conventional influenza vaccine CONTEXT A growing proportion of young children in the United States participate in day care , and these children are considered to be at high risk for influenza infection . Whether vaccinating day care children reduces household transmission of influenza is not known . OBJECTIVE To evaluate the effect of  vaccinating day care children  on reducing influenza-related morbidity among their household contacts . DESIGN Single-blind , r and omized controlled trial conducted during the 1996 - 1997 influenza season . SETTING Ten day care centers for children of US Navy personnel in San Diego , Calif. PARTICIPANTS A total of 149 day care attendees ( aged 24 - 60 months ) and their families were r and omized ; 127 children and their 328 household contacts received 2 vaccine doses and were included in the analysis . INTERVENTIONS Inactivated influenza vaccine was administered to 60 children with 162 household contacts , and hepatitis A vaccine as a control was administered to 67 age-matched children with 166 household contacts . MAIN OUTCOME MEASURES Information regarding febrile respiratory illnesses and related morbidity for household contacts of influenza-vaccinated vs control children ( subgrouped by influenza-vaccinated and unvaccinated contacts ) , obtained by telephone interviews with parents every 2 weeks from November 1996 through April 1997 . RESULTS Influenza-unvaccinated household contacts ( n = 120 ) of influenza-vaccinated day care children had 42 % fewer febrile respiratory illnesses ( P = .04 ) compared with unvaccinated household contacts of control children . Among school-aged household contacts ( aged 5 - 17 years ) , there was an 80 % reduction among contacts of vaccinated children ( n = 28 ) vs contacts of unvaccinated children ( n = 31 ) in febrile respiratory illnesses ( P = .01 ) , as well as reductions of more than 70 % in school days missed ( P = .02 ) , reported earaches ( P = .02 ) , physician visits ( P = .007 ) , physician-prescribed antibiotics ( P = .02 ) , and adults who missed work to take care of ill children ( P = .04 ) . CONCLUSIONS These results indicate that vaccinating day care children against influenza helps reduce influenza-related morbidity among their household contacts , particularly among school-aged contacts . Future studies should be conducted in civilian population s to assess the full effect of vaccinating day care children against influenza . JAMA . 2000;284:1677 - 1682 Objective . To determine the safety of cold-adapted trivalent intranasal influenza virus vaccine ( CAIV ) in children and adolescents . Study design . A r and omized , double blind , placebo-controlled safety trial in healthy children age 12 months to 17 years given CAIV ( FluMist ; MedImmune Vaccines , Inc. ) or placebo ( r and omization , 2:1 ) . Children < 9 years of age received a second dose of CAIV or placebo 28 to 42 days after the first dose . Enrolled children were then followed for 42 days after each vaccination for all medically attended events . Prespecified outcomes included 4 prespecified diagnostic groups and 170 observed individual diagnostic categories . The relative risk and the 2-sided 90 % confidence interval were calculated for each diagnostic group and individual category by clinical setting , dose and age . More than 1500 relative risk analyses were performed . Results . A total of 9689 evaluable children were enrolled in the study . Of the 4 prespecified diagnostic categories ( acute respiratory tract events , systemic bacterial infection , acute gastrointestinal tract events and rare events potentially associated with wild-type influenza ) , none was associated with vaccine . Of the biologically plausible individual diagnostic categories , 3 , acute gastrointestinal events , acute respiratory events and abdominal pain , had different analyses that demonstrated increased and decreased relative risks , making their association with the vaccine unlikely . For reactive airway disease a significant increased relative risk was observed in children 18 to 35 months of age with a relative risk of 4.06 ( 90 % confidence interval , 1.29 to 17.86 ) in this age group . The individual diagnostic categories of upper respiratory infection , musculoskeletal pain , otitis media with effusion and adenitis/adenopathy had at least one analysis that achieved a significant increased risk ratio . All of these events were infrequent . Conclusion . CAIV was generally safe in children and adolescents . The observation of an increased risk of asthma/reactive airway disease in children < 36 months of age is of potential concern . Further studies are planned to evaluate the risk of asthma/reactive airway disease after vaccine BACKGROUND Although influenza is usually a mild self-limiting disease it can cause serious complications in high risk groups . The economic costs of influenza are large due to the burden on the health system and absenteeism from work . There is evidence that the vaccine is underused in groups targeted for vaccination . OBJECTIVES To estimate : a ) the compliance rate with the influenza , vaccination in Israel during the winter seasons of 1998/1999 and 1999/2000 , b ) the role of health care personnel and the media in influencing compliance , and c ) the reasons for lack of compliance in the elderly . METHODS Two national population -based r and om telephone surveys of 1,500 households were performed during October 1999 and January 2000 to survey influenza vaccination  compliance prior to the winters of 1998/1999 and 1999/2000 respectively . Each survey was performed during four successive evenings . The response rate was 78.1 % for the first survey and 79.1 % for the second . RESULTS Vaccination compliance was similar in both surveys . The average rate of vaccination was 6 % for the population under 65 years and 50 % for the population of 65 years and above . The overall vaccination rate was around 10 % . The family physician was the main authority to recommend the vaccination , followed by the community nurse . Absence of recommendation and lack of faith in the efficacy of the vaccine were the main reasons for noncompliance . CONCLUSIONS Compliance rates with influenza vaccine in targeted groups in Israel remain relatively low . Health care personnel should be more involved in promoting the vaccine A double-blind r and omized study with bivalent influenza virus vaccines was conducted to compare the local and systemic reactions and immunogenicity of a whole-virus vaccine and a split-product vaccine in children .  Fevers of greater than 100 F were more frequent after vaccination with whole-virus than split-product vaccine especially in children one to four years old ( 69 % vs 22 % ; P less than 0.01 ) . Fevers of greater than or equal to 103 F did not occur in children who previously had been given influenza virus vaccine  , even in the absence of preexisting homologous serum antibody . The immune response to the A/Port Chalmers/1/73 antigen in the vaccine was similar after administration of either whole-virus or split-product vaccine . However , split-product vaccine induced significantly less hemagglutination-inhibiting antibody to B/Hong Kong/5/72 virus in children younger than 10 years who had not been previously immunized ; only 43 % developed detectable antibody vs. 100 % of those vaccinated with whole virus vaccine ( P less than 0.01 ) . These studies indicate that ( 1 ) in 
    Output:
    