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: 207 patients of a geriatric department were immunized against influenza with either tween-ether-split-vaccine or subunit-vaccine in a double blind study . For 6 months the following data were daily registered : rest in bed , fever over 38,5 degrees C , rhinitis , laryngopharingitis , bronchitis , pneumonia , enteritis , medication with antibiotics or chemotherapeutics . In cases with fever over 38,5 degrees C blood tests were taken for serological examination . The immune response against influenza A was excellent in both groups , the titer was higher in the subunit group , only one patient showed influenza infection . The immune response against the type B Hongkong was not satisfactory in both groups . The clinical data showed a significant lower incidence of rhinitis , laryngopharingitis and bronchitis in the group immunized with the tween-ether-split-vaccine . This effect was more distinct within the first 3 months after the immunization than within the second 3 months The safety and immunogenicity of two recent cold-adapted reassortant influenza B viruses were evaluated in persons at high risk for influenza-related morbidity and mortality . Ambulatory adults > 65 years old or with chronic high-risk conditions were r and omly assigned to receive parenteral trivalent inactivated influenza vaccine containing either influenza B/Ann Arbor/86 or B/Yamagata/88 hemagglutinin antigens , cold-adapted reassortant influenza B/Ann Arbor/1/86 or B/Yamagata/16/88 viruses ( 10(7.2 ) TCID50 ) , or placebo in double-blind fashion . Cold-adapted vaccine viruses were well tolerated , with similar rates of respiratory symptoms in all groups . There were no changes in spirometry or oxygen saturation following vaccination . Immune responses to both types of vaccine were modest , with serum antibody responses occurring significantly more frequently and with higher magnitude in those receiving inactivated than in those receiving cold-adapted vaccine . Cold-adapted , reassortant influenza B vaccines are safe in the elderly and those with chronic illness but are not optimally immunogenic in this group These studies indicate that the high-risk and normal pediatric population s can be safely and effectively immunized with a two-dose regimen of the influenza A/New Jersey/76 virus vaccine . In addition , the studies have demonstrated important differences between split-product and whole-virus vaccines in the pediatric age group . Furthermore , reactogenicity from the whole-virus vaccine administered in the schedules employed was acceptable after the first dose and negligible after the second dose . More detailed examination of the data will undoubtedly yield additional information of importance to current and future use of inactivated influenza vaccines in children In a double-blind , r and omized trial , 102 healthy elderly subjects were inoculated with one of four preparations : ( i ) intranasal bivalent live attenuated influenza vaccine containing cold-adapted A/Kawasaki/86 ( H1N1 ) and cold-adapted A/Bethesda/85 ( H3N2 ) viruses ; ( ii ) parenteral trivalent inactivated subvirion vaccine containing A/Taiwan/86 ( H1N1 ) , A/Leningrad/86 ( H3N2 ) , and B/Ann Arbor/86 antigens ; ( iii ) both vaccines ; or ( iv ) placebo . To determine whether local or systemic immunization augmented mucosal immunologic memory , all volunteers were challenged intranasally 12 weeks later with the inactivated virus vaccine . We used a hemagglutination inhibition assay to measure antibodies in sera and a kinetic enzyme-linked immunosorbent assay to measure immunoglobulin G ( IgG ) and IgA antibodies in sera and nasal washes , respectively . In comparison with the live virus vaccine , the inactivated virus vaccine elicited higher and more frequent rises of serum antibodies , while nasal wash antibody responses were similar . The vaccine combination induced serum and local antibodies slightly more often than the inactivated vaccine alone did . Coadministration of live influenza A virus vaccine did not alter the serum antibody response to the influenza B virus component of the inactivated vaccine . The anamnestic nasal antibody response elicited by intranasal inactivated virus challenge did not differ in the live , inactivated , or combined vaccine groups from that observed in the placebo group not previously immunized . These results suggest that in elderly persons cold-adapted influenza A virus vaccines offer little advantage over inactivated virus vaccines in terms of inducing serum or secretory antibody or local immunological memory . Studies are needed to determine whether both vaccines in combination are more efficacious than inactivated vaccine alone in people in this age group PURPOSE Although concern about side effects constitutes a major deterrent to patient compliance with recommendations for influenza vaccination , there is a paucity of data about the frequency of adverse reactions to newer trivalent vaccines . Our aim was to determine the frequency of adverse reactions to influenza vaccine in older , chronically ill persons , many of whom are at high risk for influenza-related morbidity . PATIENTS AND METHODS We conducted a telephone survey of 40 % of the patients who were vaccinated at a walk-in flu shot clinic . The subjects were r and omly assigned to two groups . To determine postvaccine symptom rates , Group I was interviewed seven days after vaccination . Group II was interviewed 21 days after vaccination in order to control for baseline symptom rates . Both groups were queried about  fever , disability , and flu-like illness  in the week preceding the interview . RESULTS Of 816 patients selected , 650 ( 79.6 % ) completed the interview . The mean age of the subjects was 63 , and more than two thirds were at risk for influenza-related morbidity . The frequencies of self-reported fever ( 5.3 % versus 5.1 % , p = 0.91 ) and disability ( 10.4 % versus 9.3 % , p = 0.65 ) were similar in the two groups . However , a significantly higher proportion of Group I subjects reported a flu-like illness compared to the Group II subjects ( 14.2 % versus 8.7 % , p = 0.03 ) . Although Group I subjects were more likely to report flu-like illness within two days of vaccination compared to a similar time interval for Group II subjects , there was no corresponding clustering of disability after vaccination . CONCLUSION We conclude that the overall frequency of symptoms in both groups was low ; however , the absolute risk of a flu-like illness was 5.5 % higher during the first week following influenza vaccination when compared with the third week after the injection . These symptoms did not result in a decreased ability to perform usual daily activities This report summarizes the clinical trials of the A/USSR/77 ( H1N1 ) influenza vaccines  performed in 1978 . A total of 2,091 subjects participated in these trials . The results of these clinical trials indicated that two doses of H1N1 viral antigen were necessary to produce serum titers of hemagglutinin-inhibiting ( HAI ) antibody of greater than 1:40 in 80 % or more of the test subjects younger than 25 years of age , who were unlikely to have experienced natural infection during the earlier period of prevalence of H1N1 virus ( 1947 - 1957 ) . Only one dose of the A/Texas/77 ( H3N2 ) or B/Hong Kong/72 antigen was necessary to stimulate equivalent titers of HAI antibody in serum . Thus , previous natural exposure to H1N1 viruses primed individuals 26 years of age or older to respond to H1N1 antigens . No major differences in antigenicity were noted between whole-virus and split-virus vaccines . No differences in reaction indexes measuring systemic reactions were noted when vaccine types were compared . Only one vaccine was associated with a reaction index appreciably higher than that of placebo . The relatively uniform antibody responses observed were attributed to the newer methods of vaccine st and ardization introduced after the clinical trials in 1976 . No cases of vaccine-related neurological problems , including Guillain-Barré syndrome , were found during these trials . Vaccines containing 7 - 21 micrograms of each viral antigen were antigenic and were well tolerated Trivalent cold-adapted recombinant ( CR ) influenza virus vaccines containing types A ( H1N1 and H3N2 ) and B viruses were evaluated in two double-blind , placebo-controlled trials . Susceptible adults were r and omly assigned to receive the following vaccines by intranasal drops 1 month apart : two doses of trivalent vaccine , bivalent CR influenza A ( Bi A ) vaccine followed by monovalent B ( Mono B ) vaccine or vice versa , or two doses of placebo . All vaccines were well tolerated . Shedding of each of the three vaccine viruses was reduced after the first dose of trivalent vaccine compared with primary vaccination with Bi A or Mono B. Shedding was also reduced after second vaccinations , whether homologous ( trivalent-trivalent ) or heterologous ( Bi A/Mono B or Mono B/Bi A ) . Reduced viral shedding was associated with reduced serum antibody responses . Thus , both simultaneous and sequential inoculations of susceptible adults with CR influenza vaccine viruses result in reduced viral shedding and serum antibody responses Levels of antibody against influenza virus were evaluated in serum pairing sample s from individuals immunized against influenza  by Hemagglutination Inhibition and Single Radial Hemolysis tests . For this purpose , groups of smokers , non-smokers and , of those holding respiratory complications , were formed . Results of serologic titrations pointed out to an increase in the level of antibodies for the smoker and non-smoker groups , with significant degrees of difference up to P < 0.001 difference between both averages after immunization . However , in the group of respiratory complications no significant differences ( P > 0.05 ) were found out between the averages antibody levels for the subtype A ( H1N1 ) and the Type B ( vaccine components ) ; an increase only at the level of antibodies was registered , with differences among the averages of the antibody levels , for the subtype A ( H3N2 ) ( vaccine component ) at degrees of P < 0.01 and P < 0.001 on the titration of the SRH and HI tests , respectively . It can demonstrate that immunization against influenza presents a good protection for the smoker and non-smoker groups ; however , in the group of respiratory complications it only occurred with the subtype A ( H3N2 ) , indicating that this subtype presents good antigenicity since it has induced better formation of antibodies , even in defective organisms Forty older adults with chronic diseases were vaccinated intranasally with either influenza A/California/10/78 ( H1N1 ) ( CR37 ) or influenza A/Washington/897/80 ( H3N2 ) ( CR48 ) virus . No clinical ly significant morbidity or decrement in pulmonary function occurred postvaccination . Two ( 15 % ) recipients of CR37 virus and twelve ( 44 % ) recipients of CR48 virus became infected with vaccine virus , as indicated by a fourfold rise in serum hemagglutination inhibition antibody titer ; a fourfold rise in serum immunoglobulin G ( IgG ) or IgA antibody titer , indicated by enzyme-linked immunosorbent assay ; isolation of vaccine virus from nasal washings ; or all of these . Within 1 year after cold-recombinant vaccine virus vaccination , 18 vaccines received inactivated trivalent influenza virus vaccine parenterally . Of the vaccinees , 13 ( 72 % ) developed a fourfold rise in serum antibody titer to H1N1 antigen and 16 ( 89 % ) developed a fourfold rise in serum antibody titer to H3N2 antigen . We conclude that administration of these cold-recombinant vaccine viruses to older adults with chronic diseases was safe , but that serum antibody response rates were lower than those achieved with subsequently administered inactivated influenza virus vaccine given parenterally . However , the higher seroconversion rates attained by using the inactivated trivalent influenza virus vaccine do not necessarily mean that it is more efficacious in preventing infection or severe illness or both due to natural wild-type influenza A virus Induction of local antibody responses to influenza A virus hemagglutinin by coadministration of two vaccines was investigated . Fifty elderly nursing home residents received inactivated trivalent influenza virus vaccine intramuscularly and simultaneously were r and omized to receive either bivalent live attenuated influenza A virus vaccine or saline placebo intranasally in a blinded fashion . More significant increases in anti-H1 and -H3 IgA antibodies were detectable in nasal wash specimens of subjects who received live attenuated virus vaccine than in those who received intranasal placebo . The increased anti-hemagglutinin IgA antibody response was of longer duration in recipients of live attenuated vaccine . The change in antibody titers after vaccination was positively correlated with total blood lymphocyte counts measured before vaccination in both vaccinee groups ( P < .05 ) . There was a possible advantage of administering live attenuated with inactivated virus vacc 
    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: 207 patients of a geriatric department were immunized against influenza with either tween-ether-split-vaccine or subunit-vaccine in a double blind study . For 6 months the following data were daily registered : rest in bed , fever over 38,5 degrees C , rhinitis , laryngopharingitis , bronchitis , pneumonia , enteritis , medication with antibiotics or chemotherapeutics . In cases with fever over 38,5 degrees C blood tests were taken for serological examination . The immune response against influenza A was excellent in both groups , the titer was higher in the subunit group , only one patient showed influenza infection . The immune response against the type B Hongkong was not satisfactory in both groups . The clinical data showed a significant lower incidence of rhinitis , laryngopharingitis and bronchitis in the group immunized with the tween-ether-split-vaccine . This effect was more distinct within the first 3 months after the immunization than within the second 3 months The safety and immunogenicity of two recent cold-adapted reassortant influenza B viruses were evaluated in persons at high risk for influenza-related morbidity and mortality . Ambulatory adults > 65 years old or with chronic high-risk conditions were r and omly assigned to receive parenteral trivalent inactivated influenza vaccine containing either influenza B/Ann Arbor/86 or B/Yamagata/88 hemagglutinin antigens , cold-adapted reassortant influenza B/Ann Arbor/1/86 or B/Yamagata/16/88 viruses ( 10(7.2 ) TCID50 ) , or placebo in double-blind fashion . Cold-adapted vaccine viruses were well tolerated , with similar rates of respiratory symptoms in all groups . There were no changes in spirometry or oxygen saturation following vaccination . Immune responses to both types of vaccine were modest , with serum antibody responses occurring significantly more frequently and with higher magnitude in those receiving inactivated than in those receiving cold-adapted vaccine . Cold-adapted , reassortant influenza B vaccines are safe in the elderly and those with chronic illness but are not optimally immunogenic in this group These studies indicate that the high-risk and normal pediatric population s can be safely and effectively immunized with a two-dose regimen of the influenza A/New Jersey/76 virus vaccine . In addition , the studies have demonstrated important differences between split-product and whole-virus vaccines in the pediatric age group . Furthermore , reactogenicity from the whole-virus vaccine administered in the schedules employed was acceptable after the first dose and negligible after the second dose . More detailed examination of the data will undoubtedly yield additional information of importance to current and future use of inactivated influenza vaccines in children In a double-blind , r and omized trial , 102 healthy elderly subjects were inoculated with one of four preparations : ( i ) intranasal bivalent live attenuated influenza vaccine containing cold-adapted A/Kawasaki/86 ( H1N1 ) and cold-adapted A/Bethesda/85 ( H3N2 ) viruses ; ( ii ) parenteral trivalent inactivated subvirion vaccine containing A/Taiwan/86 ( H1N1 ) , A/Leningrad/86 ( H3N2 ) , and B/Ann Arbor/86 antigens ; ( iii ) both vaccines ; or ( iv ) placebo . To determine whether local or systemic immunization augmented mucosal immunologic memory , all volunteers were challenged intranasally 12 weeks later with the inactivated virus vaccine . We used a hemagglutination inhibition assay to measure antibodies in sera and a kinetic enzyme-linked immunosorbent assay to measure immunoglobulin G ( IgG ) and IgA antibodies in sera and nasal washes , respectively . In comparison with the live virus vaccine , the inactivated virus vaccine elicited higher and more frequent rises of serum antibodies , while nasal wash antibody responses were similar . The vaccine combination induced serum and local antibodies slightly more often than the inactivated vaccine alone did . Coadministration of live influenza A virus vaccine did not alter the serum antibody response to the influenza B virus component of the inactivated vaccine . The anamnestic nasal antibody response elicited by intranasal inactivated virus challenge did not differ in the live , inactivated , or combined vaccine groups from that observed in the placebo group not previously immunized . These results suggest that in elderly persons cold-adapted influenza A virus vaccines offer little advantage over inactivated virus vaccines in terms of inducing serum or secretory antibody or local immunological memory . Studies are needed to determine whether both vaccines in combination are more efficacious than inactivated vaccine alone in people in this age group PURPOSE Although concern about side effects constitutes a major deterrent to patient compliance with recommendations for influenza vaccination , there is a paucity of data about the frequency of adverse reactions to newer trivalent vaccines . Our aim was to determine the frequency of adverse reactions to influenza vaccine in older , chronically ill persons , many of whom are at high risk for influenza-related morbidity . PATIENTS AND METHODS We conducted a telephone survey of 40 % of the patients who were vaccinated at a walk-in flu shot clinic . The subjects were r and omly assigned to two groups . To determine postvaccine symptom rates , Group I was interviewed seven days after vaccination . Group II was interviewed 21 days after vaccination in order to control for baseline symptom rates . Both groups were queried about  fever , disability , and flu-like illness  in the week preceding the interview . RESULTS Of 816 patients selected , 650 ( 79.6 % ) completed the interview . The mean age of the subjects was 63 , and more than two thirds were at risk for influenza-related morbidity . The frequencies of self-reported fever ( 5.3 % versus 5.1 % , p = 0.91 ) and disability ( 10.4 % versus 9.3 % , p = 0.65 ) were similar in the two groups . However , a significantly higher proportion of Group I subjects reported a flu-like illness compared to the Group II subjects ( 14.2 % versus 8.7 % , p = 0.03 ) . Although Group I subjects were more likely to report flu-like illness within two days of vaccination compared to a similar time interval for Group II subjects , there was no corresponding clustering of disability after vaccination . CONCLUSION We conclude that the overall frequency of symptoms in both groups was low ; however , the absolute risk of a flu-like illness was 5.5 % higher during the first week following influenza vaccination when compared with the third week after the injection . These symptoms did not result in a decreased ability to perform usual daily activities This report summarizes the clinical trials of the A/USSR/77 ( H1N1 ) influenza vaccines  performed in 1978 . A total of 2,091 subjects participated in these trials . The results of these clinical trials indicated that two doses of H1N1 viral antigen were necessary to produce serum titers of hemagglutinin-inhibiting ( HAI ) antibody of greater than 1:40 in 80 % or more of the test subjects younger than 25 years of age , who were unlikely to have experienced natural infection during the earlier period of prevalence of H1N1 virus ( 1947 - 1957 ) . Only one dose of the A/Texas/77 ( H3N2 ) or B/Hong Kong/72 antigen was necessary to stimulate equivalent titers of HAI antibody in serum . Thus , previous natural exposure to H1N1 viruses primed individuals 26 years of age or older to respond to H1N1 antigens . No major differences in antigenicity were noted between whole-virus and split-virus vaccines . No differences in reaction indexes measuring systemic reactions were noted when vaccine types were compared . Only one vaccine was associated with a reaction index appreciably higher than that of placebo . The relatively uniform antibody responses observed were attributed to the newer methods of vaccine st and ardization introduced after the clinical trials in 1976 . No cases of vaccine-related neurological problems , including Guillain-Barré syndrome , were found during these trials . Vaccines containing 7 - 21 micrograms of each viral antigen were antigenic and were well tolerated Trivalent cold-adapted recombinant ( CR ) influenza virus vaccines containing types A ( H1N1 and H3N2 ) and B viruses were evaluated in two double-blind , placebo-controlled trials . Susceptible adults were r and omly assigned to receive the following vaccines by intranasal drops 1 month apart : two doses of trivalent vaccine , bivalent CR influenza A ( Bi A ) vaccine followed by monovalent B ( Mono B ) vaccine or vice versa , or two doses of placebo . All vaccines were well tolerated . Shedding of each of the three vaccine viruses was reduced after the first dose of trivalent vaccine compared with primary vaccination with Bi A or Mono B. Shedding was also reduced after second vaccinations , whether homologous ( trivalent-trivalent ) or heterologous ( Bi A/Mono B or Mono B/Bi A ) . Reduced viral shedding was associated with reduced serum antibody responses . Thus , both simultaneous and sequential inoculations of susceptible adults with CR influenza vaccine viruses result in reduced viral shedding and serum antibody responses Levels of antibody against influenza virus were evaluated in serum pairing sample s from individuals immunized against influenza  by Hemagglutination Inhibition and Single Radial Hemolysis tests . For this purpose , groups of smokers , non-smokers and , of those holding respiratory complications , were formed . Results of serologic titrations pointed out to an increase in the level of antibodies for the smoker and non-smoker groups , with significant degrees of difference up to P < 0.001 difference between both averages after immunization . However , in the group of respiratory complications no significant differences ( P > 0.05 ) were found out between the averages antibody levels for the subtype A ( H1N1 ) and the Type B ( vaccine components ) ; an increase only at the level of antibodies was registered , with differences among the averages of the antibody levels , for the subtype A ( H3N2 ) ( vaccine component ) at degrees of P < 0.01 and P < 0.001 on the titration of the SRH and HI tests , respectively . It can demonstrate that immunization against influenza presents a good protection for the smoker and non-smoker groups ; however , in the group of respiratory complications it only occurred with the subtype A ( H3N2 ) , indicating that this subtype presents good antigenicity since it has induced better formation of antibodies , even in defective organisms Forty older adults with chronic diseases were vaccinated intranasally with either influenza A/California/10/78 ( H1N1 ) ( CR37 ) or influenza A/Washington/897/80 ( H3N2 ) ( CR48 ) virus . No clinical ly significant morbidity or decrement in pulmonary function occurred postvaccination . Two ( 15 % ) recipients of CR37 virus and twelve ( 44 % ) recipients of CR48 virus became infected with vaccine virus , as indicated by a fourfold rise in serum hemagglutination inhibition antibody titer ; a fourfold rise in serum immunoglobulin G ( IgG ) or IgA antibody titer , indicated by enzyme-linked immunosorbent assay ; isolation of vaccine virus from nasal washings ; or all of these . Within 1 year after cold-recombinant vaccine virus vaccination , 18 vaccines received inactivated trivalent influenza virus vaccine parenterally . Of the vaccinees , 13 ( 72 % ) developed a fourfold rise in serum antibody titer to H1N1 antigen and 16 ( 89 % ) developed a fourfold rise in serum antibody titer to H3N2 antigen . We conclude that administration of these cold-recombinant vaccine viruses to older adults with chronic diseases was safe , but that serum antibody response rates were lower than those achieved with subsequently administered inactivated influenza virus vaccine given parenterally . However , the higher seroconversion rates attained by using the inactivated trivalent influenza virus vaccine do not necessarily mean that it is more efficacious in preventing infection or severe illness or both due to natural wild-type influenza A virus Induction of local antibody responses to influenza A virus hemagglutinin by coadministration of two vaccines was investigated . Fifty elderly nursing home residents received inactivated trivalent influenza virus vaccine intramuscularly and simultaneously were r and omized to receive either bivalent live attenuated influenza A virus vaccine or saline placebo intranasally in a blinded fashion . More significant increases in anti-H1 and -H3 IgA antibodies were detectable in nasal wash specimens of subjects who received live attenuated virus vaccine than in those who received intranasal placebo . The increased anti-hemagglutinin IgA antibody response was of longer duration in recipients of live attenuated vaccine . The change in antibody titers after vaccination was positively correlated with total blood lymphocyte counts measured before vaccination in both vaccinee groups ( P < .05 ) . There was a possible advantage of administering live attenuated with inactivated virus vacc 
    Output:
    