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: Background : Children have high morbidity and hospitalization rates from seasonal influenza . Meta-analyses suggest that conventional inactivated influenza vaccines are of low efficacy in young children , making vaccines that induce greater and broader immune protection in this vulnerable population a medical priority . Adjuvanted influenza vaccines may offer a solution . Subjects and Methods : Unprimed healthy children ( 6 to < 36 months ) were enrolled in an observer-blinded study and r and omly assigned to receive 2 doses of MF59-adjuvanted vaccine ( Sub/MF59 , n = 130 ) or nonadjuvanted split vaccine ( split , n = 139 ) ; subgroups of these ( n = 43 and 46 , respectively ) received a booster dose 1 year later . Safety and clinical tolerability were assessed after each dose . Hemagglutination inhibition antibody titers were measured against influenza A and B strains included in the formulation of the vaccines and against mismatched strains . Results : Clinical tolerability and safety were generally comparable between vaccine groups , though some transient , mild solicited reactions were more frequent in the Sub/MF59 group . Postvaccination hemagglutination inhibition antibody titers to all 3 vaccine strains were significantly higher with Sub/MF59 than with split vaccine ( all comparisons P < 0.001 ) after each of the 3 vaccine doses . In addition , Sub/MF59 induced significantly higher cross-reactivity against A/H3N2 and A/H1N1 mismatched strains . Conclusion : MF59-adjuvanted influenza vaccine was well tolerated in healthy young children after each of 3 doses and induced greater , longer-lasting , and broader immune responses than a nonadjuvanted split vaccine . The enhanced immunogenicity of the adjuvanted vaccine was most evident in very young children and for the B vaccine strain Vaccine " Grippol "-- has been developed at the State Research Center -- Institute of Immunology . The preparation belongs to new generation vaccines and is a trivalent polymer-subunit vaccine containing the sterile conjugate of influenza virus surface proteins , types A and B , bound with copolymer polyoxidonium . The administration of " Grippol " to children of school age ( 6 - 18 years ) demonstrated low reactogenicity of the vaccine , its safety and sufficient prophylactic effectiveness . During observations on total morbidity ( with the exception of influenza and acute respiratory diseases ) no side effects produced by " Grippol " were registered . At the same time the fact that the morbidity rate of upper respiratory tract disease in the group of children immunized with the vaccine decreased in comparison with the control group ( by 2.4 times ) can not be disregarded 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 Background : We investigated the efficacy and safety of 1 versus 2 doses of live attenuated influenza vaccine ( LAIV ) in influenza vaccine – naive children aged 6 to < 36 months . Patients / Methods : Subjects were r and omized to 1 of 4 regimens in year 1 : 2 doses LAIV , 1 dose LAIV , excipient placebo , or saline placebo . In year 2 , LAIV recipients were to receive 1 dose of LAIV and placebo recipients were to receive saline placebo . Because of an unintended treatment allocation error in year 2 , 1 block of subjects who were r and omized to LAIV received saline placebo and 1 block who were r and omized to placebo received LAIV . Results : In year 1 , vaccine efficacy versus placebo among recipients of 2 and 1 doses of LAIV was 73.5 % and 57.7 % , respectively , against antigenically similar strains . In year 2 , absolute efficacy of a single dose of LAIV was 73.6 % and 65.2 % , respectively , in recipients of 2 and 1 doses of LAIV in year 1 . Year 2 efficacy was 57.0 % in subjects who received 2 doses of LAIV in year 1 and placebo in year 2 . Safety and tolerability of LAIV were consistent with previous studies . Reactogenicity was similar between placebo groups . Seroconversion rates were significantly higher in the 2-dose versus the 1-dose LAIV group in year 1 and in both LAIV groups versus placebo in years 1 and 2 . Conclusions : One dose of LAIV provided clinical ly significant protection against influenza in young children previously unvaccinated against influenza ; 2 doses provided additional protection . Protection after 2 doses in year 1 persisted through a second season without revaccination . LAIV excipients were not a major contributor to reactogenicity . These benefits provide support for increased use of LAIV in children ≥2 years of age Background : The Western Australian Influenza Vaccine Effectiveness study commenced in 2008 to evaluate a new program to provide free influenza vaccine to all children aged 6 to 59 months . We aim ed to assess the protective effect of inactivated influenza vaccination in these children . Methods : We conducted a prospect i ve case – control study in general practice s and a hospital emergency department , testing all eligible patients for influenza and a range of other common respiratory viruses .  Influenza vaccine effectiveness ( VE ) against laboratory-confirmed influenza was estimated with cases defined as children with an influenza-like illness who tested positive and controls as those with an influenza-like illness who tested negative for influenza virus . We calculated VE using the adjusted odds ratio from multivariate logistic regression . As a surrogate marker for adequate specimen collection , we explored the difference in VE point estimates defining controls as children in whom another respiratory virus was detected . Results : A total of 75 children were enrolled from general practice s and 214 through the emergency department , with 12 ( 27 % ) and 36 ( 17 % ) , respectively , having laboratory-confirmed influenza . Using all the influenza-negative controls , the adjusted VE was 58 % ( 95 % confidence interval , 9–81 ) . When controls were limited to those with another virus present , the adjusted VE was 68 % ( 95 % confidence interval , 26–86 ) . Conclusions : VE estimates were higher when controls included only those children with another respiratory virus detected . Testing for other common respiratory viruses enables the control group to be restricted to those for whom an adequate sample is likely OBJECTIVE . The goal was to evaluate the safety , tolerability , and efficacy of an investigational , refrigerator-stable formulation of live attenuated influenza vaccine ( cold-adapted influenza vaccine-trivalent ) against culture-confirmed influenza , acute otitis media , and effectiveness outcomes in young children in day care over 2 consecutive influenza seasons . METHODS . Children 6 to < 36 months of age who were attending day care were assigned r and omly in year 1 to receive 2 doses of vaccine or placebo intranasally , 35 ± 7 days apart . In year 2 , subjects received 1 dose of the same treatment as in year 1 . RESULTS . A total of 1616 subjects ( vaccine : 951 subjects ; placebo : 665 subjects ) in year 1 and 1090 subjects ( vaccine : 640 subjects ; placebo : 450 subjects ) in year 2 were able to be evaluated for efficacy . The mean age at first vaccination was 23.4 ± 7.9 months . In year 1 , the overall efficacy of the vaccine against influenza subtypes similar to the vaccine was 85.4 % ; efficacy was 91.8 % against A/H1N1 and 72.6 % against B. In year 2 , the overall efficacy was 88.7 % ; efficacy was 90.0 % against H1N1 , 90.3 % against A/H3N2 , and 81.7 % against B. Efficacy against all episodes of acute otitis media associated with culture-confirmed influenza was 90.6 % in year 1 and 97.0 % in year 2 . Runny nose or nasal discharge after dose 1 in year 1 was the only reactogenicity event that was significantly more frequent with cold-adapted influenza vaccine-trivalent ( 82.3 % ) than placebo ( 75.4 % ) . CONCLUSIONS . Cold-adapted influenza vaccine-trivalent was well tolerated and effective in preventing culture-confirmed influenza illness in children as young as 6 months of age who attended day care BACKGROUND The efficacy of the intranasal , live-attenuated , trivalent cold-adapted influenza virus vaccine ( CAIV-T ) against influenza A(H3N2 ) and B infections in healthy persons is established , but its effectiveness against natural influenza A(H1N1 ) infection is unknown . OBJECTIVE To assess the effectiveness of CAIV-T in healthy children during the 2000 - 2001 influenza A(H1N1 ) and B epidemic . DESIGN Community-based , nonr and omized , open-label trial from August 1998 through April 2001 . SETTING Intervention and comparison communities in central Texas . PARTICIPANTS Healthy children , aged 1.5 to 18 years , from the intervention communities received a single dose of CAIV-T at least 1 time or more in 1998 , 1999 , and /or 2000 . MAIN OUTCOME MEASURES The incidence of medically attended acute respiratory illnesses during the 2000 - 2001 influenza epidemic was compared in 3794 health plan CAIV-T recipients with age-eligible , health plan nonrecipients in the intervention communities for direct effectiveness ( n = 9325 ) , and with those in the 2 comparison communities for total effectiveness ( n = 16,264 ) . RESULTS The 2281 CAIV-T recipients in 2000 had significant direct protection against medically attended acute respiratory illness of 18 % to 20 % during the biphasic influenza A(H1N1 ) and B epidemic , and 17 % to 26 % during influenza A(H1N1 ) predominance . The 931 recipients of CAIV-T in 1999 containing influenza A/Beijing/262/95(H1N1 ) and B/Beijing/184/93-like viruses had persistent heterovariant protection against the 2000 - 2001 influenza A/New Caledonia/20/99(H1N1 ) and B/Sichuan/379/99 variants . The 616 recipients of a single CAIV-T dose in 1999 only , including those younger than 5 years with no prior natural exposure to influenza A(H1N1 ) viruses , showed persistent protection . CONCLUSION Healthy children who received CAIV-T in 2000 or 1999 were protected against new variants of influenza A(H1N1 ) and B in the 2000 - 2001 influenza epidemic The authors report on a community-based , nonr and omized , open-label study , conducted during the 2000 - 2001 influenza season in Temple-Belton , Texas , of the protective effectiveness of trivalent , cold-adapted , influenza virus vaccine ( CAIV-T ) in children aged 18 months-18 years . The dominant circulating strains in 2000 - 2001 were influenza A/New Caledonia/20/99 ( H1N1 ) and influenza B/Sichuan/379/99 . Children had access to CAIV-T  during the 1998 - 1999 , 1999 - 2000 , and 2000 - 2001 influenza seasons . The vaccine included influenza A/Sydney/5/97 ( H3N2 ) and B/Beijing/184/93-like ( B/Ann Arbor/l/94 ) strains in all three seasons . The vaccine included A/Beijing/262/95 ( H1N1 ) in 1998 - 1999 
    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: Background : Children have high morbidity and hospitalization rates from seasonal influenza . Meta-analyses suggest that conventional inactivated influenza vaccines are of low efficacy in young children , making vaccines that induce greater and broader immune protection in this vulnerable population a medical priority . Adjuvanted influenza vaccines may offer a solution . Subjects and Methods : Unprimed healthy children ( 6 to < 36 months ) were enrolled in an observer-blinded study and r and omly assigned to receive 2 doses of MF59-adjuvanted vaccine ( Sub/MF59 , n = 130 ) or nonadjuvanted split vaccine ( split , n = 139 ) ; subgroups of these ( n = 43 and 46 , respectively ) received a booster dose 1 year later . Safety and clinical tolerability were assessed after each dose . Hemagglutination inhibition antibody titers were measured against influenza A and B strains included in the formulation of the vaccines and against mismatched strains . Results : Clinical tolerability and safety were generally comparable between vaccine groups , though some transient , mild solicited reactions were more frequent in the Sub/MF59 group . Postvaccination hemagglutination inhibition antibody titers to all 3 vaccine strains were significantly higher with Sub/MF59 than with split vaccine ( all comparisons P < 0.001 ) after each of the 3 vaccine doses . In addition , Sub/MF59 induced significantly higher cross-reactivity against A/H3N2 and A/H1N1 mismatched strains . Conclusion : MF59-adjuvanted influenza vaccine was well tolerated in healthy young children after each of 3 doses and induced greater , longer-lasting , and broader immune responses than a nonadjuvanted split vaccine . The enhanced immunogenicity of the adjuvanted vaccine was most evident in very young children and for the B vaccine strain Vaccine " Grippol "-- has been developed at the State Research Center -- Institute of Immunology . The preparation belongs to new generation vaccines and is a trivalent polymer-subunit vaccine containing the sterile conjugate of influenza virus surface proteins , types A and B , bound with copolymer polyoxidonium . The administration of " Grippol " to children of school age ( 6 - 18 years ) demonstrated low reactogenicity of the vaccine , its safety and sufficient prophylactic effectiveness . During observations on total morbidity ( with the exception of influenza and acute respiratory diseases ) no side effects produced by " Grippol " were registered . At the same time the fact that the morbidity rate of upper respiratory tract disease in the group of children immunized with the vaccine decreased in comparison with the control group ( by 2.4 times ) can not be disregarded 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 Background : We investigated the efficacy and safety of 1 versus 2 doses of live attenuated influenza vaccine ( LAIV ) in influenza vaccine – naive children aged 6 to < 36 months . Patients / Methods : Subjects were r and omized to 1 of 4 regimens in year 1 : 2 doses LAIV , 1 dose LAIV , excipient placebo , or saline placebo . In year 2 , LAIV recipients were to receive 1 dose of LAIV and placebo recipients were to receive saline placebo . Because of an unintended treatment allocation error in year 2 , 1 block of subjects who were r and omized to LAIV received saline placebo and 1 block who were r and omized to placebo received LAIV . Results : In year 1 , vaccine efficacy versus placebo among recipients of 2 and 1 doses of LAIV was 73.5 % and 57.7 % , respectively , against antigenically similar strains . In year 2 , absolute efficacy of a single dose of LAIV was 73.6 % and 65.2 % , respectively , in recipients of 2 and 1 doses of LAIV in year 1 . Year 2 efficacy was 57.0 % in subjects who received 2 doses of LAIV in year 1 and placebo in year 2 . Safety and tolerability of LAIV were consistent with previous studies . Reactogenicity was similar between placebo groups . Seroconversion rates were significantly higher in the 2-dose versus the 1-dose LAIV group in year 1 and in both LAIV groups versus placebo in years 1 and 2 . Conclusions : One dose of LAIV provided clinical ly significant protection against influenza in young children previously unvaccinated against influenza ; 2 doses provided additional protection . Protection after 2 doses in year 1 persisted through a second season without revaccination . LAIV excipients were not a major contributor to reactogenicity . These benefits provide support for increased use of LAIV in children ≥2 years of age Background : The Western Australian Influenza Vaccine Effectiveness study commenced in 2008 to evaluate a new program to provide free influenza vaccine to all children aged 6 to 59 months . We aim ed to assess the protective effect of inactivated influenza vaccination in these children . Methods : We conducted a prospect i ve case – control study in general practice s and a hospital emergency department , testing all eligible patients for influenza and a range of other common respiratory viruses .  Influenza vaccine effectiveness ( VE ) against laboratory-confirmed influenza was estimated with cases defined as children with an influenza-like illness who tested positive and controls as those with an influenza-like illness who tested negative for influenza virus . We calculated VE using the adjusted odds ratio from multivariate logistic regression . As a surrogate marker for adequate specimen collection , we explored the difference in VE point estimates defining controls as children in whom another respiratory virus was detected . Results : A total of 75 children were enrolled from general practice s and 214 through the emergency department , with 12 ( 27 % ) and 36 ( 17 % ) , respectively , having laboratory-confirmed influenza . Using all the influenza-negative controls , the adjusted VE was 58 % ( 95 % confidence interval , 9–81 ) . When controls were limited to those with another virus present , the adjusted VE was 68 % ( 95 % confidence interval , 26–86 ) . Conclusions : VE estimates were higher when controls included only those children with another respiratory virus detected . Testing for other common respiratory viruses enables the control group to be restricted to those for whom an adequate sample is likely OBJECTIVE . The goal was to evaluate the safety , tolerability , and efficacy of an investigational , refrigerator-stable formulation of live attenuated influenza vaccine ( cold-adapted influenza vaccine-trivalent ) against culture-confirmed influenza , acute otitis media , and effectiveness outcomes in young children in day care over 2 consecutive influenza seasons . METHODS . Children 6 to < 36 months of age who were attending day care were assigned r and omly in year 1 to receive 2 doses of vaccine or placebo intranasally , 35 ± 7 days apart . In year 2 , subjects received 1 dose of the same treatment as in year 1 . RESULTS . A total of 1616 subjects ( vaccine : 951 subjects ; placebo : 665 subjects ) in year 1 and 1090 subjects ( vaccine : 640 subjects ; placebo : 450 subjects ) in year 2 were able to be evaluated for efficacy . The mean age at first vaccination was 23.4 ± 7.9 months . In year 1 , the overall efficacy of the vaccine against influenza subtypes similar to the vaccine was 85.4 % ; efficacy was 91.8 % against A/H1N1 and 72.6 % against B. In year 2 , the overall efficacy was 88.7 % ; efficacy was 90.0 % against H1N1 , 90.3 % against A/H3N2 , and 81.7 % against B. Efficacy against all episodes of acute otitis media associated with culture-confirmed influenza was 90.6 % in year 1 and 97.0 % in year 2 . Runny nose or nasal discharge after dose 1 in year 1 was the only reactogenicity event that was significantly more frequent with cold-adapted influenza vaccine-trivalent ( 82.3 % ) than placebo ( 75.4 % ) . CONCLUSIONS . Cold-adapted influenza vaccine-trivalent was well tolerated and effective in preventing culture-confirmed influenza illness in children as young as 6 months of age who attended day care BACKGROUND The efficacy of the intranasal , live-attenuated , trivalent cold-adapted influenza virus vaccine ( CAIV-T ) against influenza A(H3N2 ) and B infections in healthy persons is established , but its effectiveness against natural influenza A(H1N1 ) infection is unknown . OBJECTIVE To assess the effectiveness of CAIV-T in healthy children during the 2000 - 2001 influenza A(H1N1 ) and B epidemic . DESIGN Community-based , nonr and omized , open-label trial from August 1998 through April 2001 . SETTING Intervention and comparison communities in central Texas . PARTICIPANTS Healthy children , aged 1.5 to 18 years , from the intervention communities received a single dose of CAIV-T at least 1 time or more in 1998 , 1999 , and /or 2000 . MAIN OUTCOME MEASURES The incidence of medically attended acute respiratory illnesses during the 2000 - 2001 influenza epidemic was compared in 3794 health plan CAIV-T recipients with age-eligible , health plan nonrecipients in the intervention communities for direct effectiveness ( n = 9325 ) , and with those in the 2 comparison communities for total effectiveness ( n = 16,264 ) . RESULTS The 2281 CAIV-T recipients in 2000 had significant direct protection against medically attended acute respiratory illness of 18 % to 20 % during the biphasic influenza A(H1N1 ) and B epidemic , and 17 % to 26 % during influenza A(H1N1 ) predominance . The 931 recipients of CAIV-T in 1999 containing influenza A/Beijing/262/95(H1N1 ) and B/Beijing/184/93-like viruses had persistent heterovariant protection against the 2000 - 2001 influenza A/New Caledonia/20/99(H1N1 ) and B/Sichuan/379/99 variants . The 616 recipients of a single CAIV-T dose in 1999 only , including those younger than 5 years with no prior natural exposure to influenza A(H1N1 ) viruses , showed persistent protection . CONCLUSION Healthy children who received CAIV-T in 2000 or 1999 were protected against new variants of influenza A(H1N1 ) and B in the 2000 - 2001 influenza epidemic The authors report on a community-based , nonr and omized , open-label study , conducted during the 2000 - 2001 influenza season in Temple-Belton , Texas , of the protective effectiveness of trivalent , cold-adapted , influenza virus vaccine ( CAIV-T ) in children aged 18 months-18 years . The dominant circulating strains in 2000 - 2001 were influenza A/New Caledonia/20/99 ( H1N1 ) and influenza B/Sichuan/379/99 . Children had access to CAIV-T  during the 1998 - 1999 , 1999 - 2000 , and 2000 - 2001 influenza seasons . The vaccine included influenza A/Sydney/5/97 ( H3N2 ) and B/Beijing/184/93-like ( B/Ann Arbor/l/94 ) strains in all three seasons . The vaccine included A/Beijing/262/95 ( H1N1 ) in 1998 - 1999 
    Output:
    