Evidence map›Paper›PMID 32035708›Full record

Trial reportVaccine2020

Symptoms associated with influenza vaccination and experimental human pneumococcal colonisation of the nasopharynx.

Caz Hales, Simon P Jochems, Rachel Robinson, Carla Solórzano, Beatriz Carniel, Sherin Pojar, Jesús Reiné, Esther L German, Elissavet Nikolaou, Elena Mitsi and 11 more

Open access · hybridAbstract readRandomized Controlled Trial
In one paragraph

Trial report in Vaccine, 2020. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 4 papers, 1 of them a synthesis that pooled it.

0numbers the graph read from it
0cells of the map it votes in
4citing papers in PubMed, 1 pooled it
1.2field-weighted citation impact, top 21% of its field
1 · What the graph read from it

What it found

Each row is one number read from the abstract, on the scale the paper reported it, with its interval. Left of the dashed line favours the treatment, right favours the comparator. Under each row is the sentence it came from. New to these charts? A ten-minute tutorial.

The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.

2 · The registry

The trial behind it

Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.

Neither the registry nor the abstract names a trial number. If this is a trial report, that itself is worth knowing.

3 · Its place in the literature

Who cites it

4 citing papers in PubMed, 1 synthesis or guideline pooled it, 8 citations in OpenAlex.

  1. Pooled it
  2. Review
  3. Article
  4. Review
4 · The record

Corrections and comments

PubMed lists nothing against this paper. Absence here is not a guarantee, only a check that was made.

5 · Who and what money

Authors and funding

21 authors at 1 institution in 1 country.

Caz HalesRoyal Liverpool and Broadgreen University Hospital Trust, Prescot Street, Liverpool L7 8XP, UK; Department of Clinical Sciences, Liverpool School of Tropical Medicine, Pembroke Place, Liverpool L3 5QA, UK. Electronic address: Caz.hales@lstmed.ac.uk.
Simon P JochemsDepartment of Clinical Sciences, Liverpool School of Tropical Medicine, Pembroke Place, Liverpool L3 5QA, UK.
Rachel RobinsonRoyal Liverpool and Broadgreen University Hospital Trust, Prescot Street, Liverpool L7 8XP, UK; Department of Clinical Sciences, Liverpool School of Tropical Medicine, Pembroke Place, Liverpool L3 5QA, UK.
Carla SolórzanoDepartment of Clinical Sciences, Liverpool School of Tropical Medicine, Pembroke Place, Liverpool L3 5QA, UK.
Beatriz CarnielDepartment of Clinical Sciences, Liverpool School of Tropical Medicine, Pembroke Place, Liverpool L3 5QA, UK.
Sherin PojarDepartment of Clinical Sciences, Liverpool School of Tropical Medicine, Pembroke Place, Liverpool L3 5QA, UK.
Jesús ReinéDepartment of Clinical Sciences, Liverpool School of Tropical Medicine, Pembroke Place, Liverpool L3 5QA, UK.
Esther L GermanDepartment of Clinical Sciences, Liverpool School of Tropical Medicine, Pembroke Place, Liverpool L3 5QA, UK.
Elissavet NikolaouDepartment of Clinical Sciences, Liverpool School of Tropical Medicine, Pembroke Place, Liverpool L3 5QA, UK.
Elena MitsiDepartment of Clinical Sciences, Liverpool School of Tropical Medicine, Pembroke Place, Liverpool L3 5QA, UK.
Angela D Hyder-WrightRoyal Liverpool and Broadgreen University Hospital Trust, Prescot Street, Liverpool L7 8XP, UK; Department of Clinical Sciences, Liverpool School of Tropical Medicine, Pembroke Place, Liverpool L3 5QA, UK.
Helen HillDepartment of Clinical Sciences, Liverpool School of Tropical Medicine, Pembroke Place, Liverpool L3 5QA, UK.
Hugh AdlerRoyal Liverpool and Broadgreen University Hospital Trust, Prescot Street, Liverpool L7 8XP, UK; Department of Clinical Sciences, Liverpool School of Tropical Medicine, Pembroke Place, Liverpool L3 5QA, UK.
Victoria ConnorRoyal Liverpool and Broadgreen University Hospital Trust, Prescot Street, Liverpool L7 8XP, UK; Department of Clinical Sciences, Liverpool School of Tropical Medicine, Pembroke Place, Liverpool L3 5QA, UK.
Seher ZaidiRoyal Liverpool and Broadgreen University Hospital Trust, Prescot Street, Liverpool L7 8XP, UK; Department of Clinical Sciences, Liverpool School of Tropical Medicine, Pembroke Place, Liverpool L3 5QA, UK.
Catherine LoweRoyal Liverpool and Broadgreen University Hospital Trust, Prescot Street, Liverpool L7 8XP, UK; Department of Clinical Sciences, Liverpool School of Tropical Medicine, Pembroke Place, Liverpool L3 5QA, UK.
Xiaojing FanDepartment of Clinical Sciences, Liverpool School of Tropical Medicine, Pembroke Place, Liverpool L3 5QA, UK.
Duolao WangDepartment of Clinical Sciences, Liverpool School of Tropical Medicine, Pembroke Place, Liverpool L3 5QA, UK.
Stephen B GordonDepartment of Clinical Sciences, Liverpool School of Tropical Medicine, Pembroke Place, Liverpool L3 5QA, UK.
Jamie RylanceRoyal Liverpool and Broadgreen University Hospital Trust, Prescot Street, Liverpool L7 8XP, UK; Department of Clinical Sciences, Liverpool School of Tropical Medicine, Pembroke Place, Liverpool L3 5QA, UK.
Daniela M FerreiraDepartment of Clinical Sciences, Liverpool School of Tropical Medicine, Pembroke Place, Liverpool L3 5QA, UK.
Liverpool School of Tropical Medicine · GB

Funding

Medical Research Council MR/M011569/1
6 · The paper itself

Abstract

backgroundNasopharyngeal colonisation by S. pneumoniae is a prerequisite for invasive pneumococcal infections. Influenza co-infection leads to increased susceptibility to secondary pneumonia and mortality during influenza epidemics. Increased bacterial load and impaired immune responses to pneumococcus caused by influenza play a role in this increased susceptibility. Using an Experimental Human Challenge Model and influenza vaccines, we examined symptoms experienced by healthy adults during nasal co-infection with S. pneumoniae and live attenuated influenza virus.

methodsRandomised, blinded administration of Live Attenuated Influenza Vaccine (LAIV) or Tetravalent Inactivated Influenza Vaccine (TIV) either preceded bacterial inoculation or followed it, separated by a 3-day interval. The presence and density of S. pneumoniae was determined from nasal washes. Participants completed a symptom questionnaire from the first intervention until 6 days post second intervention.

resultsThe timing and type of influenza vaccination and presence of S. pneumoniae in the nasopharynx significantly affected symptom reporting. In the study where influenza vaccination preceded bacterial inoculation: nasal symptoms were less common in the LAIV group than the TIV group (OR 0.57, p < 0.01); with colonisation status only affecting the TIV group where more symptoms were reported by colonised participants compared to non-colonised participants following inoculation (n = 12/23 [52.17%] vs n = 13/38 [34.21%], respectively; p < 0.05). In the study where influenza vaccination followed bacterial inoculation: no difference was seen in the symptoms reported between the LAIV and TIV groups following inoculation and subsequent vaccination; and symptoms were unaffected by colonisation status.

conclusionSymptoms experienced during live viral vaccination and bacterial co-infection in the nasopharynx are directly affected by the precedence of the pathogen acquisition. Symptoms were directly affected by nasal pneumococcal colonisation but only when TIV was given prior to bacterial exposure.

Indexed as

Influenza, HumanAdultCoinfectionDouble-Blind MethodHumansInfluenza VaccinesNasopharynxStreptococcus pneumoniaeTime FactorsVaccinationVaccines, AttenuatedVaccines, InactivatedInfluenza VaccinesVaccines, AttenuatedVaccines, InactivatedControlled human infection challenge modelInfluenza vaccinationLive attenuated influenza vaccinePneumococcal inoculationPneumococcus colonisationStreptococcus pneumoniaeSymptoms

Identifiers

PMID32035708
PMCPMC7045083
OpenAlexW3005476926

What Socratic holds

Textmetadata
LicenceCC BY
Read underepoch 390

Registered trials

None linked

Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the Socratic graph.