Australia was alerted to a possible increase in allergy-related adverse events following immunisation (AEFI) with 2015 seasonal trivalent influenza vaccines (TIV) by the Victorian state vaccine safety service, SAEFVIC. We describe SAEFVIC's initial investigation and upon conclusion of the 2015 influenza vaccination programme, to define the signal event and implications for vaccine programmes. Allergy-related AEFI were defined as anaphylaxis, angioedema, urticaria or generalised allergic reaction. Investigations compared 2015 TIV AEFI reports to previous years as proportions and reporting risk (RR) per 100,000, stratified by influenza vaccine brand. The initial investigation showed an increased proportion of allergy-related AEFI compared with 2014 (25% vs 12%), predominantly in adults, with insufficient clinical severity to alter the programme risk-benefit. While overall TIV AEFI RR in 2015 was similar to previous years (RR: 1.07, 95% confidence interval (CI): 0.88-1.29), we identified a near-doubling RR for allergy-related AEFI in 2015 (RR: 1.78, 95% CI: 1.14-- 2.80) from 2011 to 2014 with no difference by vaccine brand or severity increase identified. This increase in generalised allergy-related AEFI, across all used vaccine brands, supports evidence of variable reactogenicity arising from influenza vaccine strain variations. This investigation underlines the importance of effective seasonal influenza vaccine pharmacovigilance.

No abstract available.

Objectives:Breastfeeding might be associated with respiratory allergy and asthma subtypes(i.e., allergic asthma), but such relations have never been examined yet in the US. Therefore, the aims of the study were: To examined the association between breastfeeding and respiratory allergy in children aged six years.To examined the association between breastfeeding and asthma including asthma subtypes (allergic) in children aged six yearsOur hypothesis was that exclusively breastfeeding for 3 months would reduce the risk of developing childhood respiratory allergy and allergic asthma.

Methods:A longitudinal study was used, utilizing data from mother-infant pairs that participated in the infant Feeding Practices Study-II(IFPS-II) and the Year-6-Follow-Up Study(Y6FU) in the United-States(US). The data included mother-reported breastfeeding practices in IFPS-II, childhood allergies in Y6FU, and covariates as demographic variables, siblings, wheezing, RSV, history of family allergies, maternal smoking status, and introduction to complementary foods. Multiple logistic regressions were used to examine the study aims.

Results:Overall, 1,177 questionnaires were completed in IFPS-II and Y6FU. Until 3 months, 35.9%(n = 423) of the children were exclusively breastfed, and 24.6%(n = 290) were exclusively formula-fed. Based on mothers' reports, 20.8%(n = 245) of the children had been diagnosed by a physician as having had a respiratory allergy, and 10.2% (n = 120)with asthma, and of these, 105 cases had allergic asthma(8.7%). The results of the multivariable analyses showed that children who were exclusively breastfed for 3 months were significantly less likely by 37% to have respiratory allergy(AOR = 0.63 CI 95%:0.42-0.93) compared with children who were exclusively formula fed for 3 months afteradjusting for associated covariates. There were no significant differences in the odds of having asthma across the different feeding practices. Allergic asthma, however, was significantly associated with exclusive breastfeeding for 3 months (AOR = 0.54 CI 95%:0.30-0.96), after adjusting for associated covariates.

Conclusions:Exclusive breastfeeding for the first 3 months reduce the risk for respiratory allergies and allergic asthma in children.

Funding Sources:There is no funding source to declare.

BACKGROUND:The gut microbiome in infancy influences immune system maturation, and may have an important impact allergic disease risk.

OBJECTIVE:To determine how prenatal and early life factors impact the gut microbiome in a relatively large, ethnically diverse study population of infants at 3-6 months of age, who were enrolled in VDAART, a clinical trial of vitamin D supplementation in pregnancy to prevent asthma and allergies in offspring.

METHODS:We performed 16S rRNA gene sequencing on 333 infants' stool samples. Microbial diversity was computed using the Shannon Index. Factor analysis applied to the top 25 most abundant taxa revealed four underlying bacterial co-abundance groups; the first dominated by Firmicutes (Lachnospiraceae/ Clostridiales), the second by Proteobacteria (Klebsiella/Enterobacter), the third by Bacteriodetes, and the fourth by Veillonella. Scores for co-abundance groups were used as outcomes in regression models, with prenatal/birth and demographic characteristics as independent predictors. Multivariate analysis, using all microbial community members, was also conducted.

RESULTS:Caucasian race/ethnicity was associated with lower diversity but higher Bacteroidetes co-abundance scores. Caucasian infants had lower Proteobacteria scores as compared to African Americans. C-section birth was associated with higher diversity, but with decreased Bacteroidetes co-abundance scores. Firmicutes and Proteobacteria scores were higher for infants born by C-section. Breastfed infants had lower proportions of Clostridiales. Cord blood vitamin D was linked to increased Lachnobacterium, but decreased Lactococcus.

CONCLUSIONS:The findings presented here suggest that race, mode of delivery, breastfeeding and cord blood vitamin D levels are associated with infant gut microbiome composition, with possible long-term implications for immune system modulation and asthma/allergic disease incidence.

OBJECTIVE: To discuss current evidence about the relation between prenatal and childhood Mediterranean diet, and the development of asthma and allergies in children.

DESIGN: Review of the literature.

SETTING AND RESULTS: Four recent studies conducted in Mediterranean countries (Spain, Greece) and one conducted in Mexico evaluated the association between childhood Mediterranean diet and asthma outcomes in children. All of the studies reported beneficial associations between a high level of adherence to the Mediterranean diet during childhood and symptoms of asthma or allergic rhinitis. Individual foods or food groups contributing to the protective effect of Mediterranean diet included fish, fruits, vegetables, legumes, nuts and cereals, while detrimental components included red meat, margarine and junk food intake. Two studies focused on prenatal Mediterranean diet: the first is a birth cohort in Spain that showed a protective effect of a high adherence to the Mediterranean diet during pregnancy on persistent wheeze, atopic wheeze and atopy at the age of 6.5 years; while the second is a cross-sectional study in Mexico, collecting information more than 6 years after pregnancy, that showed no associations between maternal Mediterranean diet during pregnancy and allergic symptoms in childhood except for current sneezing.

CONCLUSIONS: Findings from recent studies suggest that a high level of adherence to the Mediterranean diet early in life protects against the development of asthma and atopy in children. Further studies are needed to better understand the mechanisms of this protective effect, to evaluate the most relevant window of exposure, and to address specific components of diet in relation to disease.