Natural infection with influenza can contribute to asthma exacerbation. Thus, influenza vaccine prevents asthma exacerbation by protecting against natural infection. Influenza vaccines do not cause asthma or asthma exacerbation. Other vaccines currently routinely recommended to the general population in the U.S.* have not been shown to cause asthma or asthma exacerbation.
The 2012 report by the Institute of Medicine (IOM) , now called the National Academy of Medicine (NAM), described a number of studies with sufficient validity and precision that all reported no association between inactivated influenza vaccination and asthma exacerbation [2-10]. The report described several studies with sufficient validity and precision that generally reported no association between live attenuated influenza vaccination (LAIV) and asthma exacerbation as well [11-17]. However, a 2015 white paper on the safety of influenza vaccines concluded that LAIV was associated with an increase in wheezing in children ages 18 to 35 months who had a history of wheezing .
Influenza, along with other natural viral respiratory infections, can contribute to asthma exacerbation, as these viruses enter and replicate within airway epithelial cells, initiating an immune response. Natural influenza infection also causes greater morbidity in asthmatic subjects than in the general population, perhaps due to a difference in the antiviral response of asthmatics .
The 2012 IOM report described cases of asthma exacerbation after both inactivated and live attenuated influenza vaccination ; however, even after considering knowledge about the aforementioned natural infection, the IOM concluded that this mechanistic evidence was weak .
* These conclusions do not necessarily consider vaccines recommended only for special populations in the United States such as Yellow Fever vaccine (international travelers) or Smallpox vaccine (military personnel).
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