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Urgent challenges in implementing live attenuated influenza vaccine
Anika Singanayagam1, Maria Zambon2, Ajit Lalvani3
1Department of Medicine, Imperial College, London, UK; NIHR Health Protection Research Unit in Respiratory Infections, Imperial College, London, UK.
The Lancet. Infectious Diseases
|August 7, 2017
Summary
Live attenuated influenza vaccines show reduced effectiveness against current H1N1 strains, prompting policy changes in some countries. Further research is crucial for vaccine development and public health decisions.
Area of Science:
- Immunology
- Virology
- Public Health
Background:
- Conflicting reports exist on the effectiveness of live attenuated influenza vaccines (LAIV).
- LAIV demonstrates poor protection against current H1N1 influenza viruses, particularly those derived from the 2009 pandemic strain.
- Studies during the 2015-16 season in the USA reported a complete lack of LAIV effectiveness in children against predominant H1N1 strains.
Purpose of the Study:
- To discuss potential explanations for the observed reduced effectiveness of LAIV.
- To highlight key scientific questions regarding LAIV performance.
- To inform public health policy and commercial decisions regarding influenza vaccine production and development.
Main Methods:
- This is a "Personal View" article, synthesizing existing data and expert opinion.
- Discussion of scientific literature and policy divergence regarding LAIV use.
- Identification of research gaps and future directions.
Main Results:
- The USA recommended against LAIV use in 2016-17, switching to inactivated influenza vaccines due to poor effectiveness against H1N1.
- Other countries (UK, Canada, Finland) continue to recommend LAIV.
- This policy divergence impacts global pandemic preparedness due to LAIV production capabilities.
Conclusions:
- Understanding the reasons for reduced LAIV effectiveness is essential.
- Further research is needed to guide informed public health and commercial decisions.
- The findings have implications for future influenza vaccine development and pandemic preparedness strategies.
