Perspectives from the Society for Pediatric Research: Decreased Effectiveness of the Live Attenuated Influenza Vaccine

Michelle A. Gill, Elizabeth P. Schlaudecker

Research output: Contribution to journalReview article

3 Citations (Scopus)

Abstract

The intranasal live attenuated influenza vaccine (LAIV), FluMist, has been widely appreciated by pediatricians, parents, and children alike for its ease of administration. However, concerns regarding lack of effectiveness in recent influenza seasons led to the CDC Advisory Committee on Immunization Practices (ACIP) recommendation to administer inactivated influenza vaccines (IIVs), and not LAIV, during the 2016-17 and 2017-18 seasons. Given that data from previous years demonstrated equivalent and even improved efficacy of LAIV compared with IIV, these recent data were surprising, raising many questions about the potential mechanisms underlying this change. This review seeks to summarize the history of LAIV studies and ACIP recommendations with a focus on the recent decrease in vaccine effectiveness (VE) and discordant results among studies performed in different countries. Decreased VE for A/H1N1pdm09 viruses represents the most consistent finding across studies, as VE has been low every season these viruses predominated since 2010-11. Potential explanations underlying diminished effectiveness include the hypothesis that prior vaccination, reduced thermostability of A/H1N1pdm09, addition of a fourth virus, or reduced replication fitness of A/H1N1pdm09 strains may have contributed to this phenomenon. Ongoing studies and potential alterations to LAIV formulations provide hope for a return of effective LAIV in future influenza seasons.

Original languageEnglish (US)
Pages (from-to)31-40
Number of pages10
JournalPediatric Research
Volume83
Issue number1
DOIs
StatePublished - Jan 1 2018

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Attenuated Vaccines
Influenza Vaccines
Pediatrics
Research
Inactivated Vaccines
Vaccines
Advisory Committees
Viruses
Human Influenza
Immunization
Hope
Centers for Disease Control and Prevention (U.S.)
Vaccination
Parents
History

ASJC Scopus subject areas

  • Pediatrics, Perinatology, and Child Health

Cite this

Perspectives from the Society for Pediatric Research : Decreased Effectiveness of the Live Attenuated Influenza Vaccine. / Gill, Michelle A.; Schlaudecker, Elizabeth P.

In: Pediatric Research, Vol. 83, No. 1, 01.01.2018, p. 31-40.

Research output: Contribution to journalReview article

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