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Lancet ID: Urgent challenges in implementing live attenuated influenza vaccine

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  • Lancet ID: Urgent challenges in implementing live attenuated influenza vaccine

    Lancet Infect Dis. 2017 Aug 2. pii: S1473-3099(17)30360-2. doi: 10.1016/S1473-3099(17)30360-2. [Epub ahead of print]
    Urgent challenges in implementing live attenuated influenza vaccine.

    Singanayagam A1, Zambon M2, Lalvani A3, Barclay W4.
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    Abstract

    Conflicting reports have emerged about the effectiveness of the live attenuated influenza vaccine. The live attenuated influenza vaccine appears to protect particularly poorly against currently circulating H1N1 viruses that are derived from the 2009 pandemic H1N1 viruses. During the 2015-16 influenza season, when pandemic H1N1 was the predominant virus, studies from the USA reported a complete lack of effectiveness of the live vaccine in children. This finding led to a crucial decision in the USA to recommend that the live vaccine not be used in 2016-17 and to switch to the inactivated influenza vaccine. Other countries, including the UK, Canada, and Finland, however, have continued to recommend the use of the live vaccine. This policy divergence and uncertainty has far reaching implications for the entire global community, given the importance of the production capabilities of the live attenuated influenza vaccine for pandemic preparedness. In this Personal View, we discuss possible explanations for the observed reduced effectiveness of the live attenuated influenza vaccine and highlight the underpinning scientific questions. Further research to understand the reasons for these observations is essential to enable informed public health policy and commercial decisions about vaccine production and development in coming years.
    Copyright ? 2017 Elsevier Ltd. All rights reserved.


    PMID: 28780285 DOI: 10.1016/S1473-3099(17)30360-2
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