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

摘要: 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 effectiveness in recent seasons led to the CDC Advisory Committee on Immunization Practices (ACIP) recommendation administer inactivated vaccines (IIVs), not LAIV, during 2016–17 2017–18 seasons. Given that data from previous years demonstrated equivalent even improved efficacy LAIV compared with IIV, these were surprising, raising many questions about potential mechanisms underlying this change. This review seeks summarize history studies ACIP recommendations a focus decrease (VE) discordant results among performed different countries. Decreased VE A/H1N1pdm09 viruses represents most consistent finding across studies, as low every season predominated since 2010–11. Potential explanations diminished include hypothesis prior vaccination, reduced thermostability A/H1N1pdm09, addition fourth virus, or replication fitness strains may have contributed phenomenon. Ongoing alterations formulations provide hope return effective future