Urgent challenges in implementing live attenuated influenza vaccine

Anika Singanayagam, Maria Zambon, Ajit Lalvani, Wendy Barclay*

*Corresponding author for this work

Research output: Contribution to journalReview articlepeer-review

38 Citations (Scopus)


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.

Original languageEnglish
Pages (from-to)e25-e32
JournalThe Lancet Infectious Diseases
Issue number1
Publication statusPublished - Jan 2018

Bibliographical note

Publisher Copyright:
© 2018 Elsevier Ltd


Dive into the research topics of 'Urgent challenges in implementing live attenuated influenza vaccine'. Together they form a unique fingerprint.

Cite this