influenza 05 Grohskopf 508

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National Center for Immunization & Respiratory Diseases
Published Estimates of LAIV Effectiveness
Lisa Grohskopf
Advisory Committee on Immunization Practices
February 22, 2023
Update on Published Estimates of LAIV4 Effectiveness: Background
LAIV4 not recommended in the U.S. for 2016 -17 and 2017- 18, following 
observation of poor effectiveness against H1N1pdm09 viruses.
Subsequent studies suggested poor replicative fitness of the LAIV4 H1N1pdm09 -
l
ike vaccine virus, which was subsequently updated.
LAIV4 again a recommended option starting in 2018- 1 9 after discussion of
–Combined U.S. individual level patient VE analysis,
–Systematic review of post -2 009 US/non- US LAIV VE estimates,
–MedImmune d ata suggesting better fitness of new H1N1pdm09 vaccine virus.
LAIV4 use within CDC U.S. VE networks has been low since 2018 -1 9, precluding 
assessment of vaccine- specific VE.
LAIV VE estimates have been published from non- U .S. observational studies. 
2
Vaccine Effectiveness, %
* Report notes that 92% in 2 -6y age group received LAIV4; the remainder offered IIV4.362018- 19
3654
49536871
4572
646373
-4Published Non- US VE 
Estimates
All influenza viral 
types/subtypes
1. Stuurman et al  Vaccine 
2020;
38:6455-6463
2. Pebody, Vaccine 38 (2020) 489–4
3. Stuurman et al  Vaccine 2021;
39:3964-3973
4. https://webarchive.nationalarchive
s.gov.uk/ukgwa/20220401215804/
https://www.gov.uk/government/s
tatistics/annual -flu-reports
5. https://www.gov.uk/government/s
tatistics/annual -flu-
reports/surveillance -of-influenza -
and- other -seasonal -respiratory -
viruses-in -winter -2021- to-2022
6. Emborg ,  Euro Surveill
2022;27:pii=2200278LAIV4 IIV4
All vaccines
FIN    FinlandUK     United Kingdom
DEN    Denmark
0102030405060708090
FIN (1)
LAIV4
2-6yFIN (1)
IIV4
6m-6yUK (2)
LAIV4
2-17yUK (2)
all vaccines
2-17yFIN (3)
LAIV4
2-6yFIN (3)
IIV4
6m-6yUK (4)
LAIV4
2-17yUK (5)
LAIV4
2-17yUK (5)
all vaccines
1-17yDEN (6)
all
vaccines*
2-6y
non-hospDEN (6)
all
vaccines*
2-6y
hosp2019- 20 2021- 22
4
For more information, contact CDC
1-800- CDC- INFO (232 -4636)
TTY:  1 -888- 232- 6348    www.cdc.gov
The findings and conclusions in this report are those of the authors and do not necessarily represent the official position o f the Centers for Disease Control and Prevention.
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