Influenza vaccination: protecting the most vulnerable

Influenza virus infection causes seasonal epidemics and occasional pandemics, leading to huge morbidity and mortality worldwide. Vaccination against influenza is needed annually as protection from constantly mutating strains is required. Groups at high risk of poor outcomes include the elderly, the very young, pregnant women and those with chronic health conditions. However, vaccine effectiveness in the elderly is generally poor due to immunosenescence and may be altered due to “original antigenic sin”. Strategies to overcome these challenges in the elderly include high-dose or adjuvant vaccines. Other options include vaccinating healthcare workers and children as this reduces community-level influenza transmission. Current guidelines in the UK are that young children receive a live attenuated nasal spray vaccine, adults aged >65 years receive an adjuvanted trivalent inactivated vaccine and adults aged <65 years with comorbidities receive a quadrivalent inactivated vaccine. The goal of a universal influenza vaccine targeting conserved regions of the virus and avoiding the need for annual vaccination is edging closer with early-phase trials under way.

10.1183/16000617.0258-2020

0905-9180

Tanner, Alex

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Dorey, Robert B.

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Brendish, Nathan

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Clark, Tristan

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31 March 2021

Tanner, Alex

b28a5a4a-775b-4c61-8139-15eb1ddf10b8

Dorey, Robert B.

8d4b042f-1659-4e76-99c2-23cde78ca4f5

Brendish, Nathan

a8a4189e-01eb-4ab3-933e-a24cd188a4d7

Clark, Tristan

712ec18e-613c-45df-a013-c8a22834e14f

Tanner, Alex, Dorey, Robert B., Brendish, Nathan and Clark, Tristan (2021) Influenza vaccination: protecting the most vulnerable. European Respiratory Review, 30 (159), [200258]. (doi:10.1183/16000617.0258-2020).

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Influenza Vaccination ERR paper CC - Accepted Manuscript

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Accepted/In Press date: 3 October 2020

Published date: 31 March 2021

Additional Information: Funding Information: Conflict of interest: A.R. Tanner has nothing to disclose. R.B. Dorey has nothing to disclose. N.J. Brendish has nothing to disclose. T.W. Clark reports personal fees from BioMerieux and BioFire LLC, Synairgen Research Ltd, Cidara Therapeutics and Janssen; non-financial support from BioMerieux and BioFire LLC; personal fees and other support from Roche, and grants from NIHR, outside the submitted work. Funding Information: Support statement: This research did not receive any specific grant from funding agencies in the public, commercial, or not-for-profit sectors. This report is independent research supported by the National Institute for Health Research (NIHR Post-Doctoral Fellowship, Tristan W. Clark, PDF 2016-09-061). The views expressed in this publication are those of the author(s) and not necessarily those of the National Health Service, the National Institute for Health Research or the Department of Health. N.J. Brendish is supported by a NIHR Clinical Lecturer post. Funding Information: This research did not receive any specific grant from funding agencies in the public, commercial, or not-for-profit sectors. This report is independent research supported by the National Institute for Health Research (NIHR Post-Doctoral Fellowship, Tristan W. Clark, PDF 2016-09-061). The views expressed in this publication are those of the author(s) and not necessarily those of the National Health Service, the National Institute for Health Research or the Department of Health. N.J. Brendish is supported by a NIHR Clinical Lecturer post. Publisher Copyright: © ERS 2021.