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Review
. 2015 Apr 24;3(2):373-89.
doi: 10.3390/vaccines3020373.

Influenza Vaccination Strategies: Comparing Inactivated and Live Attenuated Influenza Vaccines

Saranya Sridhar  1 , Karl A Brokstad  2 , Rebecca J Cox  3   4   5
Affiliations
Review

Influenza Vaccination Strategies: Comparing Inactivated and Live Attenuated Influenza Vaccines

Saranya Sridhar et al. Vaccines (Basel). .

Abstract

Influenza is a major respiratory pathogen causing annual outbreaks and occasional pandemics. Influenza vaccination is the major method of prophylaxis. Currently annual influenza vaccination is recommended for groups at high risk of complications from influenza infection such as pregnant women, young children, people with underlying disease and the elderly, along with occupational groups such a healthcare workers and farm workers. There are two main types of vaccines available: the parenteral inactivated influenza vaccine and the intranasal live attenuated influenza vaccine. The inactivated vaccines are licensed from 6 months of age and have been used for more than 50 years with a good safety profile. Inactivated vaccines are standardized according to the presence of the viral major surface glycoprotein hemagglutinin and protection is mediated by the induction of vaccine strain specific antibody responses. In contrast, the live attenuated vaccines are licensed in Europe for children from 2-17 years of age and provide a multifaceted immune response with local and systemic antibody and T cell responses but with no clear correlate of protection. Here we discuss the immunological immune responses elicited by the two vaccines and discuss future work to better define correlates of protection.

Keywords: Influenza; T-cells; antibodies; immunity; immunization; live attenuated vaccine; vaccination.

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Figures

Figure 1
Figure 1
The structure of Influenza A virus and the ribonucleoprotein complex. The virus proteins are denoted as HA hemagglutinin; NA neuraminidase, M1 matrix protein 1; M2 matrix protein 2; NP nucleoprotein; and the polymerase proteins PA, PB1 and PB2.
Figure 2
Figure 2
The different formulations of influenza vaccine. Currently licensed influenza vaccines are predominately inactivated virus (whole inactivated, split, subunit or virion like particle) or live attenuated influenza vaccine. Novel vaccines are DNA or synthetic peptide vaccines.
Figure 3
Figure 3
Model of induction of immune responses after live attenuated influenza vaccination (LAIV). (1) Intranasal LAIV immunization; (2) Viral antigen is transported to the tonsils/adenoids by the Dendritic Cells (DCs); (3) Activation and proliferation of T and B cells in tonsils/adenoids with help from CD4+ T-cells. Affinity maturation of B cells; (4,5) Activated T and B cells home to site of infection and enter circulation. Plasma cells secrete antibody into the blood and at the mucosal surfaces.
See this image and copyright information in PMC

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