Drugs & Aging

, Volume 21, Issue 6, pp 349–359 | Cite as

Intranasal Cold-Adapted Influenza Virus Vaccine Combined with Inactivated Influenza Virus Vaccines

An Extra Boost for the Elderly?
  • Paul V. Targonski
  • Gregory A. Poland
Current Opinion


Although influenza vaccine delivery strategies have improved coverage rates to unprecedented levels nationally among persons aged 65 years and older, influenza remains one of the greatest vaccine-preventable threats to public health among elderly in the US. A new, intranasal live attenuated influenza vaccine (LAIV) was recently approved by the US FDA for use in persons aged 5–49 years, which excludes the elderly population. Limitations of immune response to inactivated influenza vaccine (IAIV) and effectiveness of current influenza vaccination strategies among the elderly suggest that a combined approach using LAIV and/or the IAIV in various permutations might benefit this group. We explore characteristics of the LAIV, data regarding its utility in protecting against influenza in the elderly, and challenges and opportunities regarding potential combined inactivated/live attenuated vaccination strategies for the elderly. Although LAIV appears to hold promise either alone or in combination with IAIV, large well conducted randomised trials are necessary to define further the role of LAIV in preventing influenza morbidity and mortality among the elderly. We also suggest that innovative vaccine coverage strategies designed to optimise prevention and control of influenza and minimise viral transmission in the community must accompany, in parallel, the acquisition of clinical trials data to best combat morbidity and mortality from influenza.


Influenza Influenza Vaccination Vaccine Efficacy Live Attenuate Influenza Vaccine Inactivate Influenza Vaccine 
These keywords were added by machine and not by the authors. This process is experimental and the keywords may be updated as the learning algorithm improves.



The authors thank Kim S. Zabel for editorial assistance. No sources of funding were used to assist in the preparation of this review. The authors have no conflicts of interest that are directly relevant to the content of this review.


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Authors and Affiliations

  1. 1.Department of Internal MedicineMayo ClinicRochesterUSA
  2. 2.Mayo Vaccine Research Group and the Program in Translational Immunovirology and BiodefenseMayo ClinicRochesterUSA

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