Peer-reviewed article
Higher Pediatric Influenza Vaccination Coverage in Pooled Northern Hemisphere Countries with Public Access to Live Attenuated Influenza Vaccine: Implications for Immunization Policy
Mirna Robert-Du Ry van Beest Holle, Sudhir Venkatesan, Joshua Enxing, Cherish Alex-Wele, Fungwe Jah et al. ·
Summary
Written by AI, not yet AICS's view · claude-sonnet-5-5This study compared influenza vaccination coverage in children and adolescents aged 2 to under 18 across 36 Northern Hemisphere countries in the 2024/25 season. It looked at whether coverage differed depending on access to the nasal-spray live attenuated influenza vaccine (LAIV) alongside the injected vaccine. Coverage was higher in countries where LAIV was offered through a publicly funded programme than in countries offering only the injected vaccine. The authors conclude that publicly funded access to LAIV is associated with higher coverage, whatever the funding structure for vaccines.
Key points
- Of 36 countries, 20 (55.6%) offered only the injected vaccine and 16 (44.4%) offered both LAIV and the injected vaccine.
- Median pediatric influenza vaccination coverage across all countries was 11.1%.
- Coverage was higher in countries with publicly funded LAIV than in countries with only the injected vaccine, in both analyses.
- In the subanalysis, the odds of vaccination with public LAIV availability were higher in Model 1 (OR 2.66, 95% CI 1.37-5.15). In Model 2 the OR was 1.87 (95% CI 0.66-5.29), and the interval includes 1.
- The positive association pointed the same way regardless of how vaccines were funded.
Limitations
This is a cross-sectional, country-level (ecological) analysis of one season, so it shows association, not that LAIV availability causes higher uptake. The document does not name the countries, and the Model 2 result is statistically uncertain.
Abstract
INTRODUCTION: Research shows that intranasal live attenuated influenza vaccine (LAIV) availability in addition to injectable inactivated influenza vaccine (IIV) is associated with higher influenza vaccination coverage rate (VCR). PEARL explored associations between LAIV availability and overall influenza vaccine uptake in children and adolescents. METHODS: PEARL was a cross-sectional study with ecological analysis using pooled country-level data from Northern Hemisphere countries with national recommendations for pediatric influenza vaccination (2024/25 season). Data sources included supra-national organizations and national public health institutes. LAIV availability was categorized as: none (IIV available); private (IIV available, LAIV accessible through the private market); or public (IIV available, LAIV offered via a publicly funded program). VCR was defined as the proportion of children and adolescents aged 2 to < 18 years receiving any influenza vaccine (LAIV/IIV) during the 2024/25 season. Beta regression assessed the association between LAIV availability and VCR, considering 27 covariates via two approaches: least absolute shrinkage and selection operator regression (Model 1); and literature-informed covariate selection (Model 2). Subanalyses assessed the association between LAIV availability (available versus none) and VCR, adjusting for vaccine funding structure (public: full, public: partial [funding restricted to specific age or high-risk groups], or private). RESULTS: Among 36 countries, 20 (55.6%) offered IIV and 16 (44.4%) offered LAIV and IIV. Median pediatric influenza VCR across all countries was 11.1%. VCR was higher in countries with publicly funded LAIV programs versus those offering only IIV in both analyses. In the subanalysis, the odds of influenza vaccination were higher in settings with public LAIV availability versus no LAIV availability (Model 1: odds ratio [OR] 2.66, 95% confidence interval [CI] 1.37-5.15; Model 2: OR 1.87, 95% CI 0.66-5.29). CONCLUSIONS: Higher pediatric influenza VCR was observed in settings with publicly funded access to LAIV. This positive association was directionally consistent regardless of vaccine funding structure.