Intranasal Influenza Vaccine

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Abstract
In the United States, national influenza vaccine recommendations have typically been based on the prevention of complications and death among high-risk persons. More recent is the increasing awareness that above and beyond the more severe individual medical consequences of influenza, enormous societal economic costs are associated with disruptions due to school and work absences and days of illness. In this issue of THE JOURNAL, Nichol et al1 report that use of a live, attenuated influenza virus (LAIV) vaccine, administered by intranasal spray to healthy, working adults (a group without a routine recommendation to receive influenza vaccine), was followed in the subsequent influenza epidemic season by a significant reduction in severe febrile illness, days lost from work, health care visits, and the medication use that accompanies these illnesses. Are these findings important? From an individual, medical, and public health point of view, the answer is clearly yes. Reductions in febrile illnesses, defined in various ways, ranged from approximately 13% to 27%, reductions in work days lost from 18% to 28%, and reductions in health care visits from 25% to 41%.