NCIRS experts hopeful success of LAIV programs overseas can be replicated in Australia

NCIRS experts have contributed to new perspective – published in the Medical Journal of Australia (MJA) – outlining   the potential for the newly introduced intranasal live attenuated influenza vaccine (LAIV) to help reverse Australia’s persistently low childhood influenza vaccination rates.

Despite the high burden of influenza in children in Australia, vaccination coverage remains low and inadequate to control disease at a population level. In 2025, less than a third of children (27.9%) aged 6 months to less than 5 years received an influenza vaccine, even though the vaccine is available free under the National Immunisation Program. Coverage in children aged 5 to less than 10 years and 10 to less than 20 years was even lower at 16.4% and 13.9%, respectively.
 

LAIV program success in the northern hemisphere

While new in Australia, LAIV has been used for more than 20 years in the northern hemisphere. Its use has led to substantial increases in influenza vaccination coverage and associated impacts, including reduced influenza hospitalisations and influenza-like presentations in primary care – both directly in the vaccinated population and indirectly in the broader population. 

In the United Kingdom – where LAIV is publicly funded for all children – influenza vaccine uptake in children increased from below 20% before the introduction of the LAIV program to 30–60% across most age groups, with even larger gains observed when delivered through school-based programs. 

Higher coverage was also achieved in Northern Ireland and Scotland, uptake of LAIV ranging from 45–60% when delivered through primary care programs and up to 60–80% when delivered through school-based programs.

Importantly, these gains have been maintained over multiple influenza seasons and substantially exceed coverage levels previously achieved using traditional inactivated (injectable) influenza vaccines (IIVs). 

The authors note that the introduction of LAIV in Australia offers a practical option to address barriers to childhood vaccination and to support broader community protection in Australia.
 

LAIV effectiveness and safety profile positive

Evidence from real world and randomised studies shows LAIV is as effective as traditional IIV in preventing severe influenza disease in children, with year-to-year variations in vaccine effectiveness driven largely by strain match. 

LAIV safety data are also positive. Mild nasal symptoms are the most commonly reported short term adverse events following immunisation and studies have shown no increased risk of wheeze or asthma exacerbation among children aged 2 years and over – regardless of asthma status.
 

Looking forward in Australia

The introduction of LAIV in Australia offers an opportunity to improve childhood influenza vaccination through both primary care and more scalable delivery models. Early evaluation of its uptake, effectiveness, coverage and equitable access is needed to guide future policy and program design. 

Demonstrating clear benefits, strong acceptability and reduced disease burden associated with LAIV uptake may help strengthen the case for expanding funded influenza vaccination to all children aged less than 18 years, the authors concluded.

LAIV is currently registered in Australia for children aged 2 to less than 18 years who are not contraindicated. It is available nationwide for a fee via private prescription and is offered for free in New South Wales, Queensland, South Australia and Western Australia for selected age groups through state- and territory-funded programs. IIVs are funded for children less than 5 years of age and remain available for those who are ineligible for LAIV or prefer an injectable option.

Read the MJA perspective

Visit the NCIRS influenza resources