Abstract

Abstract Background During the 2010–2021 influenza seasons, vaccination coverage was below the 70% target for the United States at 33.4–58.6% among children and 50.2% among adults.[1, 2] The live attenuated influenza vaccine (LAIV) is currently approved for healthcare professional administration (HCPA); however, self- and home-administered LAIVs may provide an additional, effective option for vaccine administration, which could expand seasonal influenza vaccine accessibility. LAIV is a quadrivalent influenza vaccine administered intranasally, with comparable effectiveness to the inactivated influenza vaccine.[3] Broadening vaccine availability to multiple vaccination sites has been shown to increase vaccination rates by up to 22%.[4] Here we summarize the current evidence on self- and home-administered LAIV efficacy and safety, and potential applications for increasing community influenza vaccination accessibility. Methods Publications evaluating the efficacy, safety, and practicality of self- and home-administered LAIV were identified from a literature search with the following search string: (live attenuated influenza vaccine OR LAIV) AND (home administration OR self administration OR self immuni*). Results In three studies comparing LAIV self- and home administration to HCPA (Table), home administration was preferred by 64, 74, and 96% of participants. Sample sizes ranged from 41 children to 4561 patients receiving LAIV, with participants aged between 2.6 and 64 years old. A trial of 4561 patients comparing LAIV self- and home administration to HCPA groups found similar effectiveness against influenza-like illness, immunogenicity, and adverse events post-vaccination. Conclusion Evidence suggests that self- and home-administered LAIV could be safely and effectively offered, and may be preferable for a subset of the population, which could expand seasonal influenza vaccine accessibility.

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