TY - JOUR T1 - Influenza vaccination: protecting the most vulnerable JF - European Respiratory Review JO - EUROPEAN RESPIRATORY REVIEW DO - 10.1183/16000617.0258-2020 VL - 30 IS - 159 SP - 200258 AU - Alex R. Tanner AU - Robert B. Dorey AU - Nathan J. Brendish AU - Tristan W. Clark Y1 - 2021/03/31 UR - http://err.ersjournals.com/content/30/159/200258.abstract N2 - Influenza virus infection causes seasonal epidemics and occasional pandemics, leading to huge morbidity and mortality worldwide. Vaccination against influenza is needed annually as protection from constantly mutating strains is required. Groups at high risk of poor outcomes include the elderly, the very young, pregnant women and those with chronic health conditions. However, vaccine effectiveness in the elderly is generally poor due to immunosenescence and may be altered due to “original antigenic sin”. Strategies to overcome these challenges in the elderly include high-dose or adjuvant vaccines. Other options include vaccinating healthcare workers and children as this reduces community-level influenza transmission. Current guidelines in the UK are that young children receive a live attenuated nasal spray vaccine, adults aged >65 years receive an adjuvanted trivalent inactivated vaccine and adults aged <65 years with comorbidities receive a quadrivalent inactivated vaccine. The goal of a universal influenza vaccine targeting conserved regions of the virus and avoiding the need for annual vaccination is edging closer with early-phase trials under way.To protect the elderly from influenza, multiple strategies to overcome immunosenescence need to be utilised, such as improving vaccine efficacy, indirect protection via vaccinating children and healthcare workers, and developing a universal vaccine https://bit.ly/30KXzYn ER -