a-t 2016; 47: 96

STIKO suspends its preferential recommendation for nasal influenza vaccine (FLUENZ TETRA) in children: The German Standing Committee on Vaccination (STIKO) recommends vaccination against influenza for children and adolescents whose health is at increased risk due to an underlying disease. Since 2013, the intranasal live vaccine (FLUENZ TETRA) should be preferred for two to six year-olds as it proved more effective than conventional inactivated vaccines against laboratory-confirmed influenza (a-t 2013; 44: 110). However, according to US observational data, the intranasal vaccine has proved to be largely ineffective in recent years, especially against A/H1N1 influenza viruses. In the USA it has therefore been recommended not to use this vaccine for the 2016/17 season (a-t 2016; 47: 72). STIKO is now also changing its advice: Nasal and conventional vaccines are recommended to the same extent for the coming season, as there is currently no evidence to suggest that the nasal vaccine is more effective (1). Alongside the US results, other observational data from Lower Saxony and Saxony-Anhalt show a lack of protection by the live vaccine in the 2015/16 season against the prevailing A/H1N1 type virus in two to six year-olds (effectiveness -13%; 95% confidence interval [CI] -178-54), whilst conventional vaccines proved effective (effectiveness 91%; 95% CI 33-99) (2). Studies conducted in Finland and Great Britain on the 2015/16 season indicate somewhat higher immunisation against Influenza A or H1N1 viruses by the nasal vaccine (47.9% and 41.5%, respectively). However, all studies confirm less effectiveness compared to inactivated vaccines (3). We continue to advise against the intranasal vaccine due to a lack of adequate evidence of efficacy and safety, - Ed.