• Justin R Ortiz and Kathleen M Neuzil.
• a Center for Vaccine Development and Global Health, University of Maryland School of Medicine , Baltimore , MD , USA.
• Expert Rev Vaccines. 2019 Jul 1; 18 (7): 711-724.

AbstractIntroduction: Influenza vaccines are safe and effective, yet they are infrequently used in low- and middle-income countries (LMICs). Areas covered: We examine influenza vaccine programs for children from within a framework of new vaccine adoption in LMICs. We review the available evidence on disease burden and vaccine introduction, the current global and financing policies, and the current status of vaccine availability, and country readiness for implementation. Expert commentary: Access to appropriate formulations of influenza vaccines and existing immunization infrastructures must be strengthened if influenza vaccine programs are to be expanded in LMICs. While WHO recommends that implementation of influenza vaccine programs should be a country decision based on national goals, capacities, and data review, vaccine decision makers from many LMICs will likely need more evidence to inform the value proposition of program investment for pediatric vaccination, particularly related to alternative immunization strategies that align with current vaccine delivery platforms, anticipated program impact on severe illness endpoints, and program costs and economic benefits. Targeted research and development to address the specific needs of LMICs may be needed to demonstrate the value proposition of influenza vaccines and to expand influenza vaccine programs in these settings.

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