Influenza vaccines for immunocompromised persons – a scoping review of the literature
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2026
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Abstract
Abstract Introduction Second-generation influenza vaccines include high-dose inactivated vaccine, recombinant vaccine and MF-59 adjuvanted inactivated vaccine. In 2022, the US Advisory Committee on Immunization Practices issued a preferential recommendation for second-generation vaccines in adults ≥65 years. A substantial proportion of immunocompromised individuals <65 years may be insufficiently protected by first generation, standard dose inactivated influenza vaccines. This scoping review assessed evidence on the immunogenicity, efficacy, effectiveness, and safety of influenza vaccines in immunocompromised populations to potentially inform public health decision-making and identify research gaps for improved influenza control. Methods In May 2026, we searched MEDLINE for studies published since 2014 that reported on vaccine effectiveness, efficacy, and immune response to influenza vaccination in immunocompromised individuals. Outcomes related to immunogenicity, clinical protection, and safety were assessed for both first- and second-generation vaccines. Results Our search strategy identified 1,239 articles, of which 112 met inclusion criteria. Among these, 69 were on first-generation, standard dose influenza vaccines, 31 on second-generation vaccines and 12 included both generations. Most studies (86%) reported immunogenicity data, while only 19% reported efficacy of effectiveness results. Few studies reported higher immunogenicity with second-generation vaccines and following a booster dose. Current evidence of second-generation influenza vaccine effectiveness was limited and inconsistent. No safety concerns were reported in immunosuppressed persons with first- and second-generation influenza vaccines. Conclusions We describe current evidence on influenza vaccine response, vaccine effectiveness and vaccine safety in immunocompromised persons. The review highlights the lack of evidence supporting enhanced effectiveness of second-generation influenza vaccines in immunocompromised persons, although immunogenicity data and data from non-immunocompromised population support their potential benefits among immunocompromised persons <65 years.
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openalex_W7164492616
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| Authors | Charles-Antoine Guay, Brendan Flannery, Manish Patel |
| Journal | Open forum infectious diseases |
| Year | 2026 |
| DOI |
10.1093/ofid/ofag360
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| URL | |
| Keywords | Keywords not found |
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