How does vaccine efficacy/effectiveness (VE) compare between live attenuated vaccine and inactivated vaccine?

Few studies directly comparing LAIV and IIV have been done, and results appear to differ for adults versus children. A randomized, placebo-controlled trial among 876 healthy adults 18-46 years old found overall VE of 75% for IIV, which was statistically significant, and 48% VE for LAIV, which was not statistically significant in a year with a drifted strain (Ohmit NEJM 2006). However, a small randomized, double-blind, placebo-controlled challenge study among 92 healthy adults (LAIV, n = 29; placebo, n = 31; inactivated influenza vaccine, n = 32) aged 18-41 years found overall efficacy of LAIV and inactivated influenza vaccine in preventing laboratory-documented influenza of 85% and 71%, respectively (Treanor et al.

, Vaccine 1999;18:899--906.). The difference in efficacy between the two vaccines was not statistically significant. However, in 3 studies among children where inactivated vaccine was compared with a refrigerator-stable experimental form of the LAIV, referred to as CAIV-T, ... more.

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