Feasibility of age- and gestation-based routine universal influenza vaccines schedules for children aged 6 months - 2 years and pregnant women

T K N Sandra Dang, Romén Rivero Cabrera, Karene Hoi Ting Yeung*, Ingeborg M van der Putten, E Anthony S Nelson

*Corresponding author for this work

Research output: Contribution to journalArticleAcademicpeer-review


BACKGROUND: Hong Kong's seasonal influenza schedule follows the World Health Organization's northern hemisphere vaccine composition recommendations but with year-round influenza activity there is the potential to implement routine age- and gestation-based schedules utilising both northern and southern hemisphere vaccines for children aged 6 months to 2 years and for pregnant women. This study assessed the potential feasibility of such schedules.

METHODS: A literature review was conducted and in-depth interviews with vaccine experts, policy makers and nurses were undertaken.

RESULTS: The following schedules were proposed and assessed for perceived feasibility: 1) a four-dose schedule in the first two years of life requiring an additional unscheduled clinic visit at 7 months; 2) a three-dose schedule excluding the 4-week booster after the first dose; 3) a two-dose schedule for pregnant women involving a dose at the booking visit and a dose with pertussis vaccine at 7 months gestation; and 4) a one-dose schedule at 7 months gestation.

CONCLUSIONS: Age- and gestation-based routine influenza vaccination schedules are theoretically feasible for both young children and pregnant women. The three-dose paediatric and one-dose obstetric schedules were assessed in interviews with vaccine experts, policy makers and nurses to be most acceptable. Further clinical studies are required to determine whether such schedules are non-inferior to current seasonal-based schedules in terms of vaccine effectiveness and vaccine uptake.

Original languageEnglish
Pages (from-to)6754-6761
Number of pages8
Issue number46
Publication statusPublished - 5 Nov 2021


  • Influenza
  • Immunisation
  • Vaccination schedule
  • Year-round
  • Young children
  • Pregnancy
  • High income countries
  • Antenatal care
  • Hong Kong

Cite this