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Groups at high risk of poor outcomes include the elderly, the very young, pregnant women and those with chronic health conditions. However, vaccine effectiveness in the elderly is generally poor due to immunosenescence and may be altered due to \u201coriginal antigenic sin\u201d. Strategies to overcome these challenges in the elderly include high-dose or adjuvant vaccines. Other options include vaccinating healthcare workers and children as this reduces community-level influenza transmission. Current guidelines in the UK are that young children receive a live attenuated nasal spray vaccine, adults aged &gt;65\u2005years receive an adjuvanted trivalent inactivated vaccine and adults aged &lt;65\u2005years with comorbidities receive a quadrivalent inactivated vaccine. The goal of a universal influenza vaccine targeting conserved regions of the virus and avoiding the need for annual vaccination is edging closer with early-phase trials under way.<\/jats:p>","DOI":"10.1183\/16000617.0258-2020","type":"journal-article","created":{"date-parts":[[2021,3,9]],"date-time":"2021-03-09T15:55:18Z","timestamp":1615305318000},"page":"200258","update-policy":"https:\/\/doi.org\/10.1183\/ers-crossmark-policy","source":"Crossref","is-referenced-by-count":96,"title":["Influenza vaccination: protecting the most vulnerable"],"prefix":"10.1183","volume":"30","author":[{"ORCID":"https:\/\/orcid.org\/0000-0002-2492-6487","authenticated-orcid":false,"given":"Alex R.","family":"Tanner","sequence":"first","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-5257-7333","authenticated-orcid":false,"given":"Robert B.","family":"Dorey","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Nathan J.","family":"Brendish","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-6026-5295","authenticated-orcid":false,"given":"Tristan W.","family":"Clark","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"81","published-online":{"date-parts":[[2021,1,13]]},"reference":[{"key":"2021030907551108000_30.159.200258.1","unstructured":"World Health Organization. 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