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A quadrivalent live attenuated influenza vaccine (LAIV4) is a needle-free, intranasal vaccine designed to protect against four different influenza virus strains: two influenza A subtypes (H1N1 and H3N2) and two influenza B lineages (Victoria and Yamagata). Unlike inactivated vaccines, LAIV contains weakened (attenuated) viruses that are cold-adapted and temperature-sensitive, allowing them to replicate in the cooler environment of the nasopharynx but not in the warmer lower respiratory tract. This modality induces both mucosal and systemic immunity, mimicking natural infection without causing disease. The most prominent commercial version is FluMist (developed by MedImmune/AstraZeneca). It is typically indicated for healthy individuals aged 2 to 49 years.
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