Why was the live attenuated influenza vaccine (LAIV) removed from the ACIP's recommendations?

The live attenuated influenza vaccine (LAIV) was removed from the Advisory Committee on Immunization Practices (ACIP) recommendations primarily due to its lower than expected efficacy against influenza, particularly during certain seasons. Studies indicated that the effectiveness of LAIV in preventing influenza was not meeting the desired thresholds, especially in specific age groups and during particular influenza seasons. This decline in efficacy led to concerns about its overall ability to provide adequate protection to those vaccinated, prompting the committee to reassess and subsequently recommend against its use in favor of more effective alternatives, such as the inactivated influenza vaccine (IIV). As a result, the removal aimed to enhance the overall effectiveness of influenza vaccination strategies in the population.