Improving Influenza Vaccine Uptake in Low- and Lower-Middle-Income Countries: A Synthesis of Interventions and Strategic Recommendations.

Seasonal influenza continues to impose a significant health and economic burden on low- and lower-middle-income countries (LLMICs), where vaccine uptake remains critically low. Despite proven benefits of vaccination, the implementation of successful influenza vaccination strategies in these regions is hindered by a complex interplay of multiple barriers, including limited resources, evidence gaps, infrastructural challenges, and socio-cultural factors. Although lessons from high-income countries offer valuable insights, their direct application in resource-constrained settings without contextual adaptation is often ineffective. Exploring the underlying barriers and developing successful interventions tailored to the unique realities of LLMICs is critical, as influenza poses a threat for the next potential pandemic. Multifaceted strategies incorporating culturally informed and risk group-specific interventions, including healthcare provider engagement for vaccine recommendations, promoting local research, leveraging existing platforms, strengthening surveillance systems, and fostering international and domestic support, can facilitate inclusive evidence-based policymaking.