Which vaccines are live‑attenuated and which are non‑live (inactivated)?

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Last updated: November 9, 2026 • View editorial policy

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Live vs Non‑Live (Inactivated) Vaccines

• Live‑attenuated vaccines: MMR, Varicella (chickenpox), Live zoster (Zostavax), Yellow fever, BCG, Oral polio (OPV; no longer routine in many countries), Oral Typhoid Ty21a, Rotavirus, Live attenuated influenza (LAIV; intranasal). 1

• Non‑live (inactivated/recombinant/subunit/toxoid) vaccines: Inactivated influenza (injectable), Pneumococcal (PCV, PPSV23), Tetanus‑diphtheria‑pertussis (Td/Tdap), Hepatitis A, Hepatitis B, HPV, Injectable polio (IPV), Meningococcal (ACWY, B), Haemophilus influenzae type b (Hib), COVID‑19 (mRNA, protein‑subunit, or non‑replicating viral‑vector), Recombinant zoster (Shingrix), Injectable typhoid Vi. 2, 3, 4, 1

How to use this (to protect morbidity, mortality, QoL)

  • If immunosuppressed: give non‑live vaccines routinely; avoid live vaccines or schedule them ≥4 weeks before immunosuppression; consider rare exceptions (e.g., MMR or live zoster in carefully selected low‑level immunosuppression) only with caution due to infection risk and limited evidence 1, 3, 2.
  • Prefer injectable inactivated influenza over intranasal LAIV in immunosuppressed patients; avoid household exposure concerns given extremely low transmission risk reported 1.

References

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