Unlike American recommendations, Health Canada recommendations are based on more recent studies. Many studies have demonstrated the efficacy and the safety of using LAIV in a population of moderately to severely but stable asthmatic individuals. In 2003, Flemming et al[20 ] demonstrated in 2000 asthmatic children and adolescents a better efficacy of LAIV as well as an asthma exacerbation rate similar to TIV. Furthermore, Redding et al[21 ] studied the safety of LAVI in 1997 with 48 patients between 9 to 17 years old with moderate to severe but stable asthma. The percentage of change in forced expiratory volume (FEV1) evaluated up until the fifth day was similar between the vaccinated and the placebo group (0.2% versus 0.4%, p=0.78).