This parallel randomised controlled trial examined the effect of a 4-week, high dose (Lf-High, 600mg/d) or low dose (Lf-Low, 200mg/d) oral lactoferrin (Lf) intervention versus placebo, on immune cell responses to respiratory virus, circulating immune cell subsets, and systemic inflammation. In healthy older adults (n=103, ≥50 years old), ex vivo cytokine release of interferon (IFN)-α2, IFN-γ, interleukin (IL)-6, and tumour necrosis factor (TNF)-α from isolated peripheral blood mononuclear cells (PBMCs) stimulated with rhinovirus A-16 (RV-16) or influenza A virus (H1N1), circulating immune cell subsets, and plasma IL-6, C-reactive protein (CRP) and TNF-α were assessed at baseline and 4 weeks. Ninety-seven participants completed the intervention (Lf-High n=32, Lf-Low n=31, placebo n=34, withdrawals n=6). There was no difference in RV-16 or H1N1-induced IFN-γ release between groups. At 4-weeks, RV-16-induced IL-6 was lower in Lf-High compared to placebo (P=0.001), and RV-16-induced IFN-α2 was higher in Lf-High compared to Lf-Low (P=0.04). Lf-High increased total T cells (P=0.03) and CD4+ T cells (P=0.03) compared to placebo. Lf-Low reduced neutrophil (P=0.04), natural killer cell (P=0.045), activated CD8+ T cell (P=0.03), and γδ T cell (P=0.03) frequency compared to placebo. Plasma IL-6 (P=0.004) and CRP (P=0.03) were lower following Lf-High compared to Lf-Low, but not placebo. Both high and low dose lactoferrin altered ex vivo immune cell responses after 4 weeks. High dose lactoferrin increased T-cell subsets, promoting adaptive immunity, and reduced systemic inflammation, while low dose lactoferrin reduced proinflammatory and cytotoxic immune cells. High and low dose lactoferrin supplements may have immunoceutical benefits in older adults.