Flu Shot Vs Nasal Spray: Which Vaccine Is Better This Year
The messaging couldnt be more clear: Everyone who is over the age of 6 months and able should get the flu vaccine this year. But while the Centers for Disease Control and Prevention and other public health officials have stressed the importance of getting vaccinated against the flu this fall, there hasnt been a lot of discussion about which kind to get.
There are several types of flu vaccines, but they can generally be grouped into two categories: the shot and the nasal spray. Each is slightly different, and its understandable to have questions about which is right for you. Heres what you need to know.
What is the difference between the flu shot and the nasal spray vaccine?
There are actually several. At a very basic level, the flu shot is given with a needle in your arm while the nasal spray vaccine is misted into your nose. But the differences dont end there.
The flu shot uses an inactivated version of the flu to stimulate your immune system, while the nasal spray vaccine uses an attenuated live virus, the CDC explains. While both vaccines may cause flu-like side effects, neither vaccine can actually give you the flu, Dr. William Schaffner, an infectious disease specialist and professor at the Vanderbilt University School of Medicine, tells Yahoo Life.
There are different forms of the flu shot, but many people under the age of 65 will receive the quadrivalent flu shot. Thats designed to protect against the following strains, per the CDC:
How Effective Is The Nhs Flu Immunisation Programme
The flu vaccine works better in some years than others . In children aged 2-17, the flu vaccine prevented 66% of flu cases in 2016-17, 27% of flu cases in 2017-18, 49% of flu cases in 2018-19 and 45% of flu cases in 2019-20 .
The aim is to protect children and also people around them, particularly those at risk of complications of flu. If children get flu they can remain infectious for longer than adults , and they are also more likely to pass on the infection. There is good evidence to show that vaccinating children against flu is a good way to reduce flu-related illness, GP visits, hospital admissions and deaths for the whole community.
Overall, since the programme began, the impact of the nasal flu vaccine has been greatest in pilot areas of the UK where children in all primary school years have been offered vaccination. This includes the whole of Scotland and Northern Ireland. In 2015 Public Health England published a study evaluating the impact of these flu vaccination pilot programmes in 2014-15 . The study showed that the programme in the pilot areas had a significant impact on flu in children and the community as a whole.
As well as offering the nasal flu vaccine to all primary school children, Scotland and Northern Ireland had higher rates of vaccine uptake than England.
Side Effects In Children
Side effects in toddlers, children, and teenagers were very similar to side effects that occurred in adults. However, children also experienced fever higher than 100°F and belly pain.
Children younger than age 5 years with a history of wheezing or asthma may be at an increased risk of developing wheezing after receiving FluMist. So if your child has had asthma or wheezing that keeps returning, their doctor may recommend that they receive a flu shot instead of FluMist. Getting a flu shot shouldnt raise their risk of wheezing.
If your child does receive the FluMist vaccine, their doctor may monitor them afterward to treat any wheezing that occurs.
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Alternatives For Preventing The Flu
Examples of other vaccines that may be used to help prevent the flu include:
- trivalent, high-dose flu shot
- quadrivalent flu shot made in eggs
- quadrivalent flu shot, egg-free
You may wonder how FluMist compares with other vaccinations that are for similar uses. Here we look at how FluMist and Fluzone are alike and different.
The Flu Vaccine Is Affordable And Convenient

The flu vaccine has never been easier to get.
- You don’t have to wait in long lines or make a future appointment — the flu vaccine can be found at most independent pharmacies and major retailers such as Costco, CVS, Target, Walgreens, and Walmart.
- Your primary care doctor may offer them, too.
- Drive-through vaccination sites may be available call your local pharmacy.
Across the country, most pharmacists are now licensed to immunize, meaning they can give you the vaccine with little waiting. In addition, pharmacies or clinics will accept insurance for the vaccine which results in little or no copay to you.
If you have don’t have insurance, check to see if your local or state health clinic or employer is offering free vaccines. Even if you have to pay, the average $30-$50 cash price is well worth the price.
College students and others living in close quarters are especially susceptible to the flu, just like COVID-19. Students may be offered the flu vaccine at little to no cost in the campus clinic. College students should make it a priority to get their flu vaccine each fall.
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Information For Patients And Their Caregivers
Flumist®
Please read this Patient Information carefully before you or your childis vaccinated withFlumist.
This is a summary of information about Flumist. It does not take the place of talking with your healthcare provider about influenza vaccination. If you have questions or would like more information, please talk with your healthcare provider.
What is Flumist?
Flumist is a vaccine that is sprayed into the nose to help protect against influenza. It can be used in children, adolescents, and adults ages 2 through 49. Flumist may not prevent influenza in everyone who gets vaccinated.
Who should not get Flumist?
You should not get Flumist if you:
- are allergic to eggs, gentamicin, gelatin, or arginine
- have ever had a life-threatening reaction to influenza vaccinations
- are 2 through 17 years old and take aspirin or medicines containing aspirin
Please talk to your healthcare provider if you are not sure if the items listed above apply to you or your child.
Children under 2 years of age should not get Flumist because there is a chance they may wheeze after getting Flumist.
Whomaynotbe able toget Flumist?
Tell your healthcare provider if you:
- are currently wheezing
- are pregnant or nursing
- are taking Tamiflu®, Relenza®, amantadine, or rimantadine
If you or your child cannot take Flumist you may still be able to get an influenza shot. Talk to your healthcare provider about this.
How is Flumist given?
What are thepossibleside effects of Flumist?
- runny or stuffy nose
Hate Shots You’re Not Alone
Please do not skip the flu vaccine just because you hate getting a shot. You are not alone – rougly 1 in 4 adults were shown to have a fear of needles in one survey. There are other options.
- FluMist Quadrivalent is a needle-free vaccine that is sprayed in the nose. It is approved for children and adults ages 2 to 49 years, but there are certain groups that can’t use FluMist, so check with your doctor.
Afluria Quadrivalent from Seqirus can be used with the Stratis needle-free jet injector.
- Anyone 18 through 64 years of age who can get Afluria may ask for needle-free Afluria, but check with your doctor, clinic, or pharmacy to be sure they have the jet injector first. It’s not necessarily pain-free, but the shot creates a narrow stream of fluid that goes through the skin, without a needle, given in one-tenth of one second.
- Children 6 months through 17 years and adults 65 and older should receive Afluria Quadrivalent only by needle and syringe.
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During Past Flu Seasons
The CDC tracks seasonal flu vaccine effectiveness each year. Over the past 17 years, the highest effectiveness was in the 2010-2011 season when it was 60% effective.
Here are the effectiveness rates over the past five seasons for which data are available:
- 20152016: 48%
Who Should Not Get The Nasal Spray Flu Vaccine
Some people should not get the nasal spray flu vaccine:
- Children younger than 2 years old
- Adults 50 years and older
- People with a history of severe allergic reaction to any ingredient of the vaccine or to a previous dose of any flu vaccine
- Children 2 through 17 years old who are receiving aspirin- or salicylate-containing medications.
- Children 2 through 4 years old who have asthma or who have had a history of wheezing in the past 12 months
- People with weakened immune systems from any cause
- People who care for severely immunocompromised persons who require a protected environment
- People without a spleen, or with a non-functioning spleen
- Pregnant people
- People with an active leak between the cerebrospinal fluid and the mouth, nose, ear, or other place within the skull
- People with cochlear implants
- People who have taken flu antiviral drugs within a certain amount of time.
In addition, the following medical conditions are precautions to the use of the nasal spray flu vaccine:
- Asthma in people 5 years and older.
- Other underlying medical conditions that can put people at higher risk of serious flu complications. These include conditions such as lung disease, heart disease , kidney disease , kidney or liver disorders, neurologic/neuromuscular, or metabolic disorders. People at Higher Risk of Developing FluRelated Complications.
- Moderate or severe acute illness with or without fever.
- Guillain-Barré Syndrome within 6 weeks following a previous dose of flu vaccine.
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Offer Fierce Protection Backed By Years Of Vaccine Effectiveness Data1
FLUMIST QUADRIVALENT and IIV vaccine effectiveness data overlapped for all strains, demonstrating the general VE comparability during the seasons between 2016 and 20202-4*
*There are no head-to-head clinical studies comparing LAIV4 and IIV. Results are descriptive only.
Unadjusted estimates.
IIV=inactivated influenza vaccine LAIV4=quadrivalent live attenuated influenza vaccine VE=vaccine effectiveness.
FLUMIST QUADRIVALENT efficacy
The effectiveness of FLUMIST QUADRIVALENT is based on data demonstrating1:
- Clinical efficacy of trivalent FluMist® in children and the efficacy of trivalent FluMist in adults
- A comparison of postvaccination geometric mean titers of hemagglutination inhibition antibodies between individuals receiving trivalent FluMist and FLUMIST QUADRIVALENT
- Clinical experience with trivalent FluMist is relevant to FLUMIST QUADRIVALENT because both vaccines are manufactured using the same process and have overlapping composition
Was Flumist Discontinued At Some Point
Yes, FluMist wasnt available during the 20162018 flu seasons. The CDC recommended against using FluMist at that time because studies showed that the vaccine was only about 3% effective from 20132016.
However, in 2018, the manufacturer of FluMist changed the vaccine so that it would be more effective. With that change, the CDC began to recommend FluMist as an option for flu vaccination in 2019. However, there was a limited supply of the vaccine available during the 20192020 flu season due to a manufacturing shortage.
FluMist is currently approved for the 20202021 flu season for use in children and adults ages 2 to 49 years. If you have questions about whether FluMist is right for you, talk with your doctor. You can also refer to CDC recommendations in the How FluMist is given section above.
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Who Is The Nasal Flu Vaccine Good For
The nasal flu vaccine is approved for use in healthy people who arent pregnant and are between the ages of two and 49, per the CDC. But there is a laundry list of health conditions that can keep you from being eligible for this flu vaccine .
Its sort of a niche vaccine, given that there are so many contraindications, Dr. Russo says. But it can be helpful for people who have a needle phobia.
While adults can get the nasal flu vaccine, most tend to opt for the shot. Generally, the nasal flu vaccine is more often given to kids, says Richard Watkins, M.D., an infectious disease physician and professor of internal medicine at the Northeast Ohio Medical University.
Can I Receive The Flumist Vaccine If I Have Or Think I Have Covid

No. You shouldnt receive the FluMist vaccine if you have or think you have COVID-19.
If you have COVID-19, your doctor has likely told you to self-isolate . In this case, you shouldnt go out to receive the FluMist vaccine. Once your doctor has told you that youre no longer able to transmit COVID-19 to others, you can ask your doctor if FluMist is right for you.
If you think you have COVID-19, talk with your doctor. They can recommend the right testing for you. If the tests show that you dont have COVID-19, your doctor may say that you can get FluMist or a flu shot.
If you have questions about FluMist or COVID-19, talk with your doctor.
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Study In Adults With Human Immunodeficiency Virus Infection
Safety and shedding of vaccine virus following Flumist administration were evaluated in 57 HIV-infected and 54 HIV-negative adults 18-58 years of age in a randomized, double-blind, placebo-controlled trial using the frozen formulation. No serious adverse events were reported during the one-month follow-up period. Vaccine strain virus was detected in 1 of 28 HIV-infected subjects on Day 5 only and none of the HIV-negative Flumist recipients. No adverse effects on HIV viral load or CD4 counts were identified following Flumist. The effectiveness of Flumist in preventing influenza illness in HIV-infected individuals has not been evaluated.
Can Nasal Spray Flu Vaccine Give Me Flu
Flu vaccines do not cause flu illness. The nasal spray flu vaccine contains weakened viruses, so that they will not cause flu illness. The weakened viruses are cold-adapted, which means they are designed to only multiply at the cooler temperatures found within the nose, and not the lungs or other areas where warmer temperatures exist.
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Early Fall Is The Perfect Time
Flu season can start early, and it takes about two weeks after receiving your vaccine for the full antibody effect to develop and provide flu protection. Thatâs why itâs better to get vaccinated in the fall, before the end of October ideally, before the flu season really kicks in. Flu vaccines are usually available by mid-September in most years.
But it’s never too late to get the flu vaccine if you miss out in the fall. Seasonal influenza disease usually peaks in January and February most years, but can occur late or early. This year, the CDC notes that flu season could be early due to low circulating virus and immunity from 2020, most likely due to protective measures from the COVID pandemic.
Be sure to get re-vaccinated each fall.
History Has Proven: The Flu Is A Monster
If you’ve ever had the flu, you know it’s not your average virus. The illness can land you flat on your back and its effects can span 2 weeks or longer. Now, with COVID in the mix, it’s even more of a concern.
For children under two, seniors, and people with chronic health conditions like:
the flu can be especially severe or even fatal. Dehydration, worsening of health conditions, and pneumonia are just a few of the possible complications.
And, NO, the flu vaccine CANNOT cause the flu . The vaccine is made up of inactivated or weakened viruses that have no ability to infect the lungs.
So, go on — you’re out of excuses — fight off the monster known as the flu today and get your vaccine.
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Reasons To Consider Getting A Flu Vaccine
The flu vaccine significantly reduces the risk of contracting the flu. Consider the 20192020 season: People who had the vaccine were 39% less likely to get the flu than those who did not.
In addition to preventing illness, the flu vaccine also reduces the risk of hospitalization and death. Heres what researchers have found about the flu vaccine:
- Getting the vaccine reduces the risk of intensive-care unit hospitalization by 26% and the risk of death by 31%, according to a 2021 study.
- Among adults who are hospitalized for the flu, people who are vaccinated are 59% less likely to need intensive care unit care, according to a 2018 study.
- People with heart disease who get the vaccine are less likely to experience cardiac events.
- People with diabetes and chronic lung disease who get the vaccine are less likely to be hospitalized for those conditions.
- Pregnant people who get the vaccine are 40% less likely to be hospitalized for flu than pregnant people who did not get the vaccine.
In addition to protecting you, getting the flu vaccine can keep you from contracting the flu and passing it to others, including infants and the elderly, who are at higher risks for complications.
Pregnant people who get the vaccine help protect their baby from the flu , which can be valuable during the first six months of life when a child is not able to be vaccinated.
Flu Vaccine Efficacy Factors
There are a number of factors that influence how effective the flu vaccine is every year. The most important is strain matchingwhether the strains that the vaccine protects against match the most widely circulating flu strains during a given season.
In addition to the construction of the vaccine, there are more personal factors that influence vaccine effectiveness.
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How Effective Is It
Flu vaccine effectiveness can change from year to year. At the time of writing this article, the 20202021 flu season is underway. In the coming months, scientists will begin to get estimates of the effectiveness of the 20202021 flu vaccine.
However, the does currently have information about the estimated effectiveness of the vaccines from past flu seasons.
The chart below shows the effectiveness of the flu vaccine for the previous five flu seasons.
Flu season |
26 percent | 42 percent |
When looking at vaccine effectiveness studies, its important to remember that the results can be influenced by several factors. These factors can include the population studied, the specific flu season, and how the study was conducted.