Fact: People With Weakened Immune Systems Are Not Eligible For Flumist Quadrivalent
But others who are in close contact with certain immunocompromised people may still be eligible. The Centers for Disease Control and Prevention , American Academy of Pediatrics , and the Society for Healthcare Epidemiology of America make recommendations for these circumstances.
For example, if you are in contact with someone who has HIV or is receiving chemotherapy, you may still get FLUMIST QUADRIVALENT. However, you should not get FLUMIST QUADRIVALENT if you are in close contact with someone with a severely weakened immune system, such as a person receiving stem cell transplants while they are in isolation.
Study: Flumist Works Better Than Shots In Kids Under 5
May 17, 2006 The intranasal influenza vaccine FluMist proved to be 55% more effective than an injectable vaccine in a phase 3 trial of children aged 6 months to about 5 years, according to a press release from MedImmune, maker of FluMist.
The study, involving 8,475 children at 249 sites in 16 countries, was presented May 1 at the annual meeting of the Pediatric Academic Societies in San Francisco.
Lead author Robert B. Belshe, MD, director of the Center for Vaccine Development at St Louis University, said in the press release, “We discovered that was significantly more effective in protecting children against influenza infection. This is especially important, because this age-group is among the most vulnerable to influenza infection, and they tend to spread influenza to other family members.”
In the news release, MedImmune cited plans to submit its data to the US Food and Drug Administration by the end of June to seek an expansion of FluMist’s indications to include children from 6 months to 5 years of age. It is currently approved for healthy children and adults between 5 and 49 years.
For the strains of influenza that the vaccines were designed for, FluMist was 44% more effective than the injected vaccine . However, FluMist was discovered to be even more effective compared with the injectable vaccine against a variant of the target H3N2 strain that appeared during the flu season studied , according to MedImmune.
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What Is The Nasal Flu Vaccine Exactly
The nasal flu vaccine is a live attenuated vaccine, meaning it contains weakened flu viruses so they wont make you sick, the Centers for Disease Control and Prevention explains. Those weakened viruses are specially designed to only multiply at the cooler temperatures found in your nose and not in your lungs or other areas in your body that are warmer.
Just like the regular flu vaccine, the nasal flu vaccine targets certain strains of influenza that researchers predict will circulate the most during that given year.
This years nasal flu vaccine is a quadrivalent vaccine, meaning it targets four strains of the flu, the CDC says. The 2021-2022 nasal flu vaccine will target the following strains, according to the Food and Drug Administration and CDC:
- an A/Victoria/2570/2019 pdm09-like virus
- an A/Cambodia/e0826360/2020 -like virus
- a B/Washington/02/2019- like virus
- a B/Phuket/3073/2013-like virus
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Flumist Generic Or Biosimilar
FluMist is available only as a brand-name medication. Its not currently available in biosimilar form.
A biosimilar is like a generic. A generic is an exact copy of the active drug in a brand-name medication thats made from chemicals.
A biosimilar, on the other hand, is a drug thats similar to a brand-name biologic drug. Biologics are drugs made using living cells. Because of this, the drugs cant be copied exactly.
Biosimilars have the same safety and effectiveness as the brand-name medication. Usually, a biosimilar drug costs less than the brand-name biologic.
Heres some information on how FluMist compares with a flu shot.
Who Should Have The Nasal Spray Flu Vaccine

The nasal spray flu vaccine is free on the NHS for:
- children aged 2 or 3 years on 31 August 2021 born between 1 September 2017 and 31 August 2019
- all primary school children
- all year 7 to year 11 children in secondary school
- children aged 2 to 17 years with long-term health conditions
If your child is aged between 6 months and 2 years and has a long-term health condition that makes them at higher risk from flu, they’ll be offered a flu vaccine injection instead of the nasal spray.
This is because the nasal spray is not licensed for children under 2 years.
The nasal spray vaccine offers the best protection for children aged 2 to 17 years. They will be offered the flu vaccine injection if the nasal spray vaccine is not suitable for them.
Some children will be offered the injected flu vaccine if they have:
- a severely weakened immune system
- asthma that’s being treated with steroid tablets or that has needed intensive care in hospital
- a flare-up of asthma symptoms and need to use a reliever inhaler more than usual
- had an allergic reaction to a flu vaccine in the past
- a condition that needs salicylate treatment
If you’re not sure, check with the school immunisation team, the nurse or GP at your surgery, or a hospital specialist.
The injected flu vaccine is given as a single injection into the muscle of the upper arm, or the thigh for children under 1 year.
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A Need For Protection
Although FluMist accounts for only 8 percent of total flu vaccine doses, its usage skews heavily toward children a population already more vulnerable to the illness.
Which is why, given the latest news, families should pursue the most effective treatment possible even if a moment of discomfort is involved.
The procedure neednt be traumatic, however.
Its a very, very small needle, Burrows says. Compared to some of the vaccines, the medicine doesnt hurt when it goes in. And its certainly much better than being sick and out of school for a week.
Recipients might expect brief soreness around the injection site, which Burrows says can be eased by moving around or playing outside . Some might experience a low-grade fever in the first 24 hours.
A flu shot wont actually give you the flu a common misnomer, Burrows says.
In a more serious context, the vaccines necessity is underscored by tragic events in recent years: Flu killed 146 children in 2014-15, per CDC data, and about 80 percent of flu-related deaths in children 6 months and older occur in patients who didnt get a flu vaccine.
Who Should Not Get The Flu Shot
Very few children should NOT get a flu shot:
- Babies under 6 months of age. Although the vaccine is not harmful to babies less than 6 months old, it does not work.
- If your child has a serious allergy to thimerosal , a thimerosal-free vaccine should be given.
The influenza vaccine is safe for individuals with an egg allergy.
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Flumist For Preventing The Flu
FluMist is FDA-approved to help prevent influenza caused by the influenza A or influenza B virus. FluMist is for use in children and adults ages 2 to 49 years.
The flu is a contagious viral infection that affects your respiratory system. The flu can be mild or serious, and in rare cases, it can lead to death. Because of the possible risks, its recommended that you receive a flu vaccine each year to help prevent you from getting the flu.
Symptoms of both forms of influenza include:
Effectiveness for preventing the flu
FluMist was studied in a clinical trial of adults ages 18 to 49 years. Researchers followed people in the study over the course of 7 weeks. People who were vaccinated with FluMist were 10.9% less likely to develop an illness with a fever than people who received a placebo. The placebo was a nasal spray that didnt contain the vaccine.
People vaccinated with FluMist were also 23.7% less likely to develop an upper respiratory infection with a fever, compared with people who received a placebo. Upper respiratory infections include the common cold.
FluMist wasnt compared with the flu shot in clinical trials of adults.
Should My Child Get A Flu Shot
Yes. All children over 6 months old should get a flu shot each year.
Babies and children 6 months to 9 years of age who have never had a flu shot will need 2 doses of the vaccine, given at least 4 weeks apart.
Those who have had one or more doses of the regular seasonal flu shot in the past, or children 9 years of age and older, will only need 1 dose per year.
The vaccine is especially important for children and youth who are at high risk of complications from the flu, including those who:
- are between 6 months and 5 years of age.
- have chronic heart or lung disorders serious enough to need regular medical follow-up.
- have chronic conditions that weaken the immune system, such as immune deficiencies, cancer, HIV or a treatment that causes immune suppression.
- have diabetes or other metabolic diseases.
- have chronic kidney disease.
- have to take acetylsalicylic acid on a daily basis.
- live in a chronic care facility.
- live in First Nation or Inuit communities.
- live with another child or adult who is at risk of complications from the flu.
Children under 5 years old are at higher risk of complications from the flu such as high fever, convulsions and pneumonia. If you have children younger than 5 years old or who have health complications, everyone living in the house should get a flu shot. This is especially important if you have children under 6 months old or if a member of your household is pregnant.
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Live Vs Inactive Vaccine
FluMist is a live vaccine. This means that FluMist has live flu viruses in it that have been weakened so that they shouldnt infect you with the flu.
In comparison, flu shots are inactive vaccines that dont have live viruses in them. As a result, flu shots cant cause the flu.
Because FluMist is a live vaccine, you shouldnt get FluMist if you have certain conditions, such as a weakened immune system. If you have a weakened immune system and youre immunized with FluMist, you may become infected with the flu. This is because your immune system may not be strong enough to fight the flu viruses in the vaccine.
If you have any questions about the difference between the FluMist nasal spray and a flu shot, talk with your doctor. They can help you decide which is the best option for you.
How Does The Nasal Flu Vaccine Work
The process of getting the nasal flu vaccine is pretty simple, says infectious disease expert Amesh A. Adalja, M.D., a senior scholar at the Johns Hopkins Center for Health Security. There is a syringe type of device that contains the vaccine, its inserted into your nose, and it mists the vaccine into your nostrils, he says. The person usually sniffs it. This method, he explains, exposes the lining of your nose to the vaccine.
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Should The Nasal Spray Flu Vaccine Be Given To Patients With Chronic Diseases
Nasal spray flu vaccine is not recommended for use in people with some chronic health conditions because the safety and effectiveness of this vaccine in people with those conditions has not been established.
See Prevention and Control of Seasonal Influenza with Vaccines: Recommendations of the Advisory Committee on Immunization PracticesUnited States, 202021 Influenza Season for a list of contraindications and precautions for the nasal spray vaccine
Side Effects And Risks

FluMist and Fluzone both contain vaccines to help prevent the flu. Therefore, these medications can cause very similar side effects, but some different ones as well. Below are examples of these side effects.
Mild side effects
These lists contain up to 10 of the most common mild side effects that can occur with FluMist, with Fluzone, or with both drugs .
- Can occur with FluMist:
Serious side effects
This list contains examples of serious side effects that can occur with FluMist and Fluzone when taken individually:
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Flumist And Other Medications
Below are some of the medications that can interact with FluMist. This section doesnt contain all drugs that may interact with FluMist.
Before taking FluMist, talk with your doctor and pharmacist. Tell them about all prescription, over-the-counter, and other drugs you take. Also tell them about any vitamins, herbs, and supplements you use. Sharing this information can help you avoid potential interactions.
If you have questions about drug interactions that may affect you, ask your doctor or pharmacist.
FluMist and aspirin
Children ages 2 through 17 years who are taking aspirin or medication that has aspirin in it shouldnt get the FluMist vaccine.
FluMist is a live vaccine. This means that FluMist has live flu viruses in it that have been changed so that they shouldnt infect your child with the flu. If your childs immune system is healthy, their body should be able to fight the flu viruses in the vaccine. But if your child has an infection, their immune system may be too weak to fight the vaccines flu viruses.
If your child takes aspirin and is infected with the flu, theres a possible risk of Reyes syndrome. This is a rare but very serious disease that affects the brain and liver. Its not known exactly what causes Reyes syndrome. However, children who are recovering from an infection are usually at the highest risk for Reyes syndrome. And there may be a link between children who take aspirin for a viral infection and developing Reyes syndrome.
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Flu Shot Vs Flumist: Which Is Better For Your Child
Each year, many children get sick with the flu some are hospitalized and some die. Young children are the most likely to get sick with the flu. Children younger than 5 years are at high risk of getting serious flu complications. Vaccinating your child is the best way to protect them.
This summer, the Centers for Disease Control released new data from a study comparing flu shots and nasal sprays. Their research found that the nasal spray prevented 50 percent more flu cases than the flu shot in children 2 to 8, and the CDC now recommends that healthy children in this age group be vaccinated with the nasal spray when its available.
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All nasal-spray vaccines are quadrivalent, which means they protect against four strains of flu virus: two influenza A strains and two influenza B strains.
Whats the difference?
Both the flu shot and nasal spray work protect against the flu , but they work differently. The shot contains an inactivated influenza virus designed to help the bodys immune system guard against the actual disease.
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The nasal spray, sold under the U.S. brand name FluMist, contains weakened versions of the live virus.
The flu shot is approved for people over the age of six months. FluMist is approved for anyone between ages 2 to 49.
Shots are more available than the spray currently.
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Which children should not receive FluMist?
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How Is Flumist Administered
Even though FluMist is a nasal vaccine, you still need a healthcare provider to administer it to you. FluMist comes in a prefilled sprayer, which is first sprayed into one nostril and then into the other.
Children ages 2 through 8 may need to get FluMist twice, with at least 1 month in between each dose. This will depend on how many times the child has received the flu vaccine before and when. People ages 9 through 49 will only need 1 dose.
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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Im Pregnant Is It Safe To Get The Flu Shot
Yes, the flu shot is safe. Those who are pregnant should be immunized. Infants born during flu season to mothers who got a flu shot are usually protected against the flu for a few months. The flu shot is also safe and highly recommended for those breastfeeding. Since infants less than 6 months of age cannot get the flu shot , antibodies against the flu are transferred through breast milk.
Can Flumist Spread Or Cause The Flu Through Shedding
Shedding is very common with the FluMist vaccine. However, its very unlikely that this shedding will spread or cause the flu.
Shedding occurs when a virus in your body replicates and is then released to the environment around you. For example, when you receive the FluMist nasal spray, the flu viruses will replicate in your nose. Then if you sneeze, you could spread the flu viruses.
In a looked at viral shedding in younger children, ages 6 to 59 months .* In this study, shedding occurred in:
- 79% of children in the study
- 89% of children ages 6 months through 23 months old
- 69% of children ages 24 months through 69 months old
Another study looked at whether people actually catch the flu when others shed the virus after getting FluMist. Children ages 8 to 36 months received FluMist or a placebo .
The researchers found that 80% of children who received FluMist shed the virus. However, the researchers found only one instance of a flu strain in a child who received a placebo. Based on these numbers, they estimated that the transmission rate of the virus from those who received FluMist vaccine was about 0.58%.
These study results indicate that its unlikely that you would become infected with the flu from someone else who received the FluMist vaccine.
If you have questions about shedding or spreading flu viruses after receiving FluMist, talk with your doctor or pharmacist.
* The Food and Drug Administration has approved FluMist for use in children and adults ages 2 to 49 years.
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