After Bad News About the FluMist Nasal Spray, Opt for the Shot

September 06, 2016 12:00 PM

Needle-phobic patients can no longer prevent the flu with nasal spray. Why it’s important to get the standard vaccination.

A recent announcement that the popular FluMist nasal spray was highly ineffective last flu season — and, this week, an American Academy of Pediatrics statement recommending against the vaccination method — might be disappointing news to children or adults hoping to avoid a needle prick.

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But that doesn’t mean they ought to skip the old-fashioned preventive measure.

“I tell all of my patients that the flu vaccination is really important for everyone to get,” says Heather Burrows, M.D., Ph.D., a clinical associate professor of pediatrics at the University of Michigan. “Even in the years when the vaccine isn’t a great match (to block flu strains), it still protects you somewhat from the severity of the illness.”

In the case of FluMist, which was developed at the University of Michigan School of Public Health, the latest match was especially poor: The spray was found to be only 3 percent effective against influenza during the 2015-16 season, according to the Centers for Disease Control and Prevention.

The CDC says it doesn’t know what caused FluMist to fail. It’s been available since 2003 and, unlike a typical flu shot, uses live (but weakened) strains of the virus. Studies, though, have shown that the nasal spray has not worked well against common flu strains over the past three seasons.

More perplexing: FluMist was once found to be more effective than standard flu shots in children. The CDC echoed that stance as recently as 2014.

Doctors, likewise, were eager to offer it.

“We did FluMist quite a lot; the kids almost always want it,” says Burrows, who estimates that about half of her eligible pediatric clientele at U-M chose FluMist instead of a needle. “The data was a surprise.”

"I always tell people to start thinking about it early and to get vaccinated as soon as it’s available."
Heather Burrows, M.D., Ph.D.

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 needn’t be traumatic, however.

“It’s a very, very small needle,” Burrows says. “Compared to some of the vaccines, the medicine doesn’t hurt when it goes in. And it’s 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 (that also helps spread the vaccine throughout the body). Some might experience a low-grade fever in the first 24 hours.

A flu shot won’t actually give you the flu — a common misnomer, Burrows says.

In a more serious context, the vaccine’s 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 didn’t get a flu vaccine.

Taking early action

Flu vaccination season typically begins in late August, but it’s still too soon to say whether the FluMist interruption will affect availability of standard vaccines, Burrows says.

Hospitals, including those at the University of Michigan, soon will take stock of their supply and determine which populations might need first priority.

Burrows says it doesn’t hurt for patients to be proactive. And even if a vaccination is received once the flu begins circulating, there is a benefit.

“I always tell people to start thinking about it early and to get vaccinated as soon as it’s available,” she says. “We almost always can get people in before flu season really starts.”

This article was originally published on July 18, 2016, and was updated on Sept. 6, 2016.