CDC Recommends Getting Flu Shot, Avoiding Nasal Spray

CDC Recommends Getting Flu Shot, Avoiding Nasal Spray
Many prefer this nasal spray flu vaccine to an injection, but it may not be effective. Photo courtesy

When given a choice, most parents would prefer seeing their child get their flu vaccine through a nasal spray than a poke in the arm. However, the United States Centers for Disease Control and Prevention (CDC) is recommending against using the nasal flu vaccination this flu season since it does not seem to be effective.

The CDC Advisory Committee on Immunization Practices (ACIP) voted on the issue and released their recommendations online June 22nd. As a panel of immunization experts, the ACIP reviewed data on the effectiveness of the vaccine and made their recommendations to the CDC. The director of the CDC has yet to finalize the organization’s recommendation, although the The American Academy of Pediatrics has endorsed the panel’s recommendation to avoid the nasal vaccine.

The committee analyzed data from the U.S. Influenza Vaccine Effectiveness Network for the 2015-2016 flu season, including information about the vaccination’s effectiveness in children aged 2 to 17. The data compared the live attenuated influenza vaccine (LAIV), which is the nasal spray called FluMist Quadrivalent, with the injectable vaccine. The data showed that the nasal spray had about a 3 percent effectiveness against any flu virus, which means statistically the vaccine gave no protective benefit to the patient. In contrast, for the 2015-2016 flu season, the inactivated influenza vaccine (IIV) injection was 63 percent effective in protecting patients aged 2 to 17 from contracting the flu. Other independent studies had similar findings.

The low effectiveness of the 2015-2016 nasal vaccine is nothing new. Data had shown that the nasal spray had poor or lower than expected effectiveness in both the 2013-2014 and 2014-2015 flu seasons. It seems the nasal flu vaccine has not been living up to expectations, despite the promise of a pain-free way to vaccinate children and others.

The effectiveness of a flu vaccine can vary from season to season, depending on how well researchers have predicted which strain of the flu virus will be circulating that year. The vaccine’s effectiveness can also be affected by characteristics of each person vaccinated and whether the particular vaccine contains a live or inactive virus. Although research before and after the nasal vaccine became available suggested it was either comparable to or more effective than the IIV shot, it seems less effective now and the CDC does not know why.

The news is not good for children and others who dread getting needles, or for the doctors and clinics who have already placed orders for the nasal vaccine. Pediatricians may be affected most since some estimates suggest about a third of all vaccines given to children are using the nasal mist. Vaccine manufactures estimated they would make 171 to 176 million doses of the flu vaccine available in the U.S. for the 2016-2017 flu season, although that included about 14 million doses of the FluMist. The CDC said it would work to ensure that enough injectable flu vaccine is available for those who need it this year.

Although getting the flu is inconvenient to some, for others, it can be deadly. Seniors, young children, pregnant women, and those with a compromised immune system or chronic illness are especially vulnerable to the influenza virus. Each year, the flu causes millions of illnesses, hundreds of thousands of hospitalizations, and thousands of deaths. The flu tends to develop suddenly, and can have symptoms like a high fever, chills or sweats, headache, sore throat, nasal congestion, dry cough, weakness and fatigue, and muscle ache. For most of the population, without complications, doctors usually recommend bed rest along with drinking plenty of fluids. For those more at risk for complications, such as the young, the old, and the chronically ill, hospitalization may be required along with antiviral medication such as Tamiflu (oseltamivir) or Relenza (zanamivir). To reduce the risk of catching the flu, the CDC recommends everyone aged 6 months and older get the flu shot. Other ways to prevent catching or spreading the flu include avoiding crowds, coughing or sneezing into a tissue or shirt sleeve, and washing hands frequently and thoroughly, using alcohol-based hand sanitizers when soap and water are not available.

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