Nasal Flu Vaccination Not Recommended – Here’s Why

Nasal Flu Vaccination Not Recommended | Here’s Why

Written by Dr. Larry

The American Assocation of Pedatrics today released a statement recommending against the intranasal flu shot (FluMist) because it has been less effective that the traditional flu shot.  I commented on this for KTVU San Francisco’s Fox station (9/6) and want to write about what I found.

First, the CDC had an advisory committe investigate the efficacy of the intranasal flu shot.  That’s a governmental organization.  Now there is a professional medical association (Pediatricians), ie not the government, that agrees with the CDC recommendation.  It adds weight.

Not a bad idea in theory, kids hate shots, and so do I, to be honest.  My daughter cried in my arms last year when she got hers–and there’s not much worse for a parent than watching your child suffer, so a way to get a flu shot without the shot–good idea.  And initial studies showed that the nose flu shot was not only as good as, but some suggested it was better than the traditional shot, according to a 2012 study.

Now we have new data—last year the traditional flu shot was 20 times better than the intranasal formulation (63% vs 3% effective in the 2015-16 flu season).  In other words, the intranasal flu shot was virtually worthless.  Not only is the shot better, but the nasal spray is ineffective.  Double whammy that knocks that formulation out for this season.

I would anticipate that pharmaceutical trying to spin it somehow.  It’s back to the drawing board for them—I would guess they have to demonstrate, again, that it works before getting back in the game.

A couple additional thoughts.  First, while the flu shot does help protect you from getting sick—and the flu is horrible, people come to me in the ER literally thinking they are dying. In 7 years, I’ve missed work only 1 day, and it was when I had swine flu.  Drenched the sheets every night for 5 days.  Not only does it protect you from getting a nasty illness—it protects the weak and vulnerable among us from dying.  Every year, anywhere from 3,000-50,000 people die from influenza.  Most of those deaths are from those people who have bad lungs to begin with, on home oxygen, barely making it as it is.  The flu can kill them.  So you getting a flu shot, in a small way, might save other people’s lives.

The second point, which can be confusing and hard to hear, is that the flu shot isn’t perfect.  The “better” flu shot last year was only 63% effective—not a good score on a high school math test, but not bad as far as flu vaccines go, believe it or not.  No flu shot confers 100% immunity.  I want people to get vaccinated to prevent disease and death, but unfortunately, you can’t get a flu shot and assume you won’t get sick.  It’s not 100% coverage, and there are plenty of other viruses (parainfluenza, rhonoviruses, EBV, etc) that you can get sick from in the winter.  That said, the flu shot offers you some protection, and for me and my daughter, is worth the stick.

Two good resources for more info:

This is the statement of the American Academy of Pediatrics.

Center for Disease Control statement:

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