FluMist returns next flu season, but it’s not for everyone

Next flu season, most people will again have the option of getting the flu shot or the FluMist, an inhaled live virus vaccine.

This week AstraZeneca, the maker of FluMist, announced that the Centers for Disease Control and Prevention’s Advisory Committee on Immunization Practices voted to recommend the vaccine for the 2018-2019 season, two years after it stopped recommending it.

In this Oct. 4, 2005 file photo, a Danielle Holland reacts as she is given a FluMist influenza vaccination in St. Leonard, Md.(AP Photo/Chris Gardner, File)

The FluMist had proven ineffective for working on the H1N1 strain two years ago. This season, AstraZeneca tested a reformulation of the FluMist to see if it worked before the CDC committee approved it for next year.

The news comes after this year’s flu shot has only been about 36 percent effective on the Type A, H3N2 strain of the flu. (That’s actually up from previous reports of 10 percent to 15 percent effectiveness.) It’s been a particularly bad flu season, the worse since the swine flu (H1N1) of 2009.

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Not everyone should get the FluMist instead of the flu shot, though.

You should get a shot instead if you:

  • Are younger than 2
  • Are immune compromised
  • Have a chronic illness like asthma
  • Are older than 49
  • Are pregnant

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The shot can be given to babies as young as 6 months old. The first time you get a flu shot or FluMist, you need two doses a month apart,if you are younger than 8 because you haven’t built up antibodies to the flu, yet.

People 65 and older have a higher dose vaccine they can take because we know that the regular vaccine wears off in about six months in people that are 65 and older. For children the shot works about 12 to 18 months.

Most parents and kids will be happy that the FluMist is back, says Dr. Leighton Ellis, pediatric chair at St. David’s North Austin Medical Center and a pediatrician at North Austin Pediatrics. “Everybody is going to be really happy not to get a shot,” she says.

There are some advantages that the FluMist has over the vaccine if it works. The antibodies in the FluMist live in the nose instead of being in the bloodstream as with the shot.

“Sometimes with FluMist you might fight it off in your nose and you might not even get sick,” Ellis says.

The disadvantages are that it’s a live vaccine, which means it can cause a sore throat or headache afterward.

Regardless of whether you choose the flu shot or FluMist, choose something, and try to do it before Halloween, Ellis says. That way you’ll be ready for peak flu season.

Even though some people are still getting the flu with this year’s vaccine, Ellis says, sometimes, they only have it for about a day and it might just look like a bad cold. The typical flu comes with three to four days of fever and the fever, soreness, chills, headache and cough happen all at once, rather than a slow build up to sickness that you find with a cold.

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Like other doctors’ offices and hospitals have reported, Ellis says she isn’t even testing most kids who come in with flu symptoms. Her office is holding onto flu tests for children younger than 2 and for children with compromised immune systems — kids that would most likely require medical intervention if they had the flu.

For most people, the flu is about rest, staying hydrated and alternating Tylenol and Motrin. Ellis isn’t automatically prescribing the antiviral Tamiflu because of its side effects in kids such as vomiting and psychotic behavior. She will prescribe it if there is an infant in the house or someone for whom the flu symptoms would be dangerous.

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While parents might be rejoicing that the FluMist will be back next year, Ellis knows her nurses won’t be. It’s harder to get a kid to agree to have something sprayed into their nose than to give them a quick shot, she says. Plus, parents then have to decide which one to choose: shot or mist.