Nasal Spray Flu Vaccine


The CDC vaccine advisory panel (Advisory Committee on Immunization Practices (ACIP)) recommended in June 2016 to not use the nasal flu vaccine in 2016-2017.

It may be in the future that the vaccine is redeveloped and recommended again. It had been a help for those afraid of needles and did not create as much 'sharps' waste (needles that need to be carefully disposed of).

How does this work?

The vaccine doesn't involve a shot.

It's just a spray squirted up into the nose, like a nasal spray.

It contains a live virus

The virus is attenuated - meaning it has been weakened.

What does it protect against?

The nasal flu spray includes 4 strains. Some vaccines only include 3. It includes H1N1, an Influenza A, and 2 Influenza B strains. Other vaccines may have only 1 B strain.

The 2015 flu season in the Southern Hemisphere had a number of B strain cases, so there is concern that a B strain may affect the Northern Hemisphere in 2015-6.

In 2015-6, the flu vaccine in the US will contain:

  • A/California/7/2009 (H1N1)pdm09-like virus
  • A/Switzerland/9715293/2013 (H3N2)-like virus
  • B/Phuket/3073/2013-like virus. This is a B/Yamagata lineage virus
  • B virus (B/Brisbane/60/2008-like virus). This is a B/Victoria lineage virus.

Will it get me sick?

Sometimes those who have the vaccine may have a mild illness, like a mild cold. This may include a slight runny nose, sniffles, stuffy nose, but is usually for a short time and not serious.

In some cases, especially children, may have more illness symptoms. Do not give your child aspirin if these develop after the flu nasal spray vaccine.

As with any vaccine or treatment, there is a small chance of an allergic reaction, which can be serious.

Is the spray better than an injection?

No. Experts (from the CDC and the Advisory Committee on Immunization Practices (ACIP)) do not recommend one over the other for efficacy.

In fact, they now do not recommend it, though the decision has not yet been made official by the CDC director.

Neither vaccine prevents all cases of the flu. Sometimes because the flu strain in the community does not match the flu strain in the vaccine.

Can anyone get the nasal spray vaccine?

Not everyone can get the nasal spray even if it is available.

As with many flu vaccines, those who cannot have this vaccine include those who had:

  • an allergic reaction to egg protein
  • a severe allergic reaction to any previous influenza vaccine. 

This vaccine contains a live attenuated influenza virus. This means some people shouldn't have this spray, including:

  • Pregnant women 
  • Children under 2
  • Adults over 50
  • Immunocompromised persons (with HIV, receiving chemotherapy, or on certain meds)
  • Children under 18 on aspirin (or aspirin containing medications)
  • Children under 4 with asthma or history of wheezing in the past 12 months.
  • Anyone who has taken medications for influenza in the last 2 days

Anyone who has taken the vaccine should avoid severely immunocompromised persons for 7 days afterward.

Breastfeeding and postpartum women can take the nasal spray. Family members and other contacts of pregnant women can take the nasal spray vaccine.

Others may want to consider discussing the vaccine with their doctor or nurse , including those who have:

  • asthma
  • are ill
  • at high risk for complications related to influenza or vaccination. This includes those who have lung, kidney, liver, or heart disease (but not hypertension alone), as well as those with neurologic/neuromuscular conditions or metabolic disorders. 
  • had Guillain-Barré syndrome (GBS) within 6 weeks after a dose of an influenza vaccine 

You can still take the vaccine if you have a mild illness. Those who have diarrhea or a cold (mild upper respiratory tract infection with or without fever) can still take the spray.

However, if your nose is stuffy, the spray may not be able to work, as it will be blocked by the congestion. You may wish to use a different vaccine or have the vaccine when your nose is clear.

Should I get both vaccines?

Adults only need one vaccine - either a shot or the nasal spray - each year. Some kids, especially those who haven't been vaccinated before, need 2 doses and you should talk to your pediatrician about this.

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