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Most children, and their parents, dread getting vaccinations. But recent research finds that flu spray, at least for children, is more effective than flu shots.

US health officials tell us that flu spray offers greater protection against coming down with the flu than flu shots for children aged 2 to 8.

The Advisory Committee on Immunization Practices, a group of experts that makes recommendations to the Centers for Disease Control, recently voted to recommend flu spray over flu shots for children.


What's Different About Flu Spray?

Currently there is just one brand of flu spray approved for use in the United States by the FDA, FluMist, made by AstraZeneca. The flu spray usually wholesales for about $22 a dose, compared to $8 to $23 for a flu shot. AstraZeneca anticipated the FDA decision and is making an additional 5 million doses of flu spray this year, enough to vaccinate another 5 million children and adults.

Flu spray is shot up the nose from a nebulizer. Whether or not children are less traumatized by the spray than by the shot is an open question, but at least there are no needles.

Flu sprays are fundamentally different from flu shots in that they contain weakened strains of live flu viruses. The flu viruses in flu shots have been killed first.

Flu spray usually contains three strains of the virus. Flu shots may "cover" just one or two strains.

The flu spray viruses cause a mild infection and build up resistance to the strain. Because children usually have not been exposed to flu viruses before, they get a stronger immune response to the weakened virus than adults would. It's well known that children respond better to flu spray than adults receiving the spray, although the spray is approved for adults up to 49 years old.

Until now, the question has been whether flu spray is really better than a flu shot for providing protection against infection. Now an advisory committee to the FDA has ruled that it is.

The Advisory Committee has not taken a stance of "flu spray or no immunization at all." The committee advises use of flu spray "only when available," and cautions that immunization should not be delayed because only shots are available.

Not All Doctors Agree with the Flu Spray Recommendation

Not all doctors are enthusiastic about this latest recommendation from the CDC. They don't want to be pressured to offer an immunization to their patients that costs their patients more. They don't want to appear to be offering children the second-best vaccine (the flu shot) when flu spray runs out. And the benefits of flu spray over flu shots in children are limited.

Studies have found that children who get flu spray instead of flu shots are less likely to develop otitis media, better known as ear infections.

They are not less likely to come down with flu, and they not less likely to have to be hospitalized with flu.

Moreover, because the flu spray uses a live virus, there is a real danger of a serious infection in recipients of flu spray who have weakened immune systems. (This is not a risk of the flu shot, because it uses dead flu viruses.)

Continue reading after recommendations

  • Waknine Y. ACIP: Influenza Spray Tops Influenza Shot for Young Children. Medscape Medical News. 26 June 2014.
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  • Photo courtesy of Miika Silfverberg by Flickr :

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