Flu Spray More Effective Than Flu Shots For Young Children

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 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.

See Also: Flu shot or not?

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.)

What Is The Best Way To Protect Your Kids from The Flu?

Many parents don't like the idea of giving their children any vaccinations at all. They may erroneously believe that flu vaccines contain mercury. FluMist has never contained thimerosal or any other compound that contains mercury. The flu shots Afluria and Fluarix also have never contained thimerosal or any other compound that contains mercury, and injectable influenza vaccine Fluzone, in the form in which it is given in doctor's offices and pharmacies, has not contained mercury since 2004. The larger vials of Fluzone used in public free vaccination programs, however, do contain small amounts of thimerosal.

And many parents doubt that flu shots really work. There are good reasons to raise this question.

That means that for that particular year (different viruses predominate in different years) flu shots were only 62% effective.

The reason public health officials encourage everyone to get vaccinated, however, is that people who don't get the flu don't spread the flu. Even when the immunization does not work perfectly, it works well enough drastically to reduce the number of transmissions of the virus and the numbers of people who get sick. This is particularly important for small children, who are kept in day school, who don't wipe their noses, and who don't cover their coughs and sneezes.

It's not a good idea for your child to get FluMist if he or she has asthma, diabetes, or kidney failure, or if your child has a history of wheezing. If your child takes Aspirin on a regular basis, the FluMist vaccine is contraindicated to prevent the possibility of developing Guillain-Barré syndrome (GBS), a rare disorder of the nervous system. 

These problems may be minimized or eliminated by use of flu shots, because they use dead viruses. But if you simply aren't going to vaccinate your children, protect them and their playmates with the following precautions.

1. Wash hands frequently. The flu virus is removed by rubbing the hands with non-antiseptic soap and rinsing them under warm running water for 15 seconds, long enough to sing "Happy Birthday" or "Row, Row, Row Your Boat" twice. Pat hands dry with a clean towel.
2. When soap and water are not available, cleanse hands with an alcohol-based hand rub.
3. Kill flu viruses in clothes, bed linens, washcloths, and towels with heat,, 167-212°F (75-100°C). Washing in hot water and drying in the dryer is enough to kill the virus.
4. Cleanse hard surfaces regularly during colds and flu season. The flu virus can lurk on countertops, door knobs, plates, and glasses. It can survive for 2 to 8 hours outside the human body. This means you don't need to wipe everything first thing in the morning, but you do need to decontaminate flu-infected surfaces several times each day.
5. Keep your children home when they are sick. Don't infect others.

See Also: Do Cold And Flu Remedies Work?

These rules are also helpful even if you and your children get your flu shots. FluMist may be helpful for children who tend to get ear infections, but flu shots and simple decontamination measures work for almost everyone.