The following people should not get an intranasal influenza vaccine such as FluMist, according to the FluMist Web site and the Centers for Disease Control and Prevention:
If you have a fever or are severely ill at the time the vaccination is scheduled, you should probably wait until you recover before getting the influenza vaccine. Talk to your doctor or nurse about whether to reschedule the vaccination.
The flu shot (inactivated vaccine) is preferred over live, intranasal influenza vaccine for physicians, nurses, family members, or anyone else coming in close contact with anyone with a weakened immune system.
Due to the possible transmission of vaccine virus, FluMist recipients should avoid being in close contact with immunocompromised individuals for three weeks following vaccination.
Do you hate needles, but still want to protect yourself against the flu? There may be a new option. If you are a healthy person between the ages of 2 and 49, FluMist, a nasal, needleless flu vaccine, could be the answer.
FluMist is a vaccine that is given as a nasal mist. FluMist contains three live viral flu strains, which have been weakened. The flu shot, by contrast, is made using a killed virus. After the weakened influenza viruses enter the nose, the body develops an immune response that helps prevent the flu for the entire season. FluMist is now approved for healthy children 2-17 years and healthy adults 18-49 years of age.
James King, M.D., a pediatrician at the University of Maryland Medical Center who has been involved in early research studies of FluMist and kids, compares how FluMist and the flu shot work inside the body.
"[FluMist] is a live but very weak virus that you spray in the nose," said King. "It sets up a little infection in the nose and thereby makes your body produce antibodies or germ fighters against the flu in your nose, throat and in your bloodstream."
By contrast, the flu shot only stimulates immunity in the blood, not in the nose and throat as FluMist does. "That's the theoretical advantage over the shot -- FluMist gives you a broader immunity. So it's a very good way of protecting against the flu," said King, who is also a professor of pediatrics at the University of Maryland School of Medicine. King says that FluMist is just as effective as the flu shot. "It's been shown to be over 90 percent effective in children against culture-proven flu so it's a very good vaccine."
However, one disadvantage of FluMist could be the cost. King says it's probably about two to three times as expensive as the flu shot, depending on where you go. "I've heard it can cost anywhere from $50 to $70 in the office to get this vaccine, whereas if you go to your doctor to get the flu shot it costs about $20." he said. Also, King pointed out that typically, FluMist is not covered by insurance.
King says that because flu changes each year, people should get vaccinated right before the next flu season. That means the ideal time to get vaccinated is October, November or December so that you're protected against that winter strain.
Healthy people ages 9 to 49 need only one dose of FluMist each year. Children 2-8 years old need two doses at least 6 weeks apart in their first year of vaccination with FluMist.
Although many may benefit from FluMist, certain people should not use this new vaccine. "People who have a weak immune system or have chronic diseases like asthma or diabetes or heart disease should not get FluMist," states Dr. King. "They should get the standard flu shot." For more details on who should avoid FluMist, click here.
Nasal congestion, runny nose, sore throat, headache, irritability, decreased activity, muscle ache and cough are the most common side effects associated with the vaccine.
According to Dr. King, about one in 10 children will get a stuffy, runny nose, which usually lasts 1-2 days. Five percent will get a low-grade fever of less than 101 degrees, which compares very favorably to other childhood vaccines. "These are very mild side effects compared with other childhood vaccines," King said. A low percentage of adults can get a sore throat and stuffy nose.
The makers of FluMist are hoping that the new vaccine may help to increase overall vaccination rates and thereby reduce the public health burden of the flu. The flu can significantly affect and disrupt the lives of children and adults. In fact, each year in the U.S., it's estimated that flu accounts for approximately 70 million missed workdays and approximately 38 million missed school days.
"It's been estimated that flu costs the U.S. population anywhere from 3 to 15 billion dollars," said Dr. King. "That translates to about one to three billion for just direct medical costs like hospitalization, doctor visits and medications. And anywhere from three to 12 billion in indirect costs -- that's days of work missed, and school missed."
To address this issue, the University of Maryland conducted an investigational study which found that school-based nasal influenza vacinations significantly reduce flu-related costs in families.
Specifically, the study found that families of school children who received FluMist during an in-school immunization program experienced a significant drop in several common medical and economic consequences from the flu. Compared to the two schools where children were not vaccinated with FluMist, at the school where students received the FluMist vaccine, families indicated a 72 percent drop in adult workdays lost, and a 46 percent drop in school days lost by all children in the family. There was also a 67 percent reduction in medical visits for adults, and a 60 percent decline for children. In addition, the use of prescription drugs, herbal medicines and over-the-counter flu remedies dropped by more than 50 percent.
"I never expected such a tremendous impact on the families," said King, who was the lead investigator for the study. "But it all makes biologic sense. Children are most susceptible to influenza, carry and spread the influenza virus over a longer period of time than adults, and are often the first to get the infection in the community. So if you stop flu in school kids, you might reduce its impact in the community. And that's what we saw."
The University of Maryland was also was one of 10 centers involved in a FluMist clinical trial conducted from 1996 to 1998. The vaccine study enrolled 1,602 healthy children ranging in age from 15 months to 6 years. At the University of Maryland Medical Center, 110 children took part in the study. Two-thirds of the children received the nasal flu vaccine and one third received a placebo.
The study showed that nasal spray flu vaccine effectively prevents the flu in children.
"This vaccine is a major breakthrough in the effort to immunize children against flu without the fear and pain of a shot," said King, who is a co-author of an article about the study. "Children who received the vaccine had 93 percent fewer cases of influenza than the children who received a placebo."
UMMC researchers also found that the nasal flu vaccine (FluMist) reduced the incidence of influenza-related complications, such as ear infections accompanied by fever.
|
Email this Page
Print this Page © 2008 University of Maryland Medical Center (UMMC). All rights reserved.
UMMC is a member of the University of Maryland Medical System, 22 S. Greene
Street, Baltimore, MD 21201. 1.800.492.5538 TDD: 1.800.735.2258
Physician Referral: 1.800.373.4111
