Originally posted here by Dr. Carol Baker, infectious disease specialist at Texas Children’s Hospital
As we settle in to the swing of summer vacations and family trips, the last thing on many parents’ minds is the flu. This week, though, the Advisory Committee on Immunization Practices (ACIP) to the Centers for Disease Control and Prevention (CDC) recommended that health care providers not use live attenuated influenza vaccine (LAIV), otherwise known as nasal spray or FluMist, this upcoming flu season.
When FluMist was initially released, infectious disease and vaccine experts alike touted LAIV because it appeared to provide better protection against influenza virus compared with the injectable vaccine, or the flu shot, for children, especially those under age 9. The ACIP, on which I serve as a liaison member for the Infectious Diseases Society of America, reviewed convincing data Wednesday that for the past three flu seasons FluMist was significantly less effective in both children and adults. Influenza virus is notorious for its ability to change, but this time a vaccine’s effectiveness changed in a way that currently is not clear.
LAIV was created to improve protection for previously unimmunized children who were known to respond poorly to the flu shot than older children and adults. I know that many parents also preferred this method to the vaccine so their children didn’t have to go through the pain of receiving a shot. Although many people previously opted for the nasal spray, LAIV this year makes up only 8 percent of the total flu vaccine supply in the U.S. The good news is that because there are several injectable vaccines that can be used in children, there should be enough supply to vaccinate our kids in the upcoming 2016-2017 season.
While there are many possible explanations for why FluMist stopped protecting as well as in the past, future studies will be necessary to provide one or more explanations. For now, it is our responsibility, as health care providers, to refrain from using LAIV until its effectiveness can be established scientifically. For now, the CDC and American Academy of Pediatrics agree that only flu shots are appropriate for use.
The severity of each flu season is always unpredictable, and the effectiveness of the flu vaccine can vary widely from season to season as well. While some may think that flu is no worse than other respiratory viruses common in the fall and winter months, flu is distinct. It causes high fever, severe muscle aches and fatigue, sore throat and in children sometimes vomiting and diarrhea, which can last a week or more. Getting vaccinated not only protects families against the virus, but if someone gets the flu, the symptoms are less severe and don’t last as long.
Getting the flu vaccine is especially important to protect the most vulnerable – pregnant women, children younger than age 2, the elderly and those with diseases or receiving medications that impair the immune system, for example, those with cancer, who are at greatest risk of being hospitalized from flu complications. Vaccination not only protects the pregnant woman, but the antibodies created by the mother in response to flu vaccine pass through the umbilical cord blood and breast milk to the baby, protecting the baby before age 6 months when the flu vaccine can be given.