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No Drop in Flu Vaccinations Since Nasal Spray Withdrawn

Last Updated: October 06, 2017.

By Steven Reinberg
HealthDay Reporter

FRIDAY, Oct. 6, 2017 (HealthDay News) -- Discontinuation of the pain-free nasal spray flu vaccine hasn't led to a drop in childhood influenza vaccination -- at least not in Oregon.

In 2016, the U.S. Centers for Disease Control and Prevention's advisory committee on vaccines reported that the nasal spray vaccine (FluMist) was ineffective and advised against its use.

Doctors and health officials then feared that with only an injectable vaccine available, needle-shy parents might avoid getting their children vaccinated, said Steve Robison, who is with the Oregon Health Authority.

However, "worry that the withdrawal of the nasal spray vaccine recommendation would lead to a large drop in influenza immunization rates for children was unfounded," said Robison, who led a study on the recommendation's aftereffects.

Providers in the state immunized roughly the same number of children across the 2016-2017 influenza season as they did in previous flu seasons, Robison's team found.

The difference in the vaccines' effectiveness was due to their makeup: FluMist was a live attenuated influenza vaccine, while the flu shot contains a dead virus.

The CDC committee found that the nasal spray was only 3 percent effective in preventing flu, essentially offering no protection. By comparison, the vaccine in the flu shot is 40 to 60 percent effective in most flu seasons, according to the CDC.

The remaining vaccination strategy might come with a sting, but "parents and providers should be more concerned with the effectiveness of a vaccine than with how it is administered," Robison said.

Dr. Gloria Riefkohl is a pediatrician at Nicklaus Children's Hospital in Miami. She agreed that vaccine effectiveness is more important than the delivery method.

"In Florida, we see flu all year-round, so it's very important that children get their flu vaccine every year," said Riefkohl, who wasn't involved with the study.

She added that all other children's vaccines are given by injection, so giving the flu shot is not a significant problem.

Riefkohl's hospital quickly replaced the nasal spray with the injectable vaccine, she said. And so far she hasn't seen a drop off in vaccinations.

The CDC recommends that everyone older than 6 months get immunized against influenza.

"It's important to get a flu shot," Riefkohl said. "And it's better to get it early in the flu season."

FluMist was produced by MedImmune, a subsidiary of AstraZeneca. It was licensed in 2003 and was the only noninjection flu vaccine available, the CDC says.

For the study, Robison and his colleagues used data from the Oregon statewide immunization registry called the ALERT Immunization Information System. They compared flu vaccination rates among children from the 2012-2013 through the 2016-2017 flu seasons.

They then zeroed in on the last two flu seasons. "We found that overall, there was no difference in childhood influenza immunization rates between the 2015-2016 season, when FluMist was widely used, and the 2016-2017 season, when FluMist was not used," Robison said.

The researchers also found that children who had previously received FluMist were only slightly less likely to return for a flu shot in 2016-2017.

Children ages 3 to 10 who had used FluMist were 3 percent less likely to return than those given an injection, while adolescents 11 to 17 who had used FluMist were 8 percent less likely to return, Robison said.

The report was published online Oct. 6 in the journal Pediatrics.

More information

For more on flu, visit the U.S. Centers for Disease Control and Prevention.

SOURCES: Steve Robison, MPH, Oregon Immunization Program, Oregon Health Authority, Portland; Gloria Riefkohl, M.D., pediatrician, Nicklaus Children's Hospital, Miami; November 2017, Pediatrics

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