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Good News for Kids: FluMist Nasal Vaccine Is Back … But with a Caveat

Written by Jessica Lanerie, M.D. on Oct 3, 2018, 10:03:43 AM

If there are two things I know, it’s that most kids aren’t overly fond of shots and vaccinating your kids for flu season is incredibly important. This can be a tough balancing act when it comes time to take your needle-shy kiddo to the doctor to protect him or her from the flu each year. It is especially tough during flu seasons like 2016-2017 and 2017-2018, when it was determined that the FluMist nasal spray shouldn’t be used because it was ineffective. This year, though, the Advisory Committee on Immunization Practices (ACIP) voted 12 to 2 to return the nasal spray to the Centers for Disease Control and Prevention’s list of recommended vaccines for the 2018-2019 flu season. The committee stopped short of explicitly recommending the nasal spray, however, and will instead let providers and patients decide if they’ll use it instead of traditional flu shots. 

FluMist is approved for most people between ages 2 and 49. The only people who should avoid it are those who have had past life-threatening reactions to flu shots, kids who are also taking aspirin, and some kids who have asthma or a history of wheezing in the past year. It’s also not recommended for pregnant women or those with suppressed immune systems. 

New Formulation this Year

This year’s FluMist uses a different type of influenza A H1N1 virus in the vaccine to address past issues with ineffectiveness. Although the ACIP approved its use, it also stated there are no vaccine effectiveness estimates available for the new formulation since A/H1N1 virus has not widely circulated recently – influenza A (H3N2) and influenza B viruses predominated. 

The American Academy of Pediatrics recommends a flu shot as the first choice for vaccination and FluMist as a last resort for those who just won’t accept a shot. This could change once the upcoming flu season hits and clinicians see how vaccines are performing.

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Flu Vaccination Most Effective Way to Prevent Influenza

In the meantime, if you have questions about whether the nasal spray is right for your child, ask your doctor – and remember – everyone should be vaccinated for the flu this season, unless they have a condition or are of an age that precludes them. A record number – 172 — of children died from influenza this past flu season. Approximately 80 percent of these deaths occurred in children who had not received a flu vaccination. Annual influenza vaccination remains the most effective way to prevent influenza illness and death.


Dr. Jessica Lanerie is a pediatrician at Kelsey-Seybold’s Sienna Plantation Clinic. After receiving her medical degree from Texas A&M Health Science Center School of Medicine in 2013, Dr. Lanerie completed a residency in Pediatrics at Baylor College of Medicine in 2016. Her clinical interests include weight management, asthma, and eczema. 


Topics: Flu shot, flu nasal vaccine, FluMist

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