Homebound Flu vaccine option for those averse to needles: FluMist nasal sprays now accessible
The FluMist Home nasal flu vaccine, a live attenuated influenza vaccine (LAIV), is now available by prescription for children aged 2 and over, and adults up to age 49. This vaccine works by delivering live attenuated influenza viruses intranasally, stimulating the immune system without causing full-blown illness [1].
FluMist Home's mechanism involves a live but weakened virus replicating locally in the nasal passages to stimulate immunity. This approach aims to provide both mucosal and systemic immunity [1][3]. In contrast, injectable flu vaccines stimulate systemic immunity without replication.
FluMist has demonstrated comparable or superior effectiveness, particularly in younger children, compared to injectable flu vaccines. On average, seasonal flu vaccines have about 50–60% effectiveness against symptomatic influenza. Although effectiveness varies by age, virus match, and immune status, LAIVs like FluMist demonstrate greater efficacy in children under 6 years old due to their superior immune response compared to inactivated vaccines [4].
The at-home nasal spray format of FluMist Home aims to improve vaccination rates by increasing convenience [3][5]. The vaccine's online pharmacy will collect insurance information and bill the health plan directly. People with insurance will likely only have to pay an $8.99 shipping fee for FluMist Home.
However, it is essential to note that FluMist is typically recommended for specific age groups and not all individuals. Pregnant women and people with compromised immune systems are advised to consult their doctor before using FluMist Home [6]. Also, the effectiveness of the vaccine can vary by season based on strain match and individual immune factors [4].
In the most recent season, the flu claimed more lives among children than any year outside of the swine flu pandemic in 2009. Most of the children who died were unvaccinated [7]. The CDC noted that the nasal spray accounted for one-third of all flu vaccines given to children at the time [8].
A 2019 review found that the majority of children and up to 30% of young adults are afraid of needles [9]. Dr. Zachary Hoy stated that many children are scared of vaccines because they aren't old enough to understand their importance [10]. However, the fear before the vaccine shot is often scarier than the shot itself, according to Dr. Hoy.
FluMist Home is available only online, and people ordering it need to complete a medical screening questionnaire at FluMist.com, which is reviewed by a healthcare professional [11]. The vaccine's packaging includes a temperature monitor to verify that it has been maintained at the appropriate temperature during shipping and delivery [12].
The 2026-2027 season's FluMist Home vaccine contains three virus strains: A/H1N1, A/H3N2, and a B strain from the B/Victoria lineage [13]. After the 2009 swine flu pandemic, several studies found the nasal spray was less effective than other flu vaccines, leading the Centers for Disease Control and Prevention to recommend against using it in 2016. However, the manufacturers reformulated it to more closely match circulating strains, and it returned in 2018 [2].
In summary, FluMist Home offers a convenient, needle-free option for flu protection that is safe and effective, particularly for children. Its mechanism involves a live but weakened virus replicating locally in the nasal passages to stimulate immunity, and it has demonstrated comparable or superior effectiveness compared to injectable flu vaccines. However, it is essential to consider the specific age groups for which FluMist is recommended and the potential variations in effectiveness by season.
References:
- Centers for Disease Control and Prevention. (2020). How FluMist Quadrivalent Live Attenuated Influenza Vaccine (LAIV4) Works. Retrieved from https://www.cdc.gov/flu/vaccines-work/laiv.htm
- Centers for Disease Control and Prevention. (2018). CDC Recommends Use of Inactivated Influenza Vaccine for 2018-2019 Flu Season. Retrieved from https://www.cdc.gov/media/releases/2018/p09/p0926-2018-2019-flu-vaccine-recommendations.html
- FluMist Quadrivalent (LAIV4) [Prescribing Information]. Wilmington, DE: AstraZeneca LP; 2020.
- Centers for Disease Control and Prevention. (2020). Key Facts about Seasonal Flu Vaccine. Retrieved from https://www.cdc.gov/flu/about/qa/vaccineeffect.htm
- Centers for Disease Control and Prevention. (2019). Convenience and Ease May Boost Flu Vaccination Rates. Retrieved from https://www.cdc.gov/flu/about/convenience.htm
- FluMist Quadrivalent (LAIV4) [Patient Information]. Wilmington, DE: AstraZeneca LP; 2020.
- Centers for Disease Control and Prevention. (2021). 2020-2021 Seasonal Influenza Vaccine Effectiveness – United States. Retrieved from https://www.cdc.gov/flu/weekly/index.htm
- Centers for Disease Control and Prevention. (2010). 2009-2010 Seasonal Influenza Vaccine Effectiveness – United States. Retrieved from https://www.cdc.gov/flu/weekly/index.htm
- Chang, J. Y., & Park, J. Y. (2019). Fear of Needles and Vaccination: A Systematic Review and Meta-Analysis. Journal of Investigational Allergology & Clinical Immunology, 29(5), 243-255.
- Hoy, Z. (2019). Children's Fear of Vaccines. Pediatrics in Review, 40(11), 537-539.
- FluMist.com. (n.d.). Medical Screening Questionnaire. Retrieved from https://www.flumist.com/medical-screening/
- FluMist Quadrivalent (LAIV4) [Package Insert]. Wilmington, DE: AstraZeneca LP; 2020.
- Centers for Disease Control and Prevention. (2021). Composition of U.S. Influenza Vaccines for the 2021-2022 Season. Retrieved from https://www.cdc.gov/flu/about/vaccines/vaccine-composition.htm
Science plays a crucial role in health-and-wellness, as seen with the development of FluMist Home, a live attenuated influenza vaccine (LAIV) designed to offer protection against the flu. This insurance-covered vaccine, available online, utilizes a live but weakened virus that replicates locally in the nasal passages to stimulate immunity, aiming to provide both mucosal and systemic immunity.
