Kids and needle-phobic adults showing up at their doctor’s office for a flu vaccine this fall might be distressed to learn a shot is their only option.
The FluMist nasal spray vaccine proved so ineffective last year that a federal panel of experts says it should not be used this year.
“I don’t know how many parents truly are aware of it,” said Daniel McGee, MD, a hospitalist with Spectrum Health Helen DeVos Children’s Hospital. “I think they will be surprised in the fall when they have to roll up their sleeves.”
The loss of an injection-free influenza vaccine will be felt especially in pediatricians’ offices, Dr. McGee said. Although FluMist comprised only 8 percent of the vaccine supply, it accounted for one-third of the vaccines given to children.
The advisory committee on immunization practices for the Centers for Disease Control and Prevention caught even some health care providers off guard when it announced in late June the nasal spray did not work last year.
“Even though it was a good match (for the flu strains circulating), the FluMist wasn’t doing its job,” Dr. McGee said. “People who received it weren’t mounting an immune response. It showed no protective effect.”
The good news is that the injected vaccines were 63 percent effective.
The announcement marks a big turn-around for the nasal spray vaccine, which hit the market in 2003.
While the injected vaccine uses an inactivated form of the flu virus, the nasal spray uses a live, attenuated virus. Dr. McGee describes it as “a live virus made very wimpy.”
The nasal spray proved effective in the early years. In fact, in the 2014-15 flu season, the CDC recommended it as the preferred way to give the vaccine to young children. Last year, it did not recommend one form of the vaccine over the other.
In examining data from the 2015-16 flu season, however, the panel of experts found it was only 3 percent effective. Statistically, that means no protection, Dr. McGee said. The experts haven’t figured out why the nasal spray’s effectiveness plummeted.
Dr. McGee sees an upside to the FluMist downfall: It shows the credibility of the vaccine review system.
“This demonstrates that vaccine effectiveness is constantly being monitored,” he said. “Things are being changed when there is reason to do so.”
He urged parents to get flu shots for their kids, even if they aren’t quite the ouch-free experience of a nasal spray.
“The injectable vaccine is a very effective vaccine that has done a great job for a number of years preventing influenza,” he said. “Influenza is a serious illness that causes many hospitalizations, particularly in the very young, the very old and in pregnant women.”
The injectable worked especially well last year, he added.
“We saw a lot fewer cases of influenza at Helen DeVos Children’s Hospital just because it was a good match,” he said.
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