FluMist vs. Flu Shot: What's Best for You

It's important to get a flu vaccine, whether you opt for the shot or the nasal spray.

The FluMist is back for the 2018 flu season after years off the market. But when evaluating the nasal mist vs. flu shot, some experts say the shot form of the flu vaccine is still a better option. Stephen Rinderknecht, DO and chair of the UnityPoint Health vaccine oversight committee, tells us how the FluMist product has changed, the difference between the mist and the shot and tips to determine the safest option for you and your family. We want to keep you healthy and doing you throughout the sick season.

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What Is a Flu Shot Alternative?

The FluMist is the only alternative to the flu shot without a needle and is given in the form of a nasal spray. Dr. Rinderknecht says it was taken off the market for a couple of years because it was ineffective at fighting a common flu strain in kids.

“The problem with FluMist effectiveness in the last couple years has been with one of the four strains in the vaccine – H1N1,” Dr. Rinderknecht says. “The manufacturer has provided data to the Centers for Disease Control and Prevention (CDC) showing evidence the H1N1 strain in this season’s FluMist is more stable and should be more effective.”

What Does the CDC Think of the FluMist?

Dr. Rinderknecht says the CDC and the American Academy of Pediatrics (AAP) are the only two organizations that make credible vaccine recommendations. He says the CDC doesn’t give preference to one flu vaccine over another, and usually, the CDC and the AAP agree. But this year, the AAP is giving preference to the shot form over the nasal spray.

The AAP looked at the data and recommends children receive the injectable form of the vaccine because it has proven to be more effective. But the organization says even the FluMist is more effective against the flu than providing no vaccine at all.

Where Can I Get the FluMist?

“Our contracted and recommended vaccine is the flu vaccine in shot form for this season. However, UnityPoint Health clinic locations do have the option of ordering and using the FluMist, as well,” Dr. Rinderknecht says.

The clinic at which Dr. Rinderknecht practices isn’t offering the FluMist as an option. And he agrees with the AAP, saying he’d like to see more evidence that it’s effective before giving it to the youngest of patients.

What’s the Difference Between the Flu Shot vs. FluMist?

  • Shot vs. nasal mists. The flu shot is an injection in the arm of an adult or the leg of a child under the age of 3. The FluMist is a nasal spray that is inhaled through the nose.
  • Inactive vs. live. All shot forms of the flu vaccine are inactivated and made of particles of the virus. These particles are not biologically alive and therefore can’t cause disease. The FluMist is a live virus that has been altered so it replicates in the nose but doesn’t cause disease.
  • Slight pain vs. no pain. While both forms of the vaccine are tolerated very well, the shot can cause pain and general achiness at the injection site.
  • Less restrictions vs. more restrictions. The shot form of the vaccine is appropriate for anyone 6 months or older. The FluMist is limited to people 2 to 49 years old. The FluMist also shouldn’t be given to children on aspirin therapy, 2- to 4-year-olds with a history of asthma or prior wheezing, pregnant women, anyone who’s received flu antiviral medication within the previous two days and anyone in contact with or anyone with a compromised immune system.

What Else Should I Know Before Getting the FluMist or Shot?

“Anyone with an egg allergy can receive the FluMist or the flu shot. Both versions are active about two weeks after being administered. My recommendation is for parents to have their child receive whatever flu vaccine is offered by their provider. Overall, getting vaccinated is much more important than which type of the vaccine is received,” Dr. Rinderknecht says.

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