On March 14, 2019, the American Academy of Pediatrics (AAP) announced that it will not be recommending the flu shot over the nasal spray flu vaccine for the 2019-2020 flu season. This represents a reversal of the AAP’s position during the 2016-2017 and 2017-2018 flu seasons, when it recommended against use of the nasal spray vaccine due to its “poor effectiveness” in fighting the H1N1 flu strains. During the 2018-2019 flu season, the AAP took the position that the nasal spray should only be used as a “last resort” for children who could not be immunized via injection.

As the AAP explains:

“The [2019-2020 flu season] recommendation comes after the Academy reviewed current data on vaccine coverage and effectiveness and flu season characteristics. It also considered the reformulation of the nasal spray vaccine. The guidance is expected to be similar to the recommendations from the Centers for Disease Control and Prevention (CDC). . . .

“In making a recommendation for 2019-20, the Academy reviewed U.K. data showing that the reformulated LAIV [nasal spray] has been effective against influenza A/H1N1 for children this season, when H1N1 has been the predominant circulating strain. While U.K. effectiveness data tend to differ somewhat from U.S. data, AAP leaders said the data were encouraging. The Academy also considered reported effectiveness of LAIV against other influenza virus strains.”

Currently, the CDC website still discusses the agency’s recommendations for the 2018-2019 flu season.

What Do Parents Need to Know about the Nasal Spray Flu Vaccine?

The nasal spray flu vaccine, sold under the name FluMist, is manufactured by AstraZeneca. It is a live attenuated influenza vaccine (LAIV), which means that it contains a living strain of the flu virus, but not of a type or in a quantity that is sufficient to actually cause a flu infection. However, it does carry the risk for certain side effects, most notably the risk for a severe allergic reaction among some children. As identified by the CDC, other potential side effects include:

  • Cough
  • Fever
  • Headache
  • Muscle aches
  • Runny nose
  • Sore throat
  • Vomiting
  • Wheezing

Additionally, the CDC recommends against use of the nasal spray flu vaccine for certain individuals – this is true regardless of the vaccine’s effectiveness in any given year. Those who should not receive the nasal spray flu vaccine include (but are not limited to):

  • Children younger than two years of age;
  • Children between the ages of two and four who have asthma or a recent history of wheezing;
  • Children over two years of age who take medications containing aspirin or salicylate; and,
  • Children who have received influenza antiviral drugs within the previous 48 hours.

In terms of benefits, one of the primary benefits of the nasal spray flu vaccine is its elimination of the risk of Shoulder Injury Related to Vaccine Administration (SIRVA). For more information on the risks of SIRVA resulting from the flu shot, you can read: Can You Suffer an Injury Following the Flu Vaccine?

Pain After a Flu Shot Could be a Sign of SIRVA

For individuals who receive a flu shot, pain is usually one of the first signs of a shoulder injury related to vaccine administration. Vaccine recipients diagnosed with SIRVA may be eligible for compensation under the National Vaccine Injury Compensation Program (VICP). To learn more in a free and confidential consultation, please call 212-800-1711 or contact us online today.