Injected vaccine is only recommended option this year
By Nancy DiFiore
In recent years, people being vaccinated against the flu have been given the option to receive the vaccine from a nasal spray. This year, everyone getting protection against the flu, including children, will have to tolerate a needle.
During this flu season, the only recommended option and best protection is the injectable flu vaccine. It's usually injected in the arm for older children and adults, and in the thigh muscle for babies and toddlers. The flu season generally is between October and May, and can peak at any time during the season.
The recommendation is based on information from a panel of immunization experts that advises the Centers for Disease Control and Prevention about the effectiveness of the flu shot (inactivated influenza vaccine) and nasal spray (live attenuated influenza vaccine).
Influenza is contagious and is caused by flu viruses. It can cause mild to severe illness, and can lead to death.
Injected vaccine outperforms nasal spray
According to the most recent estimates, the nasal spray reduced the incidence of the flu by only 3 percent, offering very little protection. By comparison, the injected vaccine reduced the risk of getting the flu by 63 percent.
“Nasal sprays were thought to be as effective as the shot, and early studies showed that they were just as effective. Normally vaccines that use live viruses can cause the immune system to have a greater response than vaccines that use the dead virus, but for some reason that wasn’t the case with these vaccines,” says Barbara Schmitt, RN, infection preventionist in the Department of Infection Prevention and Control at Rush University Medical Center.
Studies examining nasal spray vaccine effectiveness from 2013-2014 and 2014-2015 showed poor and lower than expected vaccine effectiveness among children age 2 to 17. The reason for the poor performance is currently unknown.
“Because of the ineffectiveness of the nasal spray, this year our office is only stocking the injected vaccines,” said Renee Slade, MD, a pediatric primary care physician at Rush. “It is important for the vaccine to be effective, which is why we took this step not to offer the nasal spray this season.”
Help children face their fear
While some doctors worry parents won’t get their children vaccinated this year, others advise parents how to approach the subject.
“We are disappointed that we do not have a nasal spray option, since some children are afraid of needles. My advice to parents is to tell children that ‘It's just a little pinch,’ will help a child know what to expect,” Slade said.
“We never want parents to lie to their children and say that it won’t hurt because it’s not true, and as a result children will no longer trust their parents.”
Who should get the flu shot?
While the flu vaccine is not approved for babies less than six months old, the CDC recommends that everyone six months of age and older get vaccinated. Vaccination is particularly important for people who are at a high risk of suffering from serious complications that result from getting the flu. According to the CDC, this group includes children under age 5, particularly those under 2, adults 65 years old or older and pregnant women. “To protect the youngest (and most vulnerable) babies, we recommend that everyone who lives or cares for a baby is vaccinated,” said Slade.
In addition, flu complications are a greater risk for people with the following medical conditions:
- Blood disorders
- Chronic lung disease
- Endocrine disorders
- Extreme obesity
- Kidney disorders
- Liver disorders
- Metabolic disorders
- Neurological or neurodevelopmental conditions
- Weakened immune systems
Why get the flu shot?
The flu can cause deaths and hospitalizations that are preventable. While vaccines are not 100 percent effective, the CDC reports that well-matched vaccines can reduce the risk of flu by 50 to 60 percent.
“It is especially important for health care workers to be vaccinated annually because those of us who get the vaccine are not only protecting ourselves but are also protecting family members, patients, coworkers and the community in general,” said Schmitt. “This is one pretty simple way to help protect everyone.”