FluMist: Flu Vaccine Option or 'Last Resort'?

COMMENTARY

FluMist: Reasonable Vaccine Option or 'Last Resort' for the Upcoming Flu Season?

Paul A. Offit, MD

Disclosures

June 09, 2018

Editorial Collaboration

Medscape &

Hi. My name is Paul Offit, and I'm talking to you today from the Vaccine Education Center at the Children's Hospital of Philadelphia. I want to talk about some contention about the use of the live-attenuated influenza vaccine known as FluMist. On the one hand, you have the Advisory Committee on Immunization Practices (ACIP), which advises the Centers for Disease Control and Prevention (CDC), recommending that the FluMist vaccine be used this coming year in the same manner that one would use the inactivated vaccine. Or said another way, you could use either vaccine.

But that's not what the American Academy of Pediatrics' (AAP) Red Book committee stated. They stated that they preferred the use of the inactivated influenza vaccine, and that the FluMist vaccine should only be used as a "last resort."[1] Let's talk about the data that are behind those two recommendations and see if we can make sense of them.

FluMist was first licensed for use in the United States in 2003 for those aged 5-49 years. In 2007, it was recommended for all of those between 2 and 49 years of age. The way that the vaccine is made is that it comes from two cold-temperature-adapted influenza viruses that were created in the 1960s, into which one then reassorts the hemagglutinin neuraminidase genes that are going to be prevalent for the coming season.

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