FluMist

FluMist, the live, attenuated influenza vaccine (LAIV) that is given intranasally, instead of like a traditional flu shot, was first approved by the FDA in 2003.

At that time, it could be given to healthy, nonpregnant persons aged 5 to 49 years.

The age indication was lowered to include healthy kids between the ages of 2 to 4 years in 2007, in time for the 2007-08 flu season.

Other changes to FluMist over the years include that:

  • the dose was lowered from 0.5ml to 0.2ml in 2007
  • FluMist stopped being shipped frozen in 2007, instead being shipped at a higher 35°F to 46°F
  • Flu Quadrivalent was approved in 2012, but didn’t become available until the 2013-14 flu season
  • MedImmune, the makers of FluMist, begin to investigate reports of “lower than expected effectiveness” during the 2013-14 flu season and “possible problems with thermostability” are fixed
  • for the 2014-15 flu season, FluMist became the preferred flu vaccine for children between the ages of 2 to 8 years
  • the preferential recommendation for FluMist was removed the next year, for the 2015-16 flu season, when either inactivated flu shots or FluMist were recommended

And of course, for the 2016-17 flu season, the ACIP and AAP recommended that FluMist not be used at all.

About 14 million doses of FluMist would have been available in the United States during the 2016-17 flu season. Although a small percentage of the 171 to 176 million total doses of available flu vaccine, FluMist has been very popular with pediatricians, parents and especially children, as it helps avoid a shot.

Based on data from observational studies showing lower than expected effectiveness of FluMist Quadrivalent from 2013 through 2016, on June 22, 2016, the Advisory Committee on Immunization Practices (ACIP), an advisory committee to the Centers for Disease Control and Prevention (CDC), voted to recommend that FluMist Quadrivalent should not be used during the 2016-2017 influenza season.

There are “discordant results among” studies though and experts aren’t sure why.

If You Need More FluMist Information:

References:
  • MMWR. Notice to Readers: Expansion of Use of Live Attenuated Influenza Vaccine (FluMist®) to Children Aged 2–4 Years and Other FluMist Changes for the 2007–08 Influenza Season. November 23, 2007 / 56(46);1217-1219
  • MMWR. Recommendations of the Advisory Committee on Immunization Practices — United States, 2016–17 Influenza Season. August 26, 2016 / 65(5);1–54.

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