FluMist is a live, attenuated nasal spray flu vaccine.
While pediatricians, parents and kids loved it, since it wasn’t a shot, it hasn’t been available since 2016 because it was found to be less effective than flu shots against the H1N1 strain of flu.
The History of FluMist

The FluMist nasal spray was first approved in 2003 for healthy kids over age 5 years and adults up to age 49 years.
In 2007, the age range was expanded to included healthy children between the ages of 2 and 5 years.
It quickly became a favorite of kids who didn’t like the idea of getting a flu shot each year, although some kids didn’t like getting something sprayed into their nose.
Next, in 2012, FluMist Quadrivalent, with protection against four strains of flu virus, was approved.
While some experts initially thought it might work better than traditional flu shots and it actually became the preferred flu vaccine for kids in 2014, by 2016, FluMist was no longer recommended in the United States.
The Return of FluMist
On February 12, 2017, at a meeting of the Advisory Committee on Immunization Practices (ACIP), members voted to once again recommended FluMist Quadrivalent to prevent the flu. It will be available for next year’s flu season, although the recommendation still has to be approved by the director of the CDC.
What happened to FluMist?
“In the 2013-2014 influenza season, when lower than expected effectiveness of FluMist Quadrivalent was first observed, Influenza A (H1N1) was the predominant circulating influenza virus strain. When the data showing lower than expected vaccine effectiveness became available, FDA began working with MedImmune to investigate potential reasons for this finding.”
FDA Information Regarding FluMist Quadrivalent Vaccine
Although they worked on a fix after the 2013-2014 influenza season, the following season showed poor effectiveness for all flu vaccines because of a drifted flu strain. So it wasn’t until the following year that it was noticed that FluMist still didn’t work as well as a flu shot against H1N1 flu strains, at least not in the United States.
Surprisingly, studies in other countries, including Finland and the UK showed that FluMist did work.
And now MedImmune, the company that makes FluMist, has replaced the H1N1 seed virus it uses to make FluMist, and preliminary testing shows that it is more effective and should be as effective as a flu shot.
That’s why the ACIP voted 12-2 to make FluMist available for the 2018-2019 flu season.
Will you get it for your kids next year, instead of a regular flu shot? If the number of parents and kids asking for FluMist this year is any guide, many will be glad it’s back.
What to Know About the Return of FluMist
FluMist has hopefully been improved, been made more effective, and will be ready to help prevent the flu for the 2018-2019 flu season. It will be an especially good option for those kids who don’t want a shot.
More on the Return of Flumist
- FDA Information Regarding FluMist Quadrivalent Vaccine
- Influenza ACIP Vaccine Recommendations
- FDA – FluMist Quadrivalent
- Study – Live Attenuated Influenza Vaccine contains Substantial and Unexpected Amounts of Defective Viral Genomic RNA
- Genetic Mutation Could, If Altered, Boost FluMist Vaccine’s Effectiveness, Research Suggests
- Review – Perspectives from the Society for Pediatric Research: Decreased Effectiveness of the Live Attenuated Influenza Vaccine
- Study – Vaccine failure and serologic response to live attenuated and inactivated influenza vaccines in children during the 2013–2014 season
- Study – Differential gene expression elicited by children in response to the 2015–16 live attenuated versus inactivated influenza vaccine