By: Dr. Jim Mattey

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September 2016

 

This year you will notice we are not recommending the intranasal flu vaccine, or FluMist,

that has been used in prior years.  Looking back at the last few flu seasons, it appears

that the use of this vaccine wasn’t as effective at preventing cases of flu, particularly for

the type A H1N1 (Swine flu variant), when compared to the injected vaccine.  The Advisory

Committee on Immunization Practices and American Academy of Pediatrics have both

recommended that the injected influenza vaccine be used this year.

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Every year we find that any given vaccine seems to be more or less effective against

certain strains of the flu, and no vaccine is ever completely effective against any strain.

Previous studies in earlier years showed the intranasal vaccine to provide equal or better

protection compared to the injectable flu in various circumstances.  In fact, the intranasal

vaccine was deemed preferable to the injectable vaccine in children just a few seasons

ago.

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The questions still to be answered regarding the recent performance of the intranasal

mist are whether it was a problem or combination of problems with the vaccine,

something about the strains of flu that were circulating, or the stability and possibly the

administration and handling of the vaccine itself.  We have very stringent quality control of our vaccine shipping, storage and administration procedures, but this may not be the case for some vaccination sites such as large commercial operations or school based programs.  Further studies are underway to attempt to answer these questions.

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Here at the Pediatric Care Center and Young Adult Care Center, we will always use the most current information and best practices to inform our treatment recommendations and decisions.  Our current recommendation is for all of our patients over 6 months of age to receive an annual flu vaccine in the fall, unless they have a specific contraindication. (Note: egg allergy is no longer a contraindication and no special precautions are needed for egg allergic individuals other than receiving it where a doctor is available to treat an unlikely reaction.) This is even more imperative for those patients with higher risks of complications such as those under 2 years, pregnant women, those with medical conditions such as asthma, heart disease, diabetes and other chronic illnesses.  In addition, the family members and caregivers of infants under 6 months or patients with high risk of any age should get a flu vaccine.

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We recommend and will provide injectable quadrivalent vaccine for all of our patients and their families this year.  You may schedule a shot during one of our flu clinics or directly as a nurse visit if you need to.  We are happy to provide this service as a convenience to your family and to give you the confidence your vaccine will have been properly handled and administered.

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In the future, if the intranasal vaccine is once again shown to be equally effective to the injected vaccine, we will apply the same standards to determine our recommendations.