There’s no way to take the “sting” out of the flu vaccine this year.
A federal immunization advisory committee has recommended that “nasal spray” flu vaccine, an alternative to the flu shot, not be used during the 2016-17 flu season.
The recommendation could mean a lot more children will have to get flu shots this fall to be protected from influenza. About one-third of the vaccine given to children is by nasal spray, according to the federal Centers for Disease Control and Prevention.
Using the nasal spray has provided a level of comfort for the needle-squeamish, but the immunization committee said last week that the spray was only 3 percent effective, basically offering no protection, against the flu for children ages 2 to 17 in the 2015-16 flu season. The flu shot, however, was 63 percent effective, the committee said.
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AstraZeneca, the manufacturer of FluMist Quadrivalent, said in a June 23 statement on its website that its studies show the nasal spray was 46-58 percent effective against the circulating strains of influenza during the 2015-16 flu season.
The CDC said how well a flu vaccine works can vary widely by flu season. The reason for the recent poor performance of the nasal spray was unknown, it said. The spray contains live, weakened influenza viruses, and vaccines containing live viruses can have a stronger immune response than those with inactivated virus, the agency said.
The recommendation by the CDC’s Advisory Committee on Immunization Practices not to use the nasal spray in 2016-17 has to be reviewed and approved before it becomes policy.
The CDC typically follows the committee’s advice, but it can vary, said Dr. Randy Bergen, clinical lead for the flu vaccine program for Kaiser Permanente-Northern California. It remains unclear if the nasal spray will be available for adults, he said. FluMist is approved for adults up to age 50.
We’re trying to cancel our entire request. It’s unlikely we will be offering any FluMist.
Dr. Randy Bergen, Kaiser Permanente-Northern California
But for children, Bergen is fairly confident of a CDC decision: “It’s pretty much definite that FluMist will not be offered to children this year.”
Kaiser-Northern California, which includes Fresno, uses between 60,000 and 100,000 doses of FluMist every year, Bergen said. And since most of the nasal spray is given to children, he said, “We’re trying to cancel our entire request. It’s unlikely we will be offering any FluMist.”
Health providers said patients will be disappointed by a shot-only flu season.
“People do prefer the spray over the injectables,” said Gilda Zarate-Gonzalez, deputy public health director for Madera County.
County health departments get supplies of nasal spray and injectable vaccine through the California Department of Public Health. This past flu season, Madera County got 200 “sprayers,” but they arrived late in the flu season, Zarate-Gonzalez said.
On Tuesday, Fresno County said it has ordered 630 “sprayers” for the 2016-17 flu season, but the Health Department has not heard from the state whether the FluMist order will be replaced now with vials of vaccine for flu shots.
The CDC said it had projected the nasal spray would be about 8 percent of the total of 171 million to 176 million doses of flu vaccine in the 2016-17 season.
Nasal spray was projected to be 8 percent of total flu vaccine.
Bergen said enough injectable flu vaccine should be available for everyone. “We really haven’t encountered overall shortages of flu vaccine for several years now.”
By announcing its recommendation last week, the CDC committee has allowed the nation to get ready, making sure there is enough supply of injectable flu vaccine, said Dr. Serena Yang, interim chief of pediatrics at University of California at San Francisco-Fresno. Flu season typically starts in October, she said.
The CDC recommends anyone six months and older be immunized for the flu, Yang said. Children up to age 8 who get a flu shot for the first time will have to get two shots, at least four weeks apart, she said.
Yang hopes children will get immunized, even if it means a shot. “The gold standard is the flu shot,” she said. “It always has been.”
Doctors should be encouraging immunization, Bergen said. “Parents should be agreeing to it,” he said.
The CDC immunization committee’s recommendation shows the United States is monitoring the safety and effectiveness of vaccines, Bergen said. “I’ll have a lot of unhappy patients and unhappy parents, but this is a good thing because it means we are responding to evidence-based science.”
Zarate-Gonzalez said this past flu season Madera County parents were disappointed that the nasal spray arrived too late, but most got shots for themselves and their children. “They will take the vaccine in the form that is available at the time of their appointment.”
Sanger parent Allison Rodriguez never has been offered the nasal spray, but she hasn’t relished getting flu shots for her children who are ages 2, 5 and 7. “I don’t like getting my kids the pokes. It makes me nervous,” she said. However, she follows her doctor’s advice and her children are immunized.
Fresno mom Lisa Fowler said flu shots for her four children have never been a deal breaker. “If a parent really wants to protect their child, it shouldn’t matter.”
Editor’s note: An earlier version of the story misspelled Gilda Zarate-Gonzalez’s last name as Zarete-Gonzalez.