FluMist returns for next flu season, but it won't be for everyone

Feb. 25--Next flu season, most people will again have the choice between a flu shot and FluMist, an inhaled live virus vaccine.

Last week, AstraZeneca, the maker of FluMist, announced that the Centers for Disease Control and Prevention'sAdvisory Committee on Immunization Practices voted to recommend the vaccine for the 2018-19 season, two years after it stopped recommending it.

FluMist had proven ineffective against the H1N1 strain two years ago. This season, AstraZeneca tested a reformulation of FluMist to see whether it worked before the CDC committee approved it for next year.

The news comes after this year's flu shot has been only about 36 percent effective on the Type A, H3N2 strain of the flu. (That's up from previous reports of 10 percent to 15 percent effectiveness.) It's been a particularly bad flu season, the worse since the swine flu (H1N1) of 2009.

Not everyone should get FluMist instead of a flu shot, though.

You should get a shot instead if you:

--Are younger than 2.

--Have a compromised immune system.

--Have a chronic illness, such as asthma.

--Are older than 49.

The shot can be given to babies as young as 6 months old. People younger than 8 getting a flu shot or FluMist for the first time need two doses a month apart; they haven't yet built up antibodies to the flu.

People 65 and older can take a higher dose of the vaccine because the regular vaccine wears off in about six months in people in that age range. The shot works for about 12 to 18 months in children.

Most parents and kids will be happy that FluMist is back, said Dr. Leighton Ellis, pediatric chair at St. David's North Austin Medical Center and a pediatrician at North Austin Pediatrics. "Everybody is going to be really happy not to get a shot," she says.

FluMist has some advantages over the vaccine if it works. The antibodies in FluMist live in the nose instead of being in the bloodstream as with the shot.

"Sometimes with FluMist you might fight it off in your nose and you might not even get sick," Ellis said.

The disadvantages are that it's a live vaccine, which means it can cause a sore throat or headache afterward.

Regardless of whether you choose a flu shot or FluMist, choose something and try to do it before Halloween, Ellis said. That way you'll be ready for peak flu season.

Even though some people are still getting the flu with this year's vaccine, Ellis said, sometimes they have it for only about a day and it might just look like a bad cold. The typical flu comes with three to four days of fever, and the fever, soreness, chills, headache and cough happen all at once, rather than the slower buildup to sickness that you experience with a cold.

As other doctors' offices and hospitals have reported, Ellis said she isn't even testing most kids who come in with flu symptoms. Her office is holding onto flu tests for children younger than 2 and for children with compromised immune systems -- kids that would most likely require medical intervention if they had the flu.

For most people, the flu treatment is about rest, staying hydrated and alternating Tylenol and Motrin. Ellis isn't automatically prescribing the antiviral Tamiflu because of its side effects in kids such as vomiting and psychotic behavior. She will prescribe it if there is an infant in the house or someone for whom flu symptoms would be dangerous.

While parents might rejoice that FluMist will be back next year, Ellis knows her nurses won't be. It's harder to get a kid to agree to have something sprayed into their noses than to give them a quick shot, she said. Plus, parents have to decide which to choose: shot or mist.

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