From Vincent Iannelli, M.D.,
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About.com Health's Disease and Condition content is reviewed by Kate Grossman, MD

No one wants to get the flu.

A week or more of fever, runny nose, cough, muscle aches, sore throat, and extreme tiredness is something most of us would try to avoid. More importantly, influenza is responsible for an average of approximately 36,000 deaths per year in the United States.

And although most people know that the flu can be prevented with a yearly flu vaccine, the idea of getting a shot each year is not very appealing, especially to kids.

Fortunately, there is an alternative to a flu shot. FluMist is an intranasal live virus influenza vaccine for healthy children and adolescents, ages 2 to 17 years, and healthy adults, ages 18 to 49. While most people will just require one dose of FluMist each year, children 2 to 8 years old need two doses at least 6 weeks apart the first year that they get Flumist.

FluMist isn't for everyone though. You should not get FluMist if you (or your children):

• are under 2 years of age
• are aged 50 years or over
• have asthma or other reactive airway diseases
• have chronic underlying medical conditions that may predispose you to severe flu infections
• have problems with immune suppression, including those with immune deficiency diseases, such as AIDS or cancer, and people who are being treated with drugs that cause immunosuppression
• are allergic to eggs or to a previous dose of the vaccine

FluMist vs. Flu Shots

In addition to the benefit of not getting a shot, several studies have shown that FluMist may actually provide better protection against the flu than a flu shot. One study from the Journal of Pediatrics concluded that "live attenuated influenza vaccine was a safe and more effective alternative to inactivated vaccine."

We can hopefully look forward to even more studies comparing FluMist and flushots after this year's flu season.

Why can't younger kids, under age 2, get FluMist?

It seems like these younger patients would be the most likely to be afraid of shots and appreciate a no shot vaccine.

Hopefully more testing will be done in the future and FluMist will be found to be safe in even younger children. This is in fact the first year that preschoolers have been able to get FluMist, as the previous age limit was five years.

FluMist will hopefully also be found to be safe in people over age 50, which are usually considered at high risk of having serious or deadly influenza infections.

How much does FluMist cost?

The other thing that might keep you or your kids from using FluMist is the cost. FluMist is more expensive than a regular flu shot, but the price has come down this year. And most insurance companies have started to pay for it too, making it a more affordable option now than it was in previous years.

Although not for everyone, including most people who would be considered high risk for serious complications from the flu, the FluMist nasal spray flu vaccine will likely be a good alternative for healthy people aged 2 to 49 who don't want to get a flu shot but still want to reduce their chances of getting the flu.

FluMist and Flu Shortages

FluMist is an especially good option for certain high priority people who can't get a flu shot in years when there are flu shot shortages. This includes out-of-home caregivers and household contacts of children who are less than six months old. This would include parents, siblings, daycare workers, etc., as long as they have close contact with a newborn or young infant who is less than six months old.

FluMist is also a good option for most health-care workers, unless they care for severely immunocompromised patients, and others who are not pregnant and who are less than 50 years old.

_Sources:

Intranasal influenza vaccine may be a safe, effective option for many children. Lin K - J Pediatr - 01-JUL-2007; 151(1): 102-3

Comparison of the efficacy and safety of live attenuated cold-adapted influenza vaccine, trivalent, with trivalent inactivated influenza virus vaccine in children and adolescents with asthma. Fleming DM - Pediatr Infect Dis J - 01-OCT-2006; 25(10): 860-9