Parents Still Getting Kids Flu Shots Despite Nasal Vaccine’s Absence

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Study shows withdrawal of FluMist has had little effect on immunizations.

The national removal of a recommendation for using the nasal influenza vaccine on children had little effect on influenza immunization rates, a new Oregon Health Authority study shows.

The study, published recently in the medical journal Pediatrics and co-authored by researchers at OHA’s Oregon Immunization Program, found that influenza immunization rates for Oregon children were the same before and after the withdrawal of the recommendation. Children who had previously received the live-attenuated influenza vaccine (LAIV), marketed as FluMist, were also only slightly less likely to return for an injectable influenza immunization during the 2016-17 influenza season.

Using Oregon’s ALERT Immunization Information System, a statewide registry that collects immunization data from public and private health care providers, the researchers also found that children ages 2 to 10 who had received FluMist were only 3 percent less likely to get an injectable influenza immunization in 2016-17, while those ages 11 to 17 were 7 percent less likely. Overall, Oregon flu vaccination rates for children were the same in the 2015-16 and 2016-17 seasons, despite the lack of FluMist.

“Our study looked at whether the withdrawal of the LAIV recommendation led to lower childhood influenza immunization rates in the 2016-17 influenza season in Oregon,” said Steve Robison, epidemiologist with the Oregon Immunization Program. The researchers also examined whether those children who had previously used FluMist in the previous season were less likely to return in 2016-17 for an injectable influenza immunization, when compared to children who didn’t use FluMist.

“We found that, overall, there was no difference in childhood influenza immunization rates between the 2015-16 season, when FluMist was widely used, and the 2016-17 season, when FluMist was not used,” he said. “We also found that those children with prior FluMist were only slightly less likely to return for injectable influenza immunizations in 2016-17, when compared to those who didn’t use FluMist.”

Starting with the 2016-17 influenza season, the Centers for Disease Control and Prevention’s Advisory Committee for Immunization Practice withdrew its recommendation for use of LAIV because evidence showed it was not as effective against flu as injectable vaccine. The withdrawal led to concerns among public health practitioners that parents might choose not to get injectable influenza immunizations for children if they had previously used the FluMist nasal spray. Many providers also had believed that having a non-injected influenza vaccine for children was important to support the universal recommendation that everyone older than 6 months should get immunized against influenza.

“What this study shows is that worry that the withdrawal of the LAIV recommendation would lead to a large drop in influenza immunization rates for children was unfounded,” Robison said. “Oregon providers immunized the same numbers of children across influenza seasons regardless of whether FluMist was available or not. Parents and providers may be more concerned with the effectiveness of a vaccine than with how it is administered.”

Flu is a virus that causes mild to severe respiratory illness and can lead to hospitalization. The virus kills thousands of people in the U.S. each year. People at higher risk of severe illness or death include children, adults older than 65, pregnant women and people with chronic medical conditions or weak immune systems.

The flu vaccine is the best protection against flu. It can take up to two weeks to become effective, so getting it earlier in the season is ideal. That said, it’s not too late since flu season usually lasts until spring. Vaccinations are recommended for everyone 6 months of age and older.

Flu vaccine is available from health care providers, local health departments and many pharmacies. To find flu vaccine clinic, visit the OHA flu prevention website at http://www.flu.oregon.gov/ and use OHA’s flu vaccine locator tool.

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