FluMist or Flu Shot: finding which is right for you

SANTA BARBARA COUNTY, Calif.– As flu season approaches each November, protection against the viruses is highly recommended doctors worldwide. For people experiencing anxiety surrounding needles, finding proper immunization to the flu feels a lot more difficult. However, many doctors offer another option– the FluMist Quadrivalent, which is sprayed in the nose.

According to the CDC, the United States currently offers "two ways someone can get a flu vaccine—by injection (a shot) or nasal spray. There is no preferential recommendation for any one flu vaccine over another."

So how does someone choose between the flu shot or the FluMist nasal spray flu vaccine? Dr. Henning Ansorg M.D., Public Health Officer for Santa Barbara County, said there are a few factors to take into consideration:

What is the difference between the flu shot and the FluMist?

A major difference between the two is that the FluMist is made with a live influenza virus, while the flu shot does not. Dr. Ansorg said there is "a very remote risk that somebody gets sick with an influenza-like illness when they get the nasal spray." On the other hand, the flu shot cannot give people the flu since it is an inactivated virus.

Another difference is how the vaccine is applied. The FluMist is sprayed into the nose while the flu shot is injected into the arm.

Who is eligible for the FluMist?

The FluMist was approved for use in healthy non-pregnant people, 2 through 49 years old. Dr. Ansorg said, "in a nutshell, the FluMist is really for people who are extremely panicky about injections." He added that there are restrictions for people who can get the FluMist.

According to the CDC, eligible patients for the FluMist cannot be:

• Children younger than 2 years old
• Adults 50 years and older
• People with a history of severe allergic reaction to any ingredient of the vaccine (except for egg protein) or to a previous dose of any flu vaccine
• Children 2 through 17 years old who are receiving aspirin- or salicylate-containing medications.
• Children 2 through 4 years old who have asthma or who have had a history of wheezing in the past 12 months
• People with weakened immune systems (immunosuppression) from any cause
• People who care for severely immunocompromised persons who require a protected environment (or otherwise avoid contact with those persons for 7 days after getting the nasal spray vaccine)
• People without a spleen, or with a non-functioning spleen
• Pregnant people
• People with an active leak between the cerebrospinal fluid and the mouth, nose, ear, or other place within the skull
• People with cochlear implants
• People who have taken flu antiviral drugs within a certain amount of time (within the past 48 hours for oseltamivir and zanamivir, the past 5 days for peramivir, and the past 17 days for baloxavir).

How does the FluMist work?

According to the FluMist Quadrivalent website, The FluMist triggers people's immune systems to help build antibodies against the flu in the ways: it starts in the nasal passage, where the flu enters the body. It then works its way into the bloodstream, helping circulate antibodies throughout the body. Then, the spray targets cells to help build up resistance to infection.

What are the side effects for both options?

If people experience side effects, they begin soon after vaccination are typically mild and short-lived. The CDC found different side effects in children versus adults:

In children, side effects from the nasal spray may include a runny nose, wheezing, headache, vomiting, muscle aches, low-grade fever, or a sore throat in older children.
In adults, side effects from the nasal spray vaccine may include a runny nose, headache, or a cough.

Similarly, the flu shot side effects are generally mild and go away on their own within a few days. The CDC said some side effects that may occur from a flu shot include soreness, redness, and/or swelling where the shot was given, headache, low grade fever, nausea, muscle aches, and fatigue. The flu shot, like other injections, can occasionally cause fainting.

Dr. Ansorg said, 'It's just really highly recommended to get a flu vaccine... especially for infants, because if somebody gets ill from the influenza, which is not just the cold, it's a worse virus." He said the immune system is not as robust yet in babies or the infants. Similarly, older people are more likely to get a more severe illness from the influenza. For infants and older adults, it's strongly recommended to get the flu shot.

Which is more effective– the flu shot or the FluMist?

Dr. Henning Ansorg said that both options are fairly similar in effectiveness. However, he added that it may be too early to tell. Dr. Ansorg said, "Flu vaccines are reformulated each year to optimize the matching to the new virus." Santa Barbara County has not yet seen a confirmed case of influenza, and typically do not until November.