FluMist is a brand-name vaccine. It’s FDA-approved to help prevent influenza (flu) caused by the influenza A or influenza B virus. FluMist is approved for use in children and adults ages 2 to 49 years.
The flu is a respiratory illness that’s highly contagious. Symptoms can range from fever, stuffy nose, and aches, to chest pain, confusion, and trouble breathing. The flu can be mild or serious, and in rare cases, it can lead to death.
Because of the possible risks, it’s recommended that most people receive a flu vaccine each year to help prevent the flu.
Drug details
FluMist comes as a nasal spray that a healthcare provider or pharmacist will spray into your nose. The vaccine is available in one strength: 0.2 milliliters. Children and adults ages 9 to 49 years will likely need one dose of FluMist each year. Children ages 2 to 8 years will likely need one or two doses each year. For details, see the “FluMist dosage” section below.
FluMist contains a live influenza vaccine. This means it contains a weakened form of the flu virus, which stimulates a strong response from your immune system.
FluMist may also be called FluMist Quadrivalent because it helps protect you against four different strains (types) of the flu virus. In the past, FluMist protected against only three different strains of the flu virus. However, that form of the vaccine (FluMist Trivalent) is no longer available.
Effectiveness
For information on the effectiveness of FluMist, see the “FluMist uses” section below.
FluMist is available only as a brand-name medication. It’s not currently available in biosimilar form.
A biosimilar is like a generic. A generic is an exact copy of the active drug in a brand-name medication that’s made from chemicals. (Most medications are made from chemicals.)
A biosimilar, on the other hand, is a drug that’s similar to a brand-name biologic drug. (FluMist is a type of brand-name biologic drug.) Biologics are drugs made using living cells. Because of this, the drugs can’t be copied exactly.
Biosimilars have the same safety and effectiveness as the brand-name medication. Usually, a biosimilar drug costs less than the brand-name biologic.
Here’s some information on how FluMist compares with a flu shot.
Forms
FluMist is a nasal spray form of the flu vaccine. So instead of getting an injection like you would with a flu shot, a healthcare provider or pharmacist sprays FluMist into your nose. Because you’re not receiving an injection with FluMist, you won’t have possible arm soreness or pain. (For information on possible side effects of FluMist, see the “FluMist side effects” section below.)
Ages
Another difference between FluMist and a flu shot is the ages the vaccines are used for.
FluMist is approved only for use in children and adults ages 2 through 49 years. FluMist hasn’t been approved for use in children younger than age 2 years or older adults.
In comparison, the flu shot is approved to be used in all adults as well as children ages 6 months and older.
Pregnancy
If you’re pregnant, you can’t get FluMist, but you can get a flu shot. It’s recommended that you get a flu shot during pregnancy, so talk with your doctor to learn more.
Live vs. inactive vaccine
FluMist is a live vaccine. This means that FluMist has live flu viruses in it that have been weakened so that they shouldn’t infect you with the flu.
In comparison, flu shots are inactive vaccines that don’t have live viruses in them. As a result, flu shots can’t cause the flu.
Because FluMist is a live vaccine, you shouldn’t get FluMist if you have certain conditions, such as a weakened immune system. If you have a weakened immune system and you’re immunized with FluMist, you may become infected with the flu. This is because your immune system may not be strong enough to fight the flu viruses in the vaccine. (See the “FluMist precautions” section below for more information about people who shouldn’t use FluMist.)
If you have any questions about the difference between the FluMist nasal spray and a flu shot, talk with your doctor. They can help you decide which is the best option for you.
FluMist can cause mild or serious side effects. The following lists contain some of the key side effects that may occur while taking FluMist. These lists don’t include all possible side effects.
Side effects listed below occurred in people who received either FluMist Quadrivalent or FluMist Trivalent, which is no longer available. FluMist Quadrivalent protects against four strains of the flu virus, while FluMist Trivalent protected against three strains. Although FluMist Trivalent is no longer available, the research, including side effects, from studies of both vaccines was reported together.
For more information on the possible side effects of FluMist, talk with your doctor or pharmacist. They can give you tips on how to deal with any side effects that may be bothersome.
Note: The Food and Drug Administration (FDA) tracks side effects of drugs it has approved. If you would like to notify the FDA about a side effect you’ve had with FluMist, you can do so through MedWatch.
Mild side effects
Mild side effects of FluMist can include:*
- fever†
- diarrhea†
- runny nose or stuffy nose†
- sore throat†
- headache
- cough
- muscle aches
- decreased appetite
- lethargy (being sluggish and less active than usual)
- vomiting
Most of these side effects may go away within a few days or a couple of weeks. But if they become more severe or don’t go away, talk with your doctor or pharmacist.
* This is a partial list of mild side effects from FluMist. To learn about other mild side effects, talk with your doctor or pharmacist, or see the FluMist
† For more information on these side effects, see “Side effect details” below.
Serious side effects
Serious side effects from FluMist aren’t common, but they can occur. Call your doctor right away if you have serious side effects. Call 911 or your local emergency number if your symptoms feel life threatening or if you think you’re having a medical emergency.
A possible serious side effect of FluMist, which is explained below in “Side effect details,” is:
Side effects in children
Side effects in toddlers, children, and teenagers were very similar to side effects that occurred in adults. However, children also experienced fever higher than 100°F (38°C) and belly pain.
Children younger than age 5 years with a history of wheezing or asthma may be at an increased risk of developing wheezing after receiving FluMist. So if your child has had asthma or wheezing that keeps returning, their doctor may recommend that they receive a flu shot instead of FluMist. Getting a flu shot shouldn’t raise their risk of wheezing. (For more differences between FluMist and the flu shot, see the “FluMist vs. flu shot” section above.)
If your child does receive the FluMist vaccine, their doctor may monitor them afterward to treat any wheezing that occurs.
Side effect details
You may wonder how often certain side effects occur with this drug. Here’s some detail on certain side effects this drug may cause.
Allergic reaction
As with most drugs, some people can have an allergic reaction after taking FluMist. It’s not known how many people who were immunized with FluMist in clinical studies had an allergic reaction to the vaccine.
Symptoms of a mild allergic reaction can include:
A more severe allergic reaction is rare but possible. Symptoms of a severe allergic reaction can include:
- swelling under your skin, typically in your eyelids, lips, hands, or feet
- swelling of your tongue, mouth, or throat
- trouble breathing
Call your doctor right away if you have a severe allergic reaction to FluMist. Call 911 or your local emergency number if your symptoms feel life threatening or if you think you’re having a medical emergency.
Fever
Fever was a side effect that was reported in children who received the FluMist vaccine. However, fever wasn’t a common side effect that was seen in adults who received the vaccine. A fever was defined as a body temperature higher than 100°F (38°C).
In clinical trials of children ages 2 to 6 years, fevers were reported in:
- between 13% and 16% of children who received FluMist
- 11% of children who received a flu shot or a placebo, which was a nasal spray that didn’t contain the vaccine
Fevers were also reported in clinical trials of children ages 2 to 17 years. Researchers compared FluMist Quadrivalent with FluMist Trivalent. Fevers were reported in:
- 7% of children who received FluMist Quadrivalent
- 5% of children who received FluMist Trivalent
If you or your child develop a fever after receiving the FluMist vaccine, talk with your doctor. They may recommend that you take a medication such as acetaminophen (Tylenol) to decrease the fever. They may also be able to suggest other ways to help lower the fever.
Diarrhea
Diarrhea isn’t a common side effect that was reported in clinical trials of people who received FluMist. However, diarrhea was reported in post-marketing studies of people who received the vaccine. Post-marketing studies are studies done after the FDA has given its approval. It’s not known how many people experienced diarrhea after receiving FluMist.
If you have diarrhea after you receive your FluMist dose, talk with your doctor or pharmacist. They may be able to recommend ways to help ease this side effect.
Stuffy nose
Nasal congestion (a stuffy nose) was a common side effect that was reported in both adults and children in clinical trials of FluMist.
Stuffy nose in adults
In a clinical trial of adults ages 18 to 49 years, FluMist was compared with a placebo. The results showed that nasal congestion occurred in:
- 9% of people who received FluMist
- 2% of people who received a placebo
Another study compared adults who received FluMist Quadrivalent with adults who received FluMist Trivalent. In this trial, a runny nose or nasal congestion was reported in:
- 44% of adults who received FluMist Quadrivalent
- 40% of adults who received FluMist Trivalent
Stuffy nose in children
Clinical trials compared children ages 2 to 6 years who received FluMist or a placebo. A runny nose or nasal congestion was reported in:
- between 51% and 58% of children who received FluMist
- between 42% and 50% of children who received a flu shot or a placebo
In a clinical trial of children ages 2 to 17 years, FluMist Quadrivalent was compared with FluMist Trivalent. The results showed that a runny nose or nasal congestion occurred in 32% of children who received a dose of either the Quadrivalent or Trivalent form of FluMist.
Talking with your doctor or pharmacist
If you develop a stuffy nose that’s bothersome to you after you receive FluMist, talk with your doctor or pharmacist. They may recommend ways to help you feel more comfortable.
Sore throat
Sore throat is a common side effect of FluMist. In clinical trials, both adults and children developed a sore throat.
Sore throat in adults
In a clinical trial of adults ages 18 to 49 years, FluMist was compared with a placebo. Researchers found that a sore throat occurred in:
- 28% of people who received FluMist
- 17% of people who received a placebo
In addition to this trial, another study compared adults who received FluMist Quadrivalent with adults who received FluMist Trivalent. A sore throat was reported in:
- 19% of adults who received FluMist Quadrivalent
- 20% of adults who received FluMist Trivalent
Sore throat in children
Clinical trials were also conducted in children ages 2 to 6 years who received FluMist or a placebo. In the trials, a sore throat was reported in:
- between 5% and 11% of children who received FluMist
- between 6% and 9% of children who received a flu shot or a placebo
In a clinical trial of children ages 2 to 17 years, FluMist Quadrivalent was compared with FluMist Trivalent. The results showed that a sore throat occurred in:
- 9% of children who received FluMist Quadrivalent
- 10% of children who received FluMist Trivalent
Talking with your doctor or pharmacist
If you receive the FluMist vaccine and develop a sore throat that doesn’t go away or is severe, talk with your doctor. They may recommend ways to help relieve this side effect.
How long do side effects from FluMist last?
It wasn’t reported in clinical trials how long side effects from FluMist last. However, most side effects were reported within 10 to 14 days after FluMist vaccination.
If you receive FluMist and experience side effects that seem to last and don’t improve, talk with your doctor. They can see if another condition may be causing your symptoms.
The Food and Drug Administration (FDA) has approved FluMist for use in both kids and adults ages 2 to 49 years.
FluMist isn’t been approved to be used in children younger than age 2 years because of an increased risk of wheezing and hospitalization. The FluMist vaccine that children receive is the same one that adults receive. There is no children’s version of the vaccine.
However, children ages 2 to 8 years who have never been given a flu vaccine may receive FluMist in two doses. These children haven’t been exposed to flu viruses in a flu vaccine, so the two doses help their immune system recognize the viruses.(For more information, see the “How FluMist works” section below.)
If your child has been given a flu vaccine before, they will need only one dose of FluMist.
FluMist is also not approved to be used in adults older than age 49 years. This is because the vaccine doesn’t work to help prevent flu in this population.
You should get FluMist according to your doctor’s or healthcare provider’s instructions.
FluMist comes as a nasal spray that a healthcare provider or pharmacist will spray into your nose. You’ll likely receive your dose of FluMist at a doctor’s office or pharmacy.
When you receive your vaccine, you can breathe normally. You don’t have to sniff. Your doctor or pharmacist will have you sit up straight. Then they’ll quickly spray one squirt of vaccine into each nostril.
For children ages 2 to 8 years, two doses of FluMist may be recommended. Talk with your child’s doctor about whether your child should receive one or two doses.
For more information on the number of doses of FluMist that you or your child should receive, see the “FluMist dosage” section below.
CDC recommendations
Each year, the Centers for Disease Control and Prevention (CDC) makes recommendations about flu vaccinations. The CDC recommends what age groups should receive a flu vaccine and what the vaccine dose should be. The CDC also makes recommendations about other vaccines you should get and when you should have them.
Currently, the CDC
- children younger than age 2 years and adults older than age 49 years
- pregnant people
- people who may have weakened immune systems (such as people with HIV) or people who care for others with severely weakened immune systems
- children ages 2 through 17 years who are taking aspirin or a medication similar to aspirin
- children ages 2 through 4 years who have a history of asthma or have experienced wheezing in the past year
For these groups of people, the CDC recommends a flu shot, rather than FluMist. This is because flu shots are inactive vaccines and FluMist is a live vaccine. For details on live and inactive vaccines, see “Live vs. inactive vaccine” in the “FluMist vs. flu shot” section above.
The CDC doesn’t recommend that anyone with a history of a severe allergic reaction to any of the ingredients in FluMist or a flu shot receive the flu vaccine. The CDC also doesn’t recommend FluMist or a flu shot to anyone who has taken a medication to treat the flu within 48 hours. This type of medication is known as an antiviral drug, and an example is oseltamivir (Tamiflu).
If you have any questions about which flu vaccine to get or the CDC recommendations, talk with your doctor or pharmacist. They can discuss the current recommendations with you and help you determine if getting FluMist or a flu shot is right for you.
When to get the vaccine
It’s important to get the flu vaccine a few weeks before flu season begins in your area. This is because the flu vaccine takes about 2 weeks to become effective to help prevent the flu. The CDC
However, the CDC also recommends not getting the flu vaccine too early. If you get vaccinated in July or August, the vaccine protection may not last throughout the flu season.
Some children need two doses of the flu vaccine, which need to be separated by at least 4 weeks. In this case, your child’s doctor may recommend that your child receives the first dose early. This helps ensure that both doses can be given before flu season. (See the “FluMist dosage” section below for details.)
Here are answers to some frequently asked questions about FluMist.
Can FluMist spread or cause the flu through shedding?
Shedding is very common with the FluMist vaccine. However, it’s very unlikely that this shedding will spread or cause the flu.
Shedding occurs when a virus in your body replicates (makes copies of itself) and is then released to the environment around you. For example, when you receive the FluMist nasal spray, the flu viruses will replicate in your nose. Then if you sneeze, you could spread the flu viruses.
In a
- 79% of children in the study
- 89% of children ages 6 months through 23 months old
- 69% of children ages 24 months through 69 months old
Another study looked at whether people actually catch the flu when others shed the virus after getting FluMist. Children ages 8 to 36 months received FluMist or a placebo (treatment with no active vaccine).
The researchers found that 80% of children who received FluMist shed the virus. However, the researchers found only one instance of a flu strain in a child who received a placebo. Based on these numbers, they estimated that the transmission rate of the virus from those who received FluMist vaccine was about 0.58%.
These study results indicate that it’s unlikely that you would become infected with the flu from someone else who received the FluMist vaccine.
If you have questions about shedding or spreading flu viruses after receiving FluMist, talk with your doctor or pharmacist.
* The Food and Drug Administration (FDA) has approved FluMist for use in children and adults ages 2 to 49 years.
I have asthma. Can I still get FluMist?
It depends. If you have asthma, you may be at a higher risk for developing wheezing when you receive the FluMist vaccine. Children younger than age 5 years who have wheezing that keeps returning may also be at risk for wheezing with FluMist.
If either of these situations apply, the doctor may monitor you or your child for a longer time than usual after a dose of FluMist. This allows them to treat any wheezing that occurs. In some cases, the doctor may recommend that you or your child have a flu shot instead. Talk with your doctor about the best flu vaccine for you or your child.
How well does FluMist work?
FluMist is an effective vaccine to help prevent against infection with the influenza (flu) viruses.
FluMist was studied in clinical trials of adults ages 18 to 49 years. Researchers followed people in the study over the course of 7 weeks. People vaccinated with FluMist were 23.7% less likely to develop an upper respiratory infection with a fever compared with people who received a placebo. Upper respiratory infections include the common cold.
However, no vaccine is 100% effective. Although FluMist may decrease your risk for becoming infected with the flu viruses, you could still develop the flu.
Talk with your doctor about whether FluMist is right for you and what else you can do to help prevent the flu.
Does FluMist cause autism?
No, FluMist doesn’t cause autism. There has been some speculation in the past that vaccines or ingredients in vaccines, such as thimerosal, may cause autism. However, there is no relationship between any vaccine and developing autism.
Many studies, such as one published in the Journal of Pediatrics, show that vaccines don’t cause autism. The
If you have questions about the risks of flu vaccines, talk with your doctor.
Is it OK to get FluMist if I have diabetes?
You may not be able to get FluMist if you have diabetes, including both type 1 diabetes and type 2 diabetes. This is because diabetes can weaken your immune system.
FluMist is a live vaccine, which means it has live flu viruses in it that have been weakened so that they shouldn’t infect you with the flu. If your immune system is healthy, it should be able to fight the flu viruses in the vaccine. But if your immune system is weakened due to diabetes, you may not be able to fight the viruses in the vaccine.
If you have diabetes, your doctor will probably recommend that you get a flu shot instead of FluMist. Flu shots aren’t live vaccines. For details, see “Live vs. inactive vaccine” in the “FluMist vs. flu shot” section above.
If you have questions about which flu vaccine is right for you, talk with your doctor.
Does FluMist protect me from COVID-19?
No, FluMist doesn’t protect against COVID-19. No flu vaccine will protect against COVID-19 because influenza (flu) viruses are different from the coronavirus that causes COVID-19.
However, it’s still important to be vaccinated against the flu. This is because it’s possible to become infected with both the flu and COVID-19. Having both infections can increase your risk for serious effects such as trouble breathing and, in some cases, death.
Also, when you have an infection, such as the flu, your immune system tries to fight the infection. As a result, it may be harder for your immune system to fight off additional illnesses such as COVID-19.
So, although FluMist won’t protect you from COVID-19, it should still protect you from the flu. And this could leave your body better prepared to fight off COVID-19 or other illnesses.
If you have questions about FluMist or COVID-19, talk with your doctor.
Can I receive the FluMist vaccine if I have or think I have COVID-19?
No. You shouldn’t receive the FluMist vaccine if you have or think you have COVID-19.
If you have COVID-19, your doctor has likely told you to
If you think you have COVID-19, talk with your doctor. They can recommend the right testing for you. If the tests show that you don’t have COVID-19, your doctor may say that you can get FluMist or a flu shot.
If you have questions about FluMist or COVID-19, talk with your doctor.
Was FluMist discontinued at some point?
Yes, FluMist wasn’t available during the 2016–2018 flu seasons. The CDC
However, in 2018, the manufacturer of FluMist changed the vaccine so that it would be more effective. With that change, the CDC began to recommend FluMist as an option for flu vaccination in 2019. However, there was a limited supply of the vaccine available during the 2019–2020 flu season due to a manufacturing shortage.
FluMist is currently approved for the 2020–2021 flu season for use in children and adults ages 2 to 49 years. If you have questions about whether FluMist is right for you, talk with your doctor. You can also refer to “CDC recommendations” in the “How FluMist is given” section above.
FluMist can interact with several other medications. The drug isn’t known to interact with any supplements or foods.
Different interactions can cause different effects. For instance, some interactions can interfere with how well a drug works. Other interactions can increase the number of side effects or make them more severe.
FluMist and other medications
Below are some of the medications that can interact with FluMist. This section doesn’t contain all drugs that may interact with FluMist.
Before taking FluMist, talk with your doctor and pharmacist. Tell them about all prescription, over-the-counter, and other drugs you take. Also tell them about any vitamins, herbs, and supplements you use. Sharing this information can help you avoid potential interactions.
If you have questions about drug interactions that may affect you, ask your doctor or pharmacist.
FluMist and aspirin
Children ages 2 through 17 years who are taking aspirin or medication that has aspirin in it shouldn’t get the FluMist vaccine.
FluMist is a live vaccine. This means that FluMist has live flu viruses in it that have been changed so that they shouldn’t infect your child with the flu. If your child’s immune system is healthy, their body should be able to fight the flu viruses in the vaccine. But if your child has an infection, their immune system may be too weak to fight the vaccine’s flu viruses.
If your child takes aspirin and is infected with the flu, there’s a possible risk of Reye’s syndrome. This is a rare but very serious disease that affects the brain and liver. It’s not known exactly what causes Reye’s syndrome. However, children who are recovering from an infection are usually at the highest risk for Reye’s syndrome. And there may be a link between children who take aspirin for a viral infection and developing Reye’s syndrome.
If your child is age 2 to 17 years and has received FluMist, they should avoid aspirin or any drugs that have aspirin in them for at least 4 weeks. But if your child does need to take aspirin or drugs containing aspirin within this time frame, talk with their doctor. The doctor may monitor your child more often than usual to make sure your child isn’t developing symptoms of Reye’s syndrome.
FluMist and some antiviral drugs such as Tamiflu
Taking certain antiviral drugs when you receive FluMist may make the vaccine ineffective. Antiviral drugs that work against influenza A or influenza B may also work against FluMist, and you may not get any benefits from the vaccine. It isn’t known exactly how much benefit you may get from receiving FluMist while you’re taking an antiviral drug because this hasn’t been studied.
It’s believed that taking an antiviral drug that works against influenza A or influenza B around the time you receive FluMist may make FluMist less effective. The time period is 48 hours before receiving FluMist to 2 weeks after receiving the vaccine.
If you need an antiviral drug within this time period, your doctor may recommend that you receive FluMist again after your antiviral treatment ends.
Examples of antiviral drugs that work against influenza A or B include:
If you’re not sure if you’re taking an antiviral drug that works against influenza A or B, talk with your doctor.
FluMist and antibiotics (not an interaction)
FluMist doesn’t interact with antibiotics. These are drugs that work to destroy bacteria that can cause infections.
In some cases, your doctor may want you to wait until the infection goes away before you receive FluMist. This includes waiting if you’re taking antibiotics to treat a moderate to severe infection.
Your doctor may also want you to wait to receive FluMist if you’re taking antibiotics for a sinus infection or an infection that’s causing severe nasal congestion. If you’re so congested that the vaccine can’t get to the lining of your nose, FluMist may not work properly. Your doctor may also recommend getting a flu shot instead of FluMist.
If you’re taking an antibiotic, talk with your doctor about the right time to get FluMist or a flu shot.
FluMist and herbs and supplements
There aren’t any herbs or supplements that have been specifically reported to interact with FluMist. However, you should still check with your doctor or pharmacist before using any of these products while taking FluMist.
FluMist and foods
There aren’t any foods that have been specifically reported to interact with FluMist. If you have any questions about eating certain foods with FluMist, talk with your doctor.
FluMist and other vaccines
Here’s some information on whether FluMist can be given at the same time as other vaccines.
FluMist is a live vaccine. This means that FluMist has live flu viruses in it that have been changed so that they shouldn’t infect you with the flu. Inactive vaccines, on the other hand, don’t have live viruses in them. (For details on live and inactive vaccines, see “Live vs. inactive vaccine” in the “FluMist vs. flu shot” section above.)
FluMist and inactive vaccines
FluMist hasn’t been studied when given with inactive vaccines.
Examples of inactive vaccines include:
- hepatitis A and hepatitis B
- polio
- human papillomavirus (HPV)
- tetanus
- whooping cough
- meningitis
- pneumonia
- a shingles vaccine called Shingrix
If you plan to get FluMist and think you need an inactive vaccine, ask your doctor when the best time is to get them.
FluMist and other live vaccines
FluMist is a live vaccine. It has been studied when given with other live vaccines.
One study looked at children ages 12 to 15 months. They received FluMist alone or FluMist with the measles, mumps and rubella vaccine (MMR) and chickenpox vaccines. There was no difference in how the children’s bodies reacted to the vaccines in either group. However, it’s important to note that FluMist isn’t approved for use in children ages 12 to 15 months. The vaccine is approved to be used only in children and adults ages 2 through 49 years.
Examples of other live vaccines include:
If you plan to get FluMist and think you need another live vaccine, ask your doctor when the best time is to get them.
There are no known interactions between FluMist and alcohol.
As with all medications, the cost of FluMist can vary. The actual price you’ll pay depends on your insurance plan, your location, and the pharmacy you use.
Before approving coverage for FluMist, your insurance company may require you to get prior authorization. This means that your doctor and insurance company will need to communicate about your prescription before the insurance company will cover the drug. The insurance company will review the prior authorization request and decide if the drug will be covered.
If you’re not sure if you’ll need to get prior authorization for FluMist, contact your insurance company.
Financial assistance
If you need financial support to pay for FluMist, help is available. NeedyMeds lists programs that may aid in lowering the cost of FluMist. For more information and to find out if you’re eligible for support, visit the NeedyMeds website.
Biosimilar version
FluMist is available only as a brand-name medication. It’s not currently available in biosimilar form.
A biosimilar is kind of like a generic. A generic refers to a medication created from chemicals. And a generic drug is an exact copy of the active drug in a brand-name medication.
A biosimilar is a drug that’s similar to brand-name biologic drug. (FluMist is a type of brand-name biologic drug.) Because biologics are made using living cells, the drugs can’t be copied exactly.
Biosimilars have the same safety and effectiveness as the brand-name medication. Usually, a biosimilar drug costs less than the brand-name biologic.
The FluMist dosage your doctor prescribes will depend on several factors. These include:
- your age
- how many doses of flu vaccine your child has received in the past
FluMist may also be called FluMist Quadrivalent because it helps protect you against four different strains (types) of the flu virus. In the past, FluMist protected against only three different strains of the flu virus. However, that form of the vaccine is no longer available.
The following information describes dosages that are commonly used or recommended. However, be sure to take the dosage your doctor prescribes for you. Your doctor will determine the best dosage to fit your needs.
Drug forms and strengths
FluMist comes as a nasal spray that a healthcare provider or pharmacist will spray into your nose. The vaccine is available in one strength: 0.2 milliliters (mL).
Dosage for preventing the flu
For adults ages 18 to 49 years, the FluMist dosage to help prevent the flu is one dose each flu season. The dose is split into two sprays (0.1 mL per spray), one in each nostril.
Pediatric dosage
For children ages 2 through 8 years, the FluMist dosage is one or two doses of FluMist each flu season. The dose will be split into two sprays (0.1 mL per spray), one in each nostril.
Children ages 9 years and older will typically receive the adult dosage of FluMist. Once each flu season, they’ll receive one dose of FluMist. The dose is split into two sprays (0.1 mL per spray), one in each nostril.
The CDC
- are getting a flu vaccine for the first time
- have received the flu vaccine in previous years, but have only ever received one dose each flu season
If your child has never been given a flu vaccine, they may need two doses of FluMist. Your child hasn’t been exposed to flu viruses in a flu vaccine, so the two doses help their immune system recognize the viruses. (For more information, see the “How FluMist works” section below.)
If your child needs two doses of FluMist, they should be spaced out by at least 4 weeks. Your child should also have their first dose of FluMist early so that they can have both doses before flu season starts.
What if I miss a dose?
In most cases, you’ll need only one dose of FluMist for it to be effective at helping prevent the flu. If you don’t get the FluMist vaccine before the start of the flu season, you can likely still receive it later.
Each year, how long flu season lasts is different. Some years it may last through March, and in other years, flu season can last until May. The Centers for Disease Control and Prevention (CDC)
It’s also important to note that the CDC recommends certain children receive two doses of the FluMist. (To learn more, see “Pediatric dosage” above.) If your child misses their appointment to receive the second dose, reschedule it as soon as possible.
It’s safe to get the FluMist vaccine while you’re breastfeeding.
FluMist isn’t absorbed into the body after a dose of the vaccine is given. So it’s not expected that a breastfed child would be exposed to FluMist after their mother receives the vaccine.
The CDC
If you are breastfeeding, talk with your doctor about the best type of flu vaccine for you.
The Centers for Disease Control and Prevention (CDC)
FluMist isn’t absorbed into the body after a dose of the vaccine is given. So it’s not expected that a developing baby would be exposed to the vaccine. And in studies of animals that received FluMist while pregnant, the developing baby wasn’t harmed. However, animal studies don’t always predict what will happen in humans.
The CDC
At this time, it’s not recommended that you receive FluMist during pregnancy. If you’re sexually active and you or your partner can become pregnant, talk with your doctor about your birth control needs while you’re using FluMist.
For more information about FluMist and pregnancy, see the “FluMist and pregnancy” section above.
Other vaccines are available that can prevent the flu. Some may be a better fit for you than others. If you’re interested in finding an alternative to FluMist, talk with your doctor. They can tell you about other vaccines that may work well for you.
Alternatives for preventing the flu
Examples of other vaccines that may be used to help prevent the flu include:
- trivalent, high-dose flu shot (Fluad, Fluzone High-Dose)
- quadrivalent flu shot made in eggs (Afluria Quadrivalent, Fluarix Quadrivalent, FluLaval Quadrivalent, Fluzone Quadrivalent)
- quadrivalent flu shot, egg-free (Flucelvax Quadrivalent, Flublok Quadrivalent)
You may wonder how FluMist compares with other vaccinations that are for similar uses. Here we look at how FluMist and Fluzone are alike and different.
Ingredients
FluMist contains a live influenza (flu) vaccine. It’s a quadrivalent vaccine, so it has two strains of influenza A and two strains of influenza B in it.
Fluzone is an influenza inactivated injectable vaccine. It’s available as Fluzone Quadrivalent, which has two strains of influenza A and two strains of influenza B.
Fluzone is also available as a high-dose quadrivalent vaccine. High-dose flu vaccines are given to adults ages 65 years and older. Because older adults are at higher risk for complications, it’s recommended that they receive the high-dose vaccine.
Uses
The Food and Drug Administration (FDA) has approved both FluMist and Fluzone to help prevent the flu caused by the influenza A or influenza B virus.
FluMist is approved for use in children and adults ages 2 to 49 years. FluMist may also be called FluMist Quadrivalent.
Fluzone is approved for use in children and adults ages 6 months and older. Fluzone may also be called Fluzone Quadrivalent. A different form of the drug called Fluzone High-Dose is approved for use in adults ages 65 years and older.
Drug forms and administration
FluMist comes as a nasal spray that a healthcare provider or pharmacist will spray into your nose.
Fluzone comes as a suspension (liquid mixture) that’s given as an injection into your muscle. This is called an intramuscular injection.
Both FluMist and Fluzone are usually given once a year, but in some cases, children might need two doses spaced out by a few weeks.
Side effects and risks
FluMist and Fluzone both contain vaccines to help prevent the flu. Therefore, these medications can cause very similar side effects, but some different ones as well. Below are examples of these side effects.
Mild side effects
These lists contain up to 10 of the most common mild side effects that can occur with FluMist, with Fluzone, or with both drugs (when taken individually).
- Can occur with FluMist:
- runny nose or stuffy nose
- decreased appetite
- lethargy (being sluggish and less active than usual)
- Can occur with Fluzone:
- injection site reactions (pain, redness, or swelling where the drug was injected)
- drowsiness
- Can occur with both FluMist and Fluzone:
- muscle aches or pain
- vomiting
Serious side effects
This list contains examples of serious side effects that can occur with FluMist and Fluzone when taken individually:
Effectiveness
The only condition both FluMist and Fluzone are used to help prevent is the flu.
These drugs haven’t been directly compared in clinical studies, but studies have found both FluMist and Fluzone to be effective for helping prevent the flu.
Costs
FluMist and Fluzone generally cost about the same. The actual price you’ll pay for either drug depends on your insurance plan, your location, and the pharmacy you use.
FluMist and Fluzone are both brand-name vaccines. There are currently no biosimilar forms of FluMist or Fluzone. A biosimilar is like a generic. A generic is an exact copy of the active drug in a brand-name medication that’s made from chemicals. (Most medications are made from chemicals.)
A biosimilar, on the other hand, is a drug that’s similar to a brand-name biologic drug. (FluMist is a type of brand-name biologic drug.) Biologics are drugs made using living cells. Because of this, the drugs can’t be copied exactly.
Biosimilars have the same safety and effectiveness as the brand-name medication. Usually, a biosimilar drug costs less than the brand-name biologic.
Fluzone is a kind of flu shot, and the flu shot is available as other brand names. These include Afluria, Fluarix, and Flucelvax.
Like Fluzone (above), the drug Tamiflu is also used in regard to the flu. Here’s a comparison of how FluMist and Tamiflu are alike and different.
Ingredients
FluMist contains a live influenza (flu) vaccine. It’s a quadrivalent vaccine, so it has two strains of influenza A and two strains of influenza B in it.
Tamiflu contains the active drug oseltamivir.
Uses
Here is a list of conditions that the Food and Drug Administration (FDA) has approved FluMist and Tamiflu to treat.
- FluMist is FDA-approved to help prevent:
- the flu caused by the influenza A or influenza B virus in children and adults ages 2 to 49 years
- Tamiflu is FDA-approved to:
- treat the flu in children and adults ages 2 weeks and older
- help prevent the flu in children and adults ages 1 year and older
Drug forms and administration
FluMist comes as a nasal spray that a healthcare provider or pharmacist will spray into your nose. FluMist is usually given once a year, but in some cases, children might need two doses spaced out by a few weeks.
Tamiflu comes in two forms: a capsule or suspension (liquid mixture) that you drink. When the drug is used to help prevent the flu, you’ll likely take Tamiflu once a day. When the drug used to treat the flu, you’ll likely take Tamiflu twice a day.
Costs
The costs of FluMist and Tamiflu vary depending on your treatment plan. The actual price you’ll pay for either drug depends on your insurance plan, your location, and the pharmacy you use.
FluMist and Tamiflu are both brand-name drugs. Tamiflu also comes in a generic form called oseltamivir. Brand-name medications usually cost more than generics.
There are currently no biosimilar forms of FluMist. A biosimilar is like a generic. A generic is an exact copy of the active drug in a brand-name medication that’s made from chemicals. (Most medications are made from chemicals.)
A biosimilar, on the other hand, is a drug that’s similar to a brand-name biologic drug. (FluMist is a type of brand-name biologic drug.) Biologics are drugs made using living cells. Because of this, the drugs can’t be copied exactly.
Biosimilars have the same safety and effectiveness as the brand-name medication. Usually, a biosimilar drug costs less than the brand-name biologic.
The flu is a respiratory illness that’s highly contagious. Symptoms can range from fever, stuffy nose, and aches, to chest pain, confusion, and trouble breathing. The flu can be mild or serious, and in rare cases, it can lead to death.
Because of the possible risks, it’s recommended that most people receive a flu vaccine each year to help prevent the flu.
It’s not known exactly how FluMist works to protect you from the flu. However, FluMist has live flu viruses in it that are reproduced in your nose. (To learn more about live viruses, see “Live vs. inactive vaccine” in the “FluMist vs. flu shot” section above.) This is believed to stimulate your immune system. When your immune system notices a virus, your immune system develops antibodies. Antibodies are specific proteins that help prevent infection if you’re exposed to flu viruses again.
How long does it take to work?
FluMist takes about
In some cases, your child may need two doses of FluMist. (To learn more, see the “FluMist dosage” section above). It typically takes
The Food and Drug Administration (FDA) approves vaccines such as FluMist to treat certain conditions.
FluMist for preventing the flu
FluMist is FDA-approved to help prevent influenza (flu) caused by the influenza A or influenza B virus. FluMist is for use in children and adults ages 2 to 49 years.
The flu is a contagious viral infection that affects your respiratory system. The flu can be mild or serious, and in rare cases, it can lead to death. Because of the possible risks, it’s recommended that you receive a flu vaccine each year to help prevent you from getting the flu.
Symptoms of both forms of influenza (A and B) include:
- fever
- chills
- fatigue (lack of energy)
- body aches
- sore throat
- stuffy nose
Effectiveness for preventing the flu
FluMist was studied in a clinical trial of adults ages 18 to 49 years. Researchers followed people in the study over the course of 7 weeks. People who were vaccinated with FluMist were 10.9% less likely to develop an illness with a fever than people who received a placebo. The placebo was a nasal spray that didn’t contain the vaccine.
People vaccinated with FluMist were also 23.7% less likely to develop an upper respiratory infection with a fever, compared with people who received a placebo. Upper respiratory infections include the common cold.
FluMist wasn’t compared with the flu shot in clinical trials of adults.
FluMist and children
FluMist is approved for use in children ages 2 years and older.
FluMist is approved for the same use in children and adults: to prevent infection with flu viruses. For more information, see the “FluMist for preventing the flu” section above.
A clinical trial was done in children ages 12 to 35 months* who received either FluMist or a placebo. (The placebo was a nasal spray that didn’t contain the vaccine.) The children were later tested to see if they had the flu. The following percentages of children tested positive for the flu:
- 3.4% of children who received FluMist
- 12.5% of children who received a placebo
A different clinical trial looked at children between ages 6 months and 5 years.* They were given either FluMist or a flu shot. The number of flu cases in the FluMist group was 44.5% lower than the number of flu cases in the flu shot group.
* FluMist is FDA-approved for children and adults ages 2 to 49 years.
This drug comes with several precautions. Before taking FluMist, talk with your doctor about your health history. FluMist may not be right for you if you have certain medical conditions or other factors affecting your health. These include the ones listed below.
Note: For more information about the potential negative effects of FluMist, see the “FluMist side effects” section above.
Wheezing or asthma
Some children may be at an increased risk of wheezing after receiving FluMist. These are children who are younger than age 5 years and have also experienced wheezing that keeps coming back. Adults and children with asthma also have an increased risk of wheezing after a dose of FluMist.
If you or your child has a history of wheezing or asthma, talk with your doctor before receiving FluMist. They may monitor you or your child after the dose for a longer time than usual. This is to treat any wheezing that occurs. With more severe cases of wheezing or asthma, your doctor may recommend that you have a flu shot instead.
History of Guillain-Barré syndrome
If you have a history of developing Guillain-Barré syndrome (GBS) after getting a flu vaccine, talk with your doctor before receiving FluMist. It’s possible that the flu vaccine, including FluMist, can increase your risk for developing GBS. However, this risk is very small: about a 0.0001% increased risk.
If your doctor does give you FluMist, they may monitor you afterward. In other cases, they may recommend that you don’t get a flu vaccine.
Weakened immune system
If you have a weakened immune system, the Centers for Disease Control and Prevention (CDC) doesn’t
Lung problems
If you have a lung problem such as chronic obstructive pulmonary disease (COPD), your doctor may recommend that you receive a flu shot instead of FluMist. FluMist hasn’t been studied in people at high risk of complications from the flu, including people with lung problems. So it’s not known how FluMist will affect this group of people.
Heart problems
If you have a heart problem such as congestive heart failure, your doctor may recommend that you receive a flu shot instead of FluMist. FluMist hasn’t been studied in people at high risk of complications from the flu, including people with heart problems. So it’s not known how FluMist will affect this group of people.
Kidney problems
If you have a kidney problem such as chronic kidney disease, your doctor may recommend that you receive a flu shot instead of FluMist. FluMist hasn’t been studied in people at high risk of complications from the flu, including people with kidney problems. So it’s not known how FluMist will affect this group of people.
Diabetes
If you have type 1 or type 2 diabetes, your doctor may recommend that you receive a flu shot instead of FluMist. FluMist hasn’t been studied in people at high risk of complications from the flu, including people with diabetes. So it’s not known how FluMist will affect this group of people.
Allergic reaction
If you’ve had an allergic reaction to FluMist or any of its ingredients, you shouldn’t take FluMist. Ask your doctor what other medications are better options for you.
Egg allergy
If you have a severe egg allergy, you shouldn’t receive FluMist. The vaccine is made using eggs, so FluMist may contain a small amount of egg protein. Your doctor may recommend that you instead receive a flu vaccine that’s egg-free. Keep in mind that serious allergic reactions to FluMist in people with egg allergies are very rare.
In some cases, you can still get FluMist even if you have an egg allergy. If you have an allergy to eggs that isn’t severe, talk with your doctor about whether it’s safe for you to receive FluMist. They may monitor you after you receive FluMist to help treat any symptoms of a serious allergic reaction that develop. Or your doctor may recommend that you receive an egg-free flu vaccine instead of FluMist.
Pregnancy
It isn’t recommended that you receive FluMist during pregnancy. For more information, see the “FluMist and pregnancy” section above.
Breastfeeding
FluMist is safe to get while you’re breastfeeding. For more information, see the “FluMist and breastfeeding” section above.
The following information is provided for clinicians and other healthcare professionals.
Indications
FluMist is approved to help prevent the influenza virus due to influenza A and influenza B. The vaccine is for use in children and adults ages 2 to 49 years.
Administration
FluMist is administered into the nasal passages. It is available in single-dose nasal sprayers that contain 0.2 mL of vaccine. The vaccine is given as one spray of 0.1 mL in each nostril. Most people need one dose, but in some cases, two doses may be necessary.
Mechanism of action
It is not known exactly how FluMist works to protect from the flu. However, FluMist has live flu viruses in it that are reproduced in the nasal lining. This is believed to stimulate immunity and the production of antibodies. These antibodies are then able to attack flu viruses if the antibodies come in contact with the viruses again.
Pharmacokinetics and metabolism
No data were reported on the pharmacokinetics or metabolism of FluMist.
Contraindications
FluMist is contraindicated in people with:
- severe allergic reaction, including anaphylaxis, to FluMist or anything in FluMist, such as egg protein
- children or adolescents taking aspirin therapy
Storage
FluMist should refrigerated between 36°F to 46°F (2°C to 8°C). The medication should not be frozen. FluMist should be kept in its outer container until use, to protect it from light.
If necessary, an increase in temperature up to 77°F (25°C) for up to 12 hours is permitted, as this has not had a negative effect on FluMist. However, after being at this temperature, the vaccine should be placed back in the refrigerator until use. If the vaccine is taken out of the refrigerator and then put back in before use, it should not be taken back out of the refrigerator again until use.
Disclaimer: Medical News Today has made every effort to make certain that all information is factually correct, comprehensive, and up to date. However, this article should not be used as a substitute for the knowledge and expertise of a licensed healthcare professional. You should always consult your doctor or other healthcare professional before taking any medication. The drug information contained herein is subject to change and is not intended to cover all possible uses, directions, precautions, warnings, drug interactions, allergic reactions, or adverse effects. The absence of warnings or other information for a given drug does not indicate that the drug or drug combination is safe, effective, or appropriate for all patients or all specific uses.
