After two influenza seasons in exile due to poor efficacy, the quadrivalent live-attenuated influenza vaccine (LAIV4) — a.k.a. “FluMist — returns to the routine immunization schedule and will be available again for intranasal administration beginning this summer, ahead of next year’s flu season. The announcement came from the CDC’s Advisory Committee on Immunization Practices (ACIP) in a 12-2 vote. Final approval from the CDC director is expected.

FluMist was removed as a vaccine option after the 2015-2016 flu season when surveillance studies indicated practically no protection against one of the four strains of influenza (H1N1). That problem seems to have been solved, says Susan Scutti:

Before voting in favor of the vaccine on Wednesday, the committee “heard data from the vaccine manufacturer about a possible root cause of poor effectiveness against the influenza A H1N1 virus in the past and a potential solution to address this,” Branam said. This solution includes using a different type of influenza A H1N1 virus in the vaccine…

The children’s response was comparable to what was seen before the 2009 H1N1 flu pandemic season. FluMist is popular among those who hate needles — including most children.


One thing that is predictable about influenza is its unpredictability. The same is true with the flu vaccine, where the virus can mutate and “drift” as it makes its rounds around the world each flu season, making the vaccine less effective. A bit of that has happened again this season:

This year’s 2017-18 seasonal flu shot has been just 36% effective against both A and B virus strains, the CDC estimated in a midseason report. However, it still offers some protection. “Getting the flu shot is the same kind of sensible precaution as buckling your seat belt. If you got the flu shot but you end up catching the flu, it could be less severe and less likely to land you in the hospital,” Health and Human Services Secretary Alex Azar said last week.


The return of intranasal FluMist will be welcomed by both children and adults alike who don’t like to get shots. With the pain excuse out of the way, perhaps we will see higher numbers of immunized people who will protect themselves, their loved ones, and the rest of the herd from a common and dangerous virus.


(Google Images)


*** Beginning January 22, 2018, Pediatric Alliance and some our pediatric colleagues from around the United States are participating in an AAP-sponsored immunization advocacy campaign on social media. Please follow all our social media posts during this project on Facebook and Twitter.