• The FDA has approved an at-home nasal flu vaccine.
• FluMist will be available through an online pharmacy for people ages 2-49.
• However, it is not for the very young, older adults, or the immunocompromised.
• Experts say it will expand access to flu vaccinations and keep more people safe.
• However, injectable vaccines are safe for a wider range of populations.

On September 20, 2024, the U.S. Food & Drug Administration (FDA) announced they had approved an at-home nasal spray influenza (flu) vaccine.

The vaccine, FluMist, can be administered by either the recipient or their caregiver. It is sprayed into the nose.

FluMist prevents cases of the flu caused by influenza virus subtypes A and B. It can be administered to people between the ages of 2 and 49.

The nasal flu vaccine is not an entirely new medication, however. It was first approved for usage in 2003 for people from age 5 to 49. Later, in 2007, FDA approval was given to lower the minimum age to 2.

Now, it has become the first flu vaccine that can be administered without the assistance of a healthcare professional.

The FDA states that the vaccine manufacturer will be making the vaccine available through a third-party online pharmacy.

To obtain FluMist, people can undergo a screening process, and the pharmacy will prescribe and ship the vaccine.

Flu vaccines play an essential role in controlling seasonal flu outbreaks. On average, about 700,000 people die each year from the disease’s respiratory and cardiovascular complications. However, the flu used to be much more deadly before a vaccine was developed.

While many people will only experience relatively mild symptoms, the flu is a contagious illness that can be passed along to those who are more vulnerable.

Older people, young children, and people with certain medical conditions are most at risk, per the FDA.

The availability of FluMist could make it easier for more people to be vaccinated and help protect those who are at greater risk.

How FluMist compares with injectable flu vaccines

Andrew Handel, MD, a pediatric infectious diseases expert at Stony Brook Children’s Hospital, explained that there are different types of flu vaccines available in the U.S.

“Injectable vaccines consist of inactivated (dead) virus or viral particles, whereas FluMist is a live, attenuated (or weakened) influenza vaccine given by nasal spray,” he said.

According to Handel, some studies show that FluMist is more protective against infections and severe illness than injectable vaccines. However, not all studies are consistent.

John Lowe, MD, a physician focused on preventive health at Restore Care, added to Handel’s comments saying, “It has this advantage over the injection in that it can elicit a more physiological sort of interaction with the immune system than the injection, which simply presents the body with a dead virus for the body to form an immune response against it.”

Lowe went on to say that another way that FluMist contrasts with injectable vaccines is that it is not given to people under 2 or over 49 years of age.

“The injectable form is incorporated for people in high-risk groups,” he said, explaining that it is even used for people who are immunocompromised.

Additionally, Lowe said FluMist’s nasal route of administration could be more beneficial in preventing alveolar respiratory infections since the influenza virus enters the body through the nose.

“On the other hand, the injectable preparation provides more consistent efficacy across pandemic and seasonal influenza as well as other vaccine-preventable diseases,” he added.

Finally, Lowe noted that while both injectable vaccines and FluMist can provide immunization against the flu virus, injectables remain the first-line recommendation since they are safe for the majority of the population.

What health experts think about FluMist

“The approval of FluMist for self-administration at home is a huge step forward for the FDA,” said Handel, explaining that many people skip vaccines because of obstacles like having to take children out of school to get them.

“Any effort to making vaccines more accessible will help increase uptake and keep more people safe,” he said.

Lowe agreed, calling the FDA’s approval of FluMist “a welcome improvement.”

He noted that a self-administered nasal flu vaccine could also be useful in arid regions or locations with an inadequate number of healthcare facilities.

However, Lowe cautioned that FluMist is not appropriate for everyone, especially if they are immunocompromised.

“Patients should be assessed, and it should be established that it is OK to recommend FluMist to them,” he said.

Takeaway

The FDA has announced that it has approved an at-home nasal flu vaccine that is administered by spraying it into the nose.

It can be used by people aged 2 to 49. However, it is not appropriate for very young children, older adults, or those who are immunocompromised.

Injectables remain first-line vaccines because they are safe for a larger percentage of the population.

FluMist will be available through an online pharmacy that will write the prescription and ship the medication to people’s homes.

Experts say FluMist will help make vaccination against the flu more accessible to people who might otherwise have a hard time getting into a doctor’s office. This can help expand the number of people who are vaccinated.