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CDC Offers Guidance on FluMist

Kate Traynor

The Centers for Disease Control and Prevention (CDC) Advisory Committee on Immunization Practices (ACIP) today issued recommendations on the use of FluMist, MedImmune Inc.'s live, attenuated intranasal influenza vaccine.

FluMist received marketing approval from the Food and Drug Administration in June, in time for the current flu season.

In its recommendations, ACIP emphasized that FluMist is indicated for the prevention of influenza in healthy people age 5–49 years. Those who should not receive the intranasal vaccination include

  • Children under age 5 and adults age 50 and older,   
  • People with asthma, another reactive airways disease, or a lung or cardiovascular disorder,   
  • People with diabetes mellitus or kidney disease,   
  • Children or adolescents receiving aspirin therapy, and   
  • Pregnant women.

ACIP recommended that people in these categories receive the traditional inactivated vaccine instead of the intranasal product when vaccination against flu is indicated.

An annual influenza vaccination is recommended for people who are at high risk for influenza-related complications as well as those who come into close contact with such people. In most cases, "close contacts" who are healthy and age 5–49 can receive either the live or the inactivated vaccine, according to ACIP.

But the committee noted that FluMist recipients can shed the attenuated virus contained in the vaccine and may be able to transmit it to immunocompromised people. For this reason, ACIP stated that the inactivated vaccine is preferred over FluMist to vaccinate health care workers and others who have close contact with people with a weakened immune system.

FluMist is supplied frozen in prefilled, single-use 5.0 mL syringes designed for intranasal administration. The recommended dosage is 0.25 mL of vaccine sprayed into each nostril. Children five years and older who have previously been vaccinated against influenza require one annual dose of FluMist. Children 5–8 years old who have never been vaccinated against the virus should receive two doses of FluMist 6–10 weeks apart, with the first dose administered early during the influenza season.

According to CDC, all health care workers should receive an annual influenza vaccination. Because influenza vaccine is not in short supply this year, CDC recommends that those who wish to be vaccinated do so as soon as vaccine becomes available in the community.