Flu Shot or Nasal Spray Vaccine
by Anthony Fiore, MD, MPH , medical epidemiologist for the Influenza Division of the CDC
The 2009 H1N1 influenza virus (sometimes called 'swine flu') continues to cause outbreaks of flu across the United States, making up more than 99% of influenza cases we're seeing now.
Fortunately, we have vaccines to prevent 2009 H1N1 flu, which is now available around the country. As with the seasonal flu vaccine, the 2009 H1N1 vaccine will be available in both an injection form (flu shot) and in a nasal spray.
The main difference is that the flu shot is made with inactivated (killed) virus while the nasal spray is made with a weakened (attenuated) form of the virus that is not able to actually give you the flu.
The H1N1 nasal spray vaccine is made exactly like FluMist®, which has been effectively used since 2003 to prevent seasonal flu. Tens of millions of doses have been given in clinics, schools and workplaces, and it has an excellent safety record.
The nasal spray is only recommended for use in healthy people between 2 and 49 years of age, who are not pregnant. The nasal spray vaccine is a good option for children over two and young adults, since most are healthy.
Nasal spray vaccine is also a good option for health care workers who are healthy, not pregnant and younger than 50 years old. Health care workers are among the first groups that should get vaccinated as soon as vaccines are available, so they can avoid getting the flu, then spreading it to the patients they care for or bringing it home.
An exception is those who provide care for hospitalized, severely immunocompromised patients who require inpatient care in special protected hospital environments (rooms with special air filtering systems and positive pressure ventilation). Even though the nasal spray vaccine has never been shown to cause any harm to these severely immunocompromised patients, health care workers and close contacts should receive the shot rather than the nasal spray as a precaution. However, if you choose to get the nasal spray vaccine and live or work with others who can't get the nasal spray, such as pregnant women, infants, chronically ill persons, and persons older than 50, you need not be concerned.
Who should not get the nasal spray vaccine?
In addition to the groups already mentioned, many people with underlying health conditions may not be able to use the nasal spray vaccine. Among those included in this group are adults and children with asthma or wheezing, diabetes, chronic heart conditions, kidney failure and any condition which compromises their immune system. If you have any question about which one you should take, check with your doctor on which type of vaccine is the best one for you to receive.
One question that often comes up is: "What about children with underlying illnesses like asthma, who can only get the shot? Can they be around children who get nasal spray vaccines?" The answer is yes. The weakened viruses in the vaccine will not give the flu to schoolmates or family members.
An important note: If you do chose the nasal spray form, you will not be able to get nasal sprays for both the seasonal and 2009 H1N1 vaccines at the same time, and they should be spaced out by at least 4 weeks. You can however get the shot for one and the nasal spray for the other on the same day.
For more information on both seasonal and H1N1 flu, go to www.cattco.org/health or call the Health Department Help Line at (716) 938-2980.
