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Note: For questions regarding who can receive LAIV during the 2004-05 flu season, see Questions and Answers: 2004-05 season.
Updated Dec 10, 2003
What is the nasal-spray flu vaccine (or LAIV)?
The nasal-spray flu vaccine (sometimes called LAIV for Live Attenuated Influenza
Vaccine) is a new flu vaccine that was licensed in 2003. It is different from
the other licensed influenza vaccine (also called the "flu shot") because it
contains weakened live influenza viruses instead of killed viruses and is administered
by nasal spray instead of injection.
Updated Dec 10, 2003
How does the nasal-spray flu vaccine (LAIV)
work?
The nasal-spray flu vaccine contains three different live (but weakened) influenza
viruses. When the viruses are sprayed into the nose, they stimulate the body's
immune system to develop protective antibodies that will prevent infection
by naturally occurring influenza viruses.
Updated Dec 10, 2003
The live viruses in the nasal-spray flu vaccine
(LAIV) are attenuated, cold-adapted, and temperature sensitive.
What does this mean?
Attenuated means the viruses are weakened and will not cause severe symptoms
often associated with influenza illness. Cold-adapted and temperature sensitive
mean the viruses can grow in the nose and throat, but not in the lower respiratory
tract where the temperature is higher.
Updated Dec 10, 2003
How effective is the nasal-spray flu vaccine (LAIV)?
In one large study among children aged 15-85 months, the nasal-spray flu vaccine
(LAIV) reduced the chance of influenza illness by 92% compared with placebo.
In a study among adults, the participants were not specifically tested for
influenza. However, the study found 19% fewer severe febrile respiratory tract
illnesses, 24% fewer respiratory tract illnesses with fever, 23-27% fewer days
of illness, 13-28% fewer lost work days, 15-41% fewer health care provider
visits, and 43-47% less use of antibiotics compared with placebo.
Updated Dec 10, 2003
Who can be vaccinated with the nasal-spray flu vaccine (LAIV)?
LAIV is approved for use in healthy people between the ages of 5 and 49 years.
Updated Dec 10, 2003
Who should not be vaccinated with the nasal-spray
flu vaccine (LAIV)?
- People less than 5 years of age
- People 50 years of age and over
- People with a medical condition that places them at
high risk for complications from influenza, including those
with chronic heart or lung disease, such as asthma or reactive
airways disease; people with medical conditions such as
diabetes or kidney failure; or people with illnesses that
weaken the immune system, or who take medications that
can weaken the immune system.
- Children or adolescents receiving aspirin
- People with a history of Guillain-Barré syndrome,
a rare disorder of the nervous system
- Pregnant women
- People with a history of allergy to any of the components
of LAIV or to eggs
Updated Dec 10, 2003
Should the nasal-spray flu vaccine (LAIV) be given to patients with chronic
diseases other than those specifically listed above?
No. The nasal-spray flu vaccine is approved for use only in healthy people
between the ages of 5 and 49 years.
Updated Dec 10, 2003
Can people receiving the nasal-spray flu vaccine (LAIV) pass the vaccine viruses
to others?
In clinical studies, transmission of vaccine viruses to close contacts has
occurred only rarely. The current estimated risk of getting infected with vaccine
virus after close contact with a person vaccinated with the nasal-spray flu
vaccine is low (0.6%-2.4%). Because the viruses are attenuated and cold-adapted,
infection is unlikely to result in influenza illness symptoms since the vaccine
viruses have not been shown to mutate into typical or naturally occurring influenza
viruses.
Updated Oct 7, 2004
Can contacts of people with weakened immune systems get the nasal-spray flu
vaccine (LAIV)?
People who are in contact with others with severely weakened immune systems when they are being cared for in a protective environment (for example, people with hematopoietic stem cell transplants), should not get LAIV. People who have contact with others with lesser degrees of immunosuppression (for example, people with diabetes, people with asthma taking corticosteroids, or people infected with HIV) can get LAIV.
Updated Dec 10, 2003
What side effects are associated with the nasal-spray flu vaccine (LAIV)?
In children, side effects can include runny nose, headache, vomiting, muscle
aches, and fever. In adults, side effects can include runny nose, headache,
sore throat, and cough. Fever is not a common side effect in adults receiving
the nasal-spray flu vaccine.
Updated Dec 10, 2003
When should the nasal-spray flu vaccine (LAIV) be given?
The optimal time to receive influenza vaccine is usually in October or November.
Children between the ages of 5 and 8 years who have never received influenza
vaccine should receive the nasal-spray flu vaccine for the first time in October
or earlier because they need a second dose 6 to 10 weeks after the first dose.
Updated Dec 10, 2003
How often should the nasal-spray flu vaccine (LAIV)
be given?
LAIV should be given each year before the influenza season.
Updated Dec 10, 2003
Can people who received inactivated influenza vaccine
(the flu shot) last year get the nasal-spray flu vaccine
(LAIV) this year?
Yes, people who got inactivated influenza vaccine (the flu shot) last year
can get the nasal-spray flu vaccine (LAIV) this year.
Updated Dec 10, 2003
Can the nasal-spray flu vaccine (LAIV) be given at the same time as other vaccines?
An inactivated vaccine may be given either at the same time or at any time
before or after the nasal-spray flu vaccine. A live vaccine may be given together
with the nasal-spray flu vaccine. If the two live vaccines are not given at
the same visit, they should be given more than 4 weeks apart.
Updated Dec 10, 2003
Can the nasal-spray flu vaccine (LAIV) be given
to patients when they are ill?
The nasal-spray flu vaccine (LAIV) can be given to people with minor illnesses
(e.g., diarrhea or mild upper respiratory tract infection with or without fever).
However, if nasal congestion is present that might limit delivery of the vaccine
to the nasal lining, then delaying of vaccination until the nasal congestion
is reduced should be considered.
Updated Dec 10, 2003
Can the nasal-spray flu vaccine (LAIV) be used
together with influenza antiviral medications?
If a person is taking an influenza antiviral drug (including Symmetrel [amantadine]
for Parkinson's disease), then the nasal-spray flu vaccine should not be given
until 48 hours after the last dose of the influenza antiviral medication was
given. If a person has received the nasal-spray flu vaccine, an influenza antiviral
medication should not be given until 2 weeks after the flu mist was administered.
Updated Dec 15, 2003
If a child under the age of 9 years is getting influenza vaccine for the first
time and requires 2 doses, does the same type of vaccine have to be used
for both doses?
No, the first and second doses do not have to match; live or inactivated vaccine
can be used for either dose. If inactivated influenza vaccine (the flu shot)
is used first, then the nasal-spray flu vaccine (LAIV) should be given at least
4 weeks later. If the nasal-spray flu vaccine is used first, the second vaccine
should be given 6 to 10 weeks later.
Updated Dec 10, 2003
How is the nasal-spray flu vaccine (LAIV) stored?
The nasal-spray flu vaccine (LAIV) must be stored frozen at -15ºC or colder.
It may not be stored in a frost-free freezer (because temperature cycling in
these freezers may reach more than -15ºC) unless a storage box provided
by the manufacturer is used. After thawing, the vaccine may be stored for up
to 24 hours in a refrigerator at 2-8ºC, and it should not be refrozen.
Vaccine thawed for more than 24 hours should be discarded.
Updated Dec 10, 2003
What personal protective equipment is recommended
for health-care workers who are giving the vaccine?
Disposable gloves should be worn by health-care workers administering the nasal-spray
flu vaccine (LAIV).
Updated Dec 10, 2003
Does the nasal-spray flu vaccine (LAIV) contain
thimerosal?
No, the nasal-spray flu vaccine (LAIV) does not contain thimerosal or any other
preservative. |
