A common question from patients is which type of flu vaccine to choose- injection or nasal spray?
Both types of seasonal flu vaccines are called trivalent vaccines which means that there are three (tri) targeted strains included in the vaccine. The H1N1 vaccine is a monovalent vaccine which means there is one (mono) targeted strain. All flu injections contain an inactivated ‘dead’ type of the flu virus and the nasal spray contains a live and weakened type of the flu virus.
Flu Injections
Effectiveness: When the strains in the vaccine are matched well against the strains causing illness in our communities the vaccine is approximately 75% effective in preventing the flu. When the strains in the vaccine are NOT well matched the vaccine is at best 50% effective in preventing the flu.
The vaccine is not a live vaccine thus it is NOT capable of causing the flu despite common belief that you can get sick from the flu shot. The possible side effects are local soreness and fever.
Nasal Spray (Flumist)
Effectiveness: When the strains in the vaccine are matched well against the strains causing illness in the community the vaccine is approximately 75-90% effective in preventing the flu. When the strains in the vaccine are NOT well matched the vaccine has been shown STILL to be close to 75% effective.
The vaccine is a cold adapted live attenuated vaccine. That means that the vaccine contains a modified type of flu virus that is not contagious to others and does not cause the same symptoms as a ‘wild type’ flu virus but still induces immunity. Because it is a live virus it is not recommended for people who have a weakened immune system. It is safe to give to a person who may be around another individual who has a weakened immune system as long as that person is not restricted in their activities. If a family member is completely restricted from being around others because their immune system is extremely weak (like a bone marrow transplant) then nobody in the family should receive Flumist. The possible side effects are congestion and fever. In young children it was shown to occasionally cause wheezing which is why it is not recommended to children under 2 or anybody with asthma.
The bottom line is that for healthy children over 2 years, Flumist seems to have more pros than a flu shot. They are both effective but Flumist is painless, equally or more effective, and still effective even if the circulating strains are not well matched in the vaccine.
Contributed by Dr. Darren Saks of Tenafly Pediatrics, 201.651-0404, http://www.tenaflypediatrics.com/