Influenza Vaccine, Live Intranasal (patient information)

Template:Drug header For more patient information about the seasonal human influenza virus, see Influenza

Why get vaccinated?

Influenza (flu) is a contagious disease. It is caused by the influenza virus, which spreads from person to person through coughing or sneezing. Other illnesses have the same symptoms and are often mistaken for influenza. But only the influenza virus can cause influenza.

Anyone can get influenza, but rates of infection are highest among children. For most people, it lasts only a few days. It can cause: fever, sore throat, chills, fatigue, cough, headache, and muscle aches

Some people get much sicker. Influenza can lead to pneumonia and can be dangerous for people with heart or breathing conditions. It can cause high fever and seizures in children. Influenza kills about 36,000 people each year in the United States, mostly among the elderly.

Influenza vaccine can prevent influenza.

Live, attenuated influenza vaccine (nasal spray)

There are two types of influenza vaccine:

• Live, attenuated influenza vaccine (LAIV) was licensed in 2003. LAIV contains live but attenuated (weakened) influenza virus. It is sprayed into the nostrils rather than injected into the muscle. It is recommended for healthy children and adults from 5 through 49 years of age, who are not pregnant.
• Inactivated influenza vaccine, sometimes called the flu shot, has been used for many years and is given by injection. This vaccine is described in a separate monograph.

Influenza viruses are always changing. Therefore, influenza vaccines are updated every year, and an annual vaccination is recommended. For most people influenza vaccine prevents serious influenza-related illness. It will not prevent influenza-like illnesses caused by other viruses.

It takes about 2 weeks for protection to develop after the vaccination, and protection can last up to a year.

Who can get LAIV?

Live, intranasal influenza vaccine is approved for healthy children and adults from 5 through 49 years of age, including those who can spread influenza to people at high risk, such as:

Household contacts and out-of-home caretakers of children from 0-59 months of age. Physicians and nurses, and family members or any one else in close contact with people at risk of serious influenza.

Influenza vaccine is also recommended for anyone else who wants to reduce their chance of getting influenza. LAIV may be considered for:

• People who provide essential community services.
• People living in dormitories or under other crowded conditions, to prevent outbreaks.

Who should not get LAIV?

LAIV is not licensed for everyone. The following people should check with their health-care provider about getting the inactivated vaccine (flu shot).

• Adults 50 years of age or older or children younger than 5.
• People who have long-term health problems with heart disease; kidney disease; lung disease; metabolic disease, such as diabetes; asthma; anemia, and other blood disorders.
• People with a weakened immune system.
• Children or adolescents on long-term aspirin treatment.
• Pregnant women.
• Anyone with a history of Guillain-Barré syndrome (a severe paralytic illness, also called GBS).

Inactivated influenza vaccine (the flu shot) is the preferred vaccine for people (including health-care workers, and family members) coming in close contact with anyone who has a severely weakened immune system (that is, anyone who requires care in a protected environment).

Some people should talk with a doctor before getting either influenza vaccine:

• Anyone who has ever had a serious allergic reaction to eggs or to a previous dose of influenza vaccine.
• People who are moderately or severely ill should usually wait until they recover before getting flu vaccine. If you are ill, talk to your doctor or nurse about whether to reschedule the vaccination. People with a mild illness can usually get the vaccine.

When should I get influenza vaccine?

The best time to get influenza vaccine is in October or November, but LAIV may be given as soon as it is available. Influenza season usually peaks in February, but it can peak any time from November through May. So getting the vaccine in December, or even later, can be beneficial in most years.

Most people need one dose of influenza vaccine each year. Children younger than 9 years of age getting influenza vaccine for the first time should get 2 doses For LAIV, these doses should be given 6-10 weeks apart.

LAIV may be given at the same time as other vaccines.

What are the risks from LAIV?

A vaccine, like any medicine, could possibly cause serious problems, such as severe allergic reactions. However, the risk of a vaccine causing serious harm, or death, is extremely small. Live influenza vaccine viruses rarely spread from person to person. Even if they do, they are not likely to cause illness. LAIV is made from weakened virus and does not cause influenza. The vaccine can cause mild symptoms in people who get it (see below).

Mild Problems (In children and adolescents 5-17 years of age):

• runny nose, nasal congestion or cough
• headache and muscle aches
• fever
• abdominal pain or occasional vomiting or diarrhea

Mild Problems (In adults 18-49 years of age):

• runny nose or nasal congestion
• cough, chills, tiredness/weakness
• sore throat
• headache

These symptoms did not last long and went away on their own. Although they can occur after vaccination, they may not have been caused by the vaccine.

Severe Problems:

• Life-threatening allergic reactions from vaccines are very rare. If they do occur, it is within a few minutes to a few hours after the vaccination.
• If rare reactions occur with any new product, they may not be identified until thousands, or millions, of people have used it. Over four million doses of LAIV have been distributed since it was licensed, and no serious problems have been identified. Like all vaccines, LAIV will continue to be monitored for unusual or severe problems.

What if there is a severe reaction?

What should I look for?

Any unusual condition, such as a high fever or behavior changes. Signs of a serious allergic reaction can include difficulty breathing, hoarseness or wheezing, hives, paleness, weakness, a fast heart beat or dizziness.

What should I do?

• Call a doctor, or get the person to a doctor right away.
• Tell your doctor what happened, the date and time it happened, and when the vaccination was given.
• Ask your health care provider to file a Vaccine Adverse Event Reporting System (VAERS) form if you have any reaction to the vaccine. Or call VAERS yourself at 1-800-822-7967, or visit their website at http://vaers.hhs.gov.

The National Vaccine Injury Compensation Program

In the rare event that you or your child has a serious reaction to a vaccine, a federal program has been created to help pay for the care of those who have been harmed.

For details about the National Vaccine Injury Compensation Program, call 1-800-338-2382 or visit the program's website at http://www.hrsa.gov/vaccinecompensation.

How can I learn more?

• Ask your doctor or other health care provider. They can give you the vaccine package insert or suggest other sources of information.
• Call your local or state health department's immunization program.
• Contact the Centers for Disease Control and Prevention (CDC): call 1-800-232-4636 (1-800-CDC-INFO) or visit the National Immunization Program's website at http://www.cdc.gov/nip.

Live Attenuated Influenza Vaccine Information Statement. U.S. Department of Health and Human Services/Centers for Disease Control and Prevention National Immunization Program. 6/30/2006.

Brand names

• FluMist®