Live Attenuated Influenza Vaccine [LAIV] (The Nasal Spray Flu Vaccine) (2024)

How effective is the nasal spray seasonal flu vaccine?

Flu vaccine effectiveness (VE) can vary from year to year, among different age and risk groups, by vaccine type, and even by virus type and subtype. Prior to the 2009 flu pandemic, the nasal spray vaccine was found to be effective against different flu viruses. After the 2009 pandemic, several U.S. studies among 2 through 17-year-olds found that the nasal spray vaccine was as effective against influenza B viruses and influenza A(H3N2) viruses as inactivated influenza vaccines but was less effective than inactivated flu vaccines against the 2009 pandemic H1N1 viruses. These data led ACIP and CDC to recommend against use of the nasal spray vaccine for the 2016-17 and 2017-18 seasons.

Since the 2017-2018 season, the manufacturer of nasal spray vaccine has used new influenza A(H1N1) vaccine virus ingredients in production. Because of limited use, there have been no effectiveness estimates in the United States since LAIV was recommended again in the 2018-2019 influenza season. Data from other countries have demonstrated protection from LAIV to be similar to that of standard-dose, egg-based inactivated flu vaccine in children.

Can I get the nasal spray flu vaccine at the same time as other vaccines?

Yes, nasal spray flu vaccine can be given at the same time as other vaccines (live or non-live). If nasal spray flu vaccine is not given at the same time as another live vaccine, they should be spaced at least four weeks apart.There is no recommended spacing period between nasal spray flu vaccine and non-live vaccines.

Should the nasal spray flu vaccine be given to patients with chronic diseases?

Nasal spray flu vaccine is not recommended for use in people with some chronic health conditions because the safety and effectiveness of this vaccine in people with those conditions has not been established.

Prevention and Control of Seasonal Influenza with Vaccines: Recommendations of the Advisory Committee on Immunization Practiceshas a list of contraindications and precautions for the nasal spray vaccine.

Should pregnant and postpartum people avoid contact with people who were recently vaccinated with the nasal spray vaccine?

Pregnant and postpartumpeople do not need to avoid contact with people who recently got the nasal spray flu vaccine. However, the nasal spray flu vaccine should not be given to people who are pregnant. People who have recently had a baby can get a flu shot or the nasal spray flu vaccine.

Are there any contraindications to giving breastfeeding people the nasal spray vaccine?

Breastfeeding is not a contraindication for the nasal spray vaccine. Breastfeeding people younger than 50 years can get the nasal spray flu vaccine as long as they do not have a contraindication to getting that vaccine. Prevention and Control of Seasonal Influenza with Vaccines: Recommendations of the Advisory Committee on Immunization Practiceshas a list of contraindications and precautions for the nasal spray vaccine.

Can the nasal spray flu vaccine be given to patients when they are ill?

The nasal spray flu vaccine can be given to people with mild illnesses (e.g., diarrhea or mild upper respiratory tract infection with or without fever). However, nasal congestion might limit delivery of the vaccine to the nasal lining, and so delaying vaccination until the nasal congestion is reduced or using an age-appropriate injectable vaccine instead should be considered. People with moderate or severe illness, with or without fever, should generally wait to be vaccinated until they have recovered. Your health care provider can provide advice about when to get vaccinated if you are feeling ill.

Can nasal spray flu vaccine give me flu?

Flu vaccines do not cause flu illness. The nasal spray flu vaccine contains weakened (attenuated) viruses, so that they will not cause flu illness. The weakened viruses are cold-adapted, which means they are designed to only multiply at the cooler temperatures found within the nose, and not the lungs or other areas where warmer temperatures exist.

What are the side effects that could occur with the nasal spray flu vaccine?

In children, side effects from the nasal spray may include:

• Runny nose
• Wheezing
• Headache
• Vomiting
• Muscle aches
• Fever (low grade)
• Sore throat (in older children)

In adults, side effects from the nasal spray vaccine may include:

• Runny nose
• Headache
• Cough

If these problems occur, they begin soon after vaccination and usually are mild and short-lived. People sometimes faint after medical procedures, including vaccination. Tell your provider if you feel dizzy or have vision changes or ringing in the ears. Rarely, people can experience a severe allergic reaction after a flu vaccine (or any vaccine); there are about 1-2 cases of severe allergic reactions per million flu vaccine doses administered and these reactions can be treated with medication. People who think that they have been injured by a flu vaccine can file a report with the Vaccine Adverse Event Reporting System (VAERS).

More information about the safety of flu vaccines is available at Influenza Vaccine Safety.

Vaccine Information Statements (VIS)

Flu VISs are no longer updated every year. The edition dated 8/15/2019 should be used for the current flu season.

Nasal Spray (Live Attenuated Influenza Vaccine (LAIV)) VIS