Thursday, 15 March 2018 22:04

Could FluMist have prevented many of this year’s flu deaths?

Written by Dr. Daliah Wachs
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The US Centers for Disease Control and Prevention advisory committee voted this week to return the FluMist, nasal spray flu vaccine, to the recommended options for the 2018-2019 flu season.

In 2016 it was not recommended and discouraged as they found its effectiveness against seasonal flu to be approximately 46%, when 65% efficacy was touted by the injectable flu shot.  However this flu season, the current flu vaccine was found to be only 35% effective with one of the worst flu seasons in years taking the lives of healthy young adults and children.

Why was this season so severe? The H3N2 strain was the predominant one, notorious for bad flu seasons, and is crafty, able to mutate before the vaccine is finalized. Hence our flu vaccine was not able to be as close a match as desired.

The panel voted 12-2 this week to include FluMist as an option for medical providers to recommend against the upcoming 2018-2019 flu season.

Why was FluMist removed?  Experts found it to be ineffective against one of the influenza A H1N1 strains. With its overall efficacy found to be lower than the flu shot it was deemed a less ideal option than the shot.

FluMist is a live attenuated vaccine that is not recommended in infants and pregnant women. It’s indicated for those between the ages of 2-49 and introduces a live, weakened version of the flu virus to incite an immune response. This differs from the injectable flu vaccine which uses killed versions of the flu strains to induce a flu response.

Children prefer the FluMist as the nasal spray offers a less painful option than an injection.

The FluMist Quadrivalent nasal spray, manufactured by MedImmune of AstraZeneca PLC, offers protection against 4 strains of flu including H1N1, H3N2 and two influenza B strains.  According to FluMist’s prescribing information, the FluMist proved 90% effective against H3N2 as opposed to influenza B where it scored 44.3% effectiveness. Another review found its efficacy against H3N2 to be 79%.

 

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Now that’s not to say the FluMist would have been immune to the vaccine issues experienced with this year’s flu shot as H3N2 is a highly virulent and mutable virus, and could have snowed the FluMist vaccine makers as well.

Yet we may need to consider that the FluMist may be more efficacious for some strains of the flu whereas the flu shot may better protect us against others. More research needs to be done in this area. As of now choosing which flu shot to get for the next flu season may be a crap shoot.

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Daliah Wachs is a guest contributor to GCN news. Doctor Wachs is an MD,  FAAFP and a Board Certified Family Physician.  The Dr. Daliah Show , is nationally syndicated M-F from 11:00 am - 2:00 pm and Saturday from Noon-1:00 pm (all central times) at GCN.