Help! Flu Shot Vs. Flu Mist?

Updated on October 19, 2007
S.M. asks from Omaha, NE
4 answers

I am having difficulty deciding whether my daughter should recieve the flu shot or the flu mist. I don't know much about the mist, but it would be nice to avoid getting a shot. Does anyone have an opinion, or know much about the flu mist? Has anyone's child had the mist and did they tolerate it well? Should I try the mist, or just stay with the shot? Help me make my decision soon! I need to get an appointment made quickly. Help!

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So What Happened?

My 3 1/2 yr old daughter was given the flu mist. She fussed a little because she said that it tastes bad, but after being given a drink, she said that she would rather have the mist again instead of a shot next year too. My son had a shot and didn't fuss at all. They both tolerated the vaccines very well. Hopefully, we will have a healthy winter!

More Answers



answers from Rapid City on

Hi S.!

What a great question. I've often wondered too which would be best. I am so glad the other mom responded. It's good info for the rest of us.





answers from Lincoln on

Its my understanding the mist is only for children 5 years and older. My kids are 3 1/2 and almost 2 and have both had the flu shot in past years. We are getting them again this year. Go woth the shot...but ask your doctor for sure on age limits for the mist.



answers from Omaha on

I'm going to do the flu mist this year for my 3.5 year old son. The mist is good for HEALHTY PEOPLE AGES 2-49. The reason I chose it is because I read it had more strains of the flu than the flu shot...but according to the info from teh CDC's website (see below), that is not the case. Also, flu shots used to contain mercury...I'm not sure if that's been changed or if it's still in some flu shots still.

Seasonal Flu Vaccine
What kind of flu vaccines are there?
There are two types of vaccines that protect against the flu. The "flu shot" is an inactivated vaccine (containing killed virus) that is given with a needle, usually in the arm. The flu shot is approved for use among people 6 months of age or older, including healthy people and those with chronic medical conditions. A different kind of vaccine, called the nasal-spray flu vaccine (sometimes referred to as LAIV for Live Attenuated Influenza Vaccine or FluMist®), was approved in 2003. The nasal-spray flu vaccine contains attenuated (weakened) live viruses, and is administered by nasal sprayer. It is approved for use only among healthy people 2-49 years* of age who are not pregnant.

Each of the two types of vaccine contains three influenza viruses, which are chosen based on information about recently circulating strains. Each of the three vaccine strains in both vaccines – one A (H3N2) virus, one A (H1N1) virus, and one B virus – are representative of the influenza vaccine strains recommended for that year. Viruses for both vaccines are grown in eggs.

*On September 19, 2007 the U.S. Food and Drug Administration approved use of the nasal influenza vaccine LAIV (FluMist®) for healthy children ages 2-4 years old (24-59 months old) without a history of recurrent wheezing, as well as for healthy persons ages 5-49 years who are not pregnant. Previously, approval was for healthy persons ages 5-49 years who are not pregnant. More information is available at

How do flu vaccines work?
Both flu vaccines (the flu shot and the nasal-spray flu vaccine (LAIV)) work in the same way; they cause antibodies to develop in the body, and these antibodies provide protection against influenza virus infection.

Why should people get vaccinated against the flu?
Influenza is a serious disease, and people of any age can get it. In an average year, the flu causes 36,000 deaths (mostly among those aged 65 years or older) and more than 200,000 hospitalizations in the United States. The "flu season" in the United States is usually from November through April each year. During this time, flu viruses are circulating in the population. An annual flu vaccine (either the flu shot or the nasal-spray flu vaccine) is the best way to reduce the chances that you will get the flu.

When should I get a flu vaccination?
Beginning each September, the flu shot should be offered to people when they are seen by health-care providers for routine care or as a result of hospitalization.

Try to get vaccinated in October or November because flu activity in the United States generally peaks between late December and early March.

You can still benefit from getting vaccinated after Decemberr, even if flu is present in your community. Vaccine should continue to be offered to unvaccinated people throughout the flu season as long as vaccine is still available. Once you get vaccinated, your body makes protective antibodies in about two weeks.

Does flu vaccine work right away?
No. It takes about two weeks after vaccination for antibodies to develop in the body and provide protection against influenza virus infection. In the meantime, you are still at risk for getting the flu. That's why it's better to get vaccinated early in the fall, before the flu season really gets under way.

Can I get the flu even though I got a flu vaccine this year?
Yes. The ability of flu vaccine to protect a person depends on two things: 1) the age and health status of the person getting the vaccine, and 2) the similarity or "match" between the virus strains in the vaccine and those in circulation.

Why do I need to get vaccinated against the flu every year?
Flu viruses change from year to year, which means two things. First, you can get the flu more than once during your lifetime. The immunity (natural protection that develops against a disease after a person has had that disease) that is built up from having the flu caused by one virus strain doesn't always provide protection when a new strain is circulating. Second, a vaccine made against flu viruses circulating last year may not protect against the newer viruses. That is why the influenza vaccine is updated to include current viruses every year.

Another reason to get flu vaccine every year is that after you get vaccinated, your immunity to the disease declines over time and may be too low to provide protection after one year.

How are the viruses for flu vaccine selected?
Each year, many laboratories throughout the world, including in the United States, collect flu viruses. Some of these flu viruses are sent to one of four World Health Organization (WHO) reference laboratories, one of which is at the Centers for Disease Control and Prevention (CDC) in Atlanta, for detailed testing. These laboratories also test how well antibodies made to the current vaccine react to the circulating virus and new flu viruses. This information, along with information about flu activity, is summarized and presented to an advisory committee of the U.S. Food and Drug Administration (FDA) and at a WHO meeting. These meetings result in the selection of three viruses (two subtypes of influenza A viruses and one influenza B virus) to go into flu vaccines for the following fall and winter. Usually, one or two of the three virus strains in the vaccine are changed each year.

Is there enough influenza vaccine for the 2007-08 season?
Yes. At the current time, the 5 U.S. influenza vaccine manufacturers are projecting that as many as 132 million doses of influenza vaccine will be available in the U.S. for use during the 2007-08 influenza season. This will be the most flu vaccine ever distributed in the U.S. during a single influenza season.

Why are manufacturers and distributors taking a phased approach to vaccine distribution?
We wish that the nation's full supply of flu vaccine could be produced and distributed by the beginning of October of each year. But, given how flu vaccine is currently produced that is not possible. The influenza manufacturing process is complex. Influenza viruses vary from year to year, so influenza vaccine must be updated annually to include the viruses that are expected to circulate in the upcoming season. Once viruses are selected for the new vaccine, manufacturers must operate under a very tight timeline. Influenza vaccine production begins as early as 6-9 months before the beginning of vaccine distribution. Even with this early start, it isn't possible to complete the entire production and distribution process prior to the vaccination season, particularly given the limited number of influenza vaccine manufacturing plants that we have in the United States and the large number of doses that are required to be produced each year. Instead, influenza vaccine distribution takes place in a phased fashion over a number of months. It begins in late summer for some manufacturers and vaccine products and usually completes near the end of November or early in December. Unfortunately, this situation leaves doctors and other vaccine providers with uncertainty about when they can expect to receive their full order and makes it difficult for them to plan their vaccination activities. Manufacturers and distributors are working to try to get some vaccine to as many providers as possible as soon as possible so that they can begin vaccinating their patients. Getting some vaccine to all providers early in the season is important, because all providers serve at least some high-risk patients (such as people 50 years of age and older or those with chronic health conditions such as asthma, kidney disease, diabetes, lung disease and weakened immune system) and their household contacts.

What role does the Department of Health and Human Services play in the supply and distribution of the seasonal influenza vaccine?
Influenza vaccine production and distribution are primarily private sector endeavors. The Department of Health and Human Services and CDC do not have the authority to control influenza vaccine distribution nor the resources to manage such an effort. However, the Department has made significant efforts to enhance production capacity of seasonal influenza vaccines, including supporting manufacturers as they invest in processes to stabilize and increase their production capacity and improving guidance about the approval process at the Food and Drug Administration.

Page last modified September 19, 2007
Content Source: Coordinating Center for Infectious Diseases (CCID)
National Center for Immunization and Respiratory Diseases (NCIRD)



answers from Omaha on

I'm a pharmacy student, so I know a little about both. Flumist was recently approved for kids ages 2 and up, so your daughter could certainly get it. The Flumist may tickle her nose a bit (it has to go into both nostrils), and it may also go down the back of her throat a little. The kids I have seen receive the Flumist have tolerated it really well. It will most likely be a little more expensive, but if she's afraid of needles it may be worth it. They are both effective, though.
Hope that helps!

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