If you are like many parents, the nasal spray flu mist vaccine sounds like an easy way to protect your child against the flu. You don't have to worry about your child's fear of needles or any tears or tantrums leading up to the shot.
However, in 2016, the Centers for Disease Control and Prevention (CDC) announced that the nasal mist flu vaccine was not as effective as the injectable flu vaccine, and physicians stopped offering it as an option. Then in 2018, the nasal flu vaccine came back on the market, and it's now available again for the 2022-2023 flu season. The CDC has approved the nasal flu vaccine for most children aged 2 and older.
Learn more about the nasal flu vaccine and what pediatricians recommend as the most effective way to protect your child against the flu.
What's the difference between the flu shot and nasal spray?
The flu shot is a vaccine that is injected using a needle. The standard flu vaccine uses inactivated or "dead" virus particles to cause your body to make antibodies to the flu virus. There are many different flu viruses, and each year, the vaccine is adjusted to protect against strains that are predicted to be the most common.
The nasal flu vaccine is a mist that is sprayed into your nose. The nasal spray contains four live flu viruses, unlike the inactivated viruses included in the standard flu shot. However, these viruses are weakened so that the nasal flu spray will not cause the flu.
Flu shot vs nasal spray: Which is more effective?
In its guidelines for the 2018-2019 flu season, the American Academy of Pediatrics (AAP) said the injectable vaccine was the better option for children over the needle-free flu nasal spray. However, in their updated guidelines for the 2021-2022 flu season, the CDC and AAP do not state a preference between the flu shot versus the nasal flu vaccine. These recommendations remain the same for the 2022-2023 flu season.
"In past years, the injectable form was preferred due to better protection, but this flu season, the flu mist has an equal preference with the injectable vaccine," says Preeti Sharma, M.D., a pulmonologist at Children's Health℠ and Associate Professor at UT Southwestern. "Still, in many cases, the flu nasal mist is not the best choice, especially for people with a history of lung diseases, or for anyone who is immunocompromised."
Parents should talk to their pediatrician about which flu vaccine is recommended for their child. Children must be 2 years of age or older to receive the nasal spray vaccine. The flu nasal spray is not recommended for anyone with chronic lung problems like asthma or cystic fibrosis, for children taking certain medications or for anyone with a compromised immune system. The CDC also notes that nasal congestion may limit the ability of the vaccine to reach the nasal lining.
Whether you opt for the flu shot or nasal spray vaccine, flu season is still coming. Protecting your child from the influenza virus is very important in ensuring your family stays healthy.
"Every person 6 months of age or older should be immunized against the flu virus," says Dr. Sharma. "The flu can be very dangerous, particularly for children who are considered a high-risk population for influenza."
Flu facts: Why you should protect your child
- On average, 8% of people in the U.S. come down with the flu each year.
- Children are most likely to get sick from the flu.
- Pneumonia is one of the most serious complications of an influenza infection.
- According to the CDC, 34 children died of influenza in the U.S. during the 2021-2022 flu season. The season prior, 188 pediatric deaths were reported.
- The best protection against the seasonal flu is the flu vaccine, and it's encouraged for all people over 6 months of age.
When and where should my child get their flu shot?
Usually, it's best to get the flu shot in early fall. It can take up to two weeks for the antibodies to develop after the vaccine is administered, so it's most effective to get the flu shot before flu season hits. For the 2022-2023 flu season, the CDC recommends getting the flu shot before the end of October, if possible.
If you miss the early window for getting the flu vaccine, you should still get it, Dr. Sharma says it's better late than never. Some flu seasons stretch out for months. Getting the flu vaccine at any time helps reduce your family's risk of getting sick and the chance of flu-related complications.
Although getting a flu vaccine has become more convenient and is available more than ever, if you can, the best place to turn for a vaccination should be your child's primary health care provider. They best understand your child's medical history and specific needs and can offer flu vaccination as part of their ongoing comprehensive care plan.
Can you get the flu vaccine at the same time as the COVID‑19 vaccine?
Flu vaccines and COVID‑19 vaccines can be given at the same time per CDC guidelines. The COVID‑19 vaccine is currently authorized for anyone 6 months and older.
How to protect your child from getting the flu
Of course, vaccination is just the first step in the battle against the flu. It's important to keep in mind other ways that you can help keep your family flu-free:
- Practice good hand hygiene
- Cover your nose and mouth when you cough or sneeze
- Avoid close contact with people who are sick
- Disinfect surfaces
See more ways to prevent your family from getting the flu.
The nasal flu vaccine has live flu viruses while the flu shot has inactivated virus particles. See more differences between the two flu vaccines and which is best for your child from @Childrens.
Learn more
Getting the flu shot every year is essential to keeping your family healthy. Learn more about how the flu shot works and its effectiveness.

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