Should children get the nasal flu vaccine?

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.

In past years, the Center for Disease Control and Prevention (CDC) and American Academy of Pediatrics (AAP) have recommended the injectable flu vaccine over the nasal spray vaccine because the injectable vaccine was more effective. This year, they do not state a preference between these options for most people.

"The nasal spray vaccine called FluMist is generally suitable for people ages 2-49 who are not immunocompromised, and who don't have respiratory illnesses like cystic fibrosis or primary ciliary dyskinesia," says Preeti Sharma, M.D., a pulmonologist at Children's Health℠ and Associate Professor at UT Southwestern.

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?

For the 2024-2025 flu season, the CDC says any licensed flu vaccine, whether the shot or nasal spray, can be used as long as the patient meets the age requirements and does not have certain health conditions.

"In past years, the injectable form was preferred due to better protection, but over the last few flu seasons, the nasal spray vaccine has an equal preference with the injectable vaccine," Dr. Sharma says. "While the nasal flu mist is effective, it might not be the best option for patients with lung disease or who are 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, at least 103 children died from the flu during the 2023-2024 flu season, and nearly 90% of them were not vaccinated against it.

• 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. 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

Vaccination is the first step in preventing the flu. You can also help prevent the flu by:

• Practicing good hand hygiene

• Covering your nose and mouth when you cough or sneeze

• Avoiding close contact with people who are sick

• Disinfecting surfaces

See more ways to prevent your family from getting the flu.

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.