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Access to Care

Why Some Kids Might Not Get FluMist This Year

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Min-Jin Park/via Flickr
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Some pediatricans are following CDC guidelines and not giving kids FluMist, opting for a regular flu shot instead.

Most Michigan pediatricians will be following the recommendation of the Centers for Disease Control, which says children ages 2-17 should get a regular flu vaccine injection this year, not the FluMist nasal spray vaccine.

"The (FluMist) vaccine effectiveness is just simply not there," says Teresa Holtrop, a pediatrician and president-elect of the Michigan chapter of the American Academy of Pediatrics.

FluMist was developed by Michigan-trained epidemiologist Hunein Maassab.  He died in 2014.

Holtrop says FluMist didn't work very well in the 2013-14 flu season or the 2014-15 flu season, and in the most recent flu season, 2015-16, it didn't work at all.

Researchers are trying to figure out why.

"Maybe as people become frequently immunized," says Holtrop, "the immunological response of the individual is not as strong. It's not competely clear."

FluMist is a popular form of vaccination for children because it doesn't hurt. 

Holtrop says parents should just be matter of fact and calm with their kids, explain that they have to get an injection this year, "hold them, and get it over with quickly."

Influenza can range from a miserable illness lasting a week or two, to one that results in hospitalization or even death.

In the 2015-16 flu season, 85 children died of complications from the flu in the U.S. The year before, 148 children died of flu.

Even the regular flu vaccine is not 100% effective. That's because there are several variants of flu circulating at any one time, and the virus can mutate rapidly. 

In some years, researchers have guessed wrong which variants should be included in the shot, or the shot wasn't as effective because one of the viruses had mutated. That was the case in 2013-14, when the flu shot was only 13-23% effective.

In 2015-16, the vaccine effectiveness of the shot was 65%.

Health experts recommend that everyone over the age of six months get a flu vaccine.  

They say even if a vaccinated person still gets the flu, it is less likely to be a severe case, and they point out there is usually no way to know in advance if a flu season is going to be especially severe.

Meanwhile, the company that manufactures FluMist, AstraZeneca, says it disagrees with the CDC about the effectiveness of the vaccine.

The US CDC effectiveness data for 2015-2016 season contrast with studies by AstraZeneca as well as preliminary independent findings by public health authorities in other countries.2,3,4 These findings demonstrate FluMist Quadrivalent was 46-58% effective overall against the circulating influenza strains during the 2015-2016 season. .....AstraZeneca is working with the CDC to better understand its data to help ensure eligible patients continue to receive the vaccine in future seasons in the US.

The company says FluMist U.S. sales in 2015 amounted to $206 million, and the CDC recommendation will result in the company taking a write-down of $80 million in the second quarter of 2016.

This story was updated to include comments from AstraZeneca.