Should my preemie get the flu spray or shot?

In yesterdays posting I discussed the efficacy of the flu vaccine for parents and other adults who are around preemies. Studies suggest that the nasal spray (live attenuated vaccine) is less effective than the shot for healthy adults ages 18-49. But what about our preemies? Are they better off with the shot or the spray? Many preemies have suffered through a multitude of shots and other painful procedures, so the idea that a simple nasal spray can offer protection from the flu is very attractive.

Let’s look at the evidence:

A study published in the journal Vaccine (in 2009 by Rhorer et al.) reviewed recent studies examining the efficacy of the nasal spray and the shot. This publication is a meta-analysis, meaning it evaluated the results of several previously published studies. In children who had never previously been vaccinated against the flu, the spray resulted in 46% fewer cases of the flu when compared with the injection (and this is data from head-to-head trials). In children who had been vaccinated previously (in other flu seasons) the spray resulted in 35% fewer cases of influenza than the shot.

The flu vaccination was very effective at preventing influenza. Consider the following:

Children who receive the flu nasal spray for the first time and receive both doses (2 doses are needed the first ever time a person ever gets the influenza vaccine) are 77% less likes to get influenza than unvaccinated children.

Children who receive the flu nasal spray for the first time but only get one dose instead of the recommended two are 60% less likely than unvaccinated children to get the flu.

Children who were vaccinated in a previous year against the flu who get the nasal spray (only need one dose) are 87% less likely to get the flu when compared with unvaccinated children. In one study, children who got the nasal spray were 92% less likely to get influenza than unvaccinated kids.

The only issue with nasal spray is not everyone can take it. Children must be older than 2 years of age and otherwise healthy with no chronic diseases. In addition, people with a medical conditions that places them at high risk for complications from influenza, such as chronic heart disease, lung disease (such as asthma or bronchopulmonary dysplasia), immune system problems, or kidney failure should not get the nasal spray. Pregnant women should also not get the spray.

Kids can get the flu nasal spray if they have a mild illness, however, if there is severe congestion the spray might not be absorbed completely from the nose.

Flu vaccines are VERY effective in children. The spray seems to be the most effective from ages 6 months to 17 years. So, a healthy preemie with no medical condition is probably best off with the spray. Those with chronic medical conditions will still benefit from vaccination, it just has to be the shot.

Does the flu vaccine work for kids? You bet it does.

Remember, this blog is not individual medical advice.

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