10/01/2014 01:04 pm ET Updated Dec 01, 2014

Ouchless Flu in 2014-2015: Nasal Flu Spray Recommended For Young Children

Wendy Sue Swanson, MD, MBE, FAAP

It's flu "shot" season, but thankfully, not every vaccine hurts going in. If the thought of needles deters you from getting the vaccine for your child or your family, Live Attenuated Influenza Vaccine (LAIV), a nasal spray, is a great option for those age 2 to 49 years old. In fact, there's data to suggest the nasal flu vaccine is more effective in protecting children from influenza in young childhood. Recommendations this year include a push to have children between 2 and 8 years of age immunized with the nasal spray whenever possible. If the nasal isn't available, the shot should be given -- no reason to wait.

We need the vaccine every year for two main reasons:

  1. Typically, different influenza virus circulate around the world from year to year. Over 100 international centers maintain year-round surveillance to determine and predict which strain will cause human infections. The information is used to forecast the recipe for the vaccine here at home. This year the strains (types) of influenza in the shot and nasal spray are the same as last year (2013-2014).
  2. Protection Fades. When you get a flu vaccine, you stimulate the immune system to create protection against the strains of the virus in the vaccine. That immunity (the antibodies that are created) tends to fade and wane in your bloodstream after about 6-12 months. Therefore, even if you got the flu vaccine last year, you really want your family to have it again this year so it protects you through the winter influenza season, which can continue late into the springtime, but tends to peak in February or March.

Worth noting: About 20,000 children younger than 5 years old are hospitalized from flu every year according to the CDC report, "Which Flu Vaccine Should Children 2 to 8 Years Old Get?"

Who Can Get The Nasal Flu Vaccine?

  • Age 2 and up: Children without serious stuffed up noses and no contraindications (see below) to nasal flu vaccine can get it.
  • Age 2 to 8: Especially recommended to have nasal flu spray if available, because it's been found to be more protective.
  • Age 8 & Up: Children over age 8 years of age without contraindication can also get a nasal flu spray, but there is no official recommendation for the nasal spray over the shot.
  • Kids Who Can't: Children are recommended NOT to get the nasal flu spray when on aspirin, if they have a history of an egg allergy, a weakened immune system, are around family members or close contacts who are immunosuppressed or have serious wheezing or persistent asthma in last year if between age 2 to 4 years.

What Parents Need To Know About Flu Vaccines

  • Flu vaccine (shot or spray) won't give you the flu. The effectiveness varies on a number of things, including how old the child is getting it, if the viral strains included are the ones circulating and the number of shots you've had in the past and timing of immunization. The flu shot is the best way to prevent influenza infections!
  • Children with underlying lung problems need to get a flu shot. However, if they have wheezed in the last year, talk with your child's doctor or nurse to see if they can have a nasal flu spray.
  • Children under 9 may need a second dose, especially if an infant or if this is the first season ever getting the flu vaccine. Talk with your child's care team for more information.
  • Protection lasts several months to a year -- now's the time for flu protection.

Information about nasal flu spray from CDC, Healthy Children and my "Debunking 5 Myths about the Flu"