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FluMist

Generic name: influenza virus vaccine (nasal) [ in-floo-ENZ-a-VYE-rus-VAK-seen ]
Drug class: Viral vaccines

Medically reviewed by Philip Thornton, DipPharm. Last updated on Nov 7, 2021.

What is FluMist?

FluMist is used to prevent infection caused by influenza virus. The vaccine is redeveloped each year to contain specific strains of activated (live) flu virus that are recommended by public health officials for that year.

FluMist nasal spray is a "live virus" vaccine. Influenza virus vaccine is also available as an injection (flu shot) which is a "killed virus" vaccine. This medication guide addresses only the nasal form of influenza virus vaccine.

FluMist is for use in adults up to 49 years old, and children who are at least 2 years old.

FluMist works by exposing you to a small dose of the influenza virus, which helps your body to develop immunity to the disease. This vaccine will not treat an active infection that has already developed in the body.

Becoming infected with influenza is much more dangerous to your health than receiving FluMist. Influenza causes thousands of deaths each year, and hundreds of thousands of hospitalizations. However, like any medicine, this vaccine can cause side effects but the risk of serious side effects is extremely low.

Like any vaccine, FluMist may not provide protection from disease in every person.

Influenza (commonly known as "the flu") is a serious disease caused by a virus. Influenza virus can spread from one person to another through small droplets of saliva that are expelled into the air when an infected person coughs or sneezes. The virus can also be passed through contact with objects the infected person has touched, such as a door handle or other surfaces.

Warnings

You may not be able to receive FluMist if you are allergic to eggs, if you or someone in your household has a weak immune system, if you are under 18 years old and have recently taken aspirin, or if you have a history of breathing problems, heart or kidney problems, diabetes, Guillain-Barre syndrome, or severe allergic reaction to a flu vaccine.

You should not receive a booster dose of FluMist if you had a life-threatening allergic reaction after the first dose.

Keep track of any and all side effects you have after receiving FluMist. If you ever need to receive FluMist in the future, you will need to tell your doctor if the previous dose caused any side effects.

FluMist is made from "live viruses" and may cause you to have mild flu-like symptoms.

Before taking this medicine

You should not receive FluMist if you are allergic to eggs, or if you have:

  • a history of severe allergic reaction to any flu vaccine; or

  • if you are between 2 and 17 years old and have recently taken aspirin.

FluMist is not approved for use by children younger than 2 years or adults older than 49 years.

You should not receive a FluMistif you have used:

You may not be able to receive FluMist if you have certain medical conditions. Tell the vaccination provider if you have:

  • asthma, wheezing, or other breathing problems;

  • (for children younger than 5 years) a history of wheezing;

  • a history of Guillain-BarrĂ© syndrome within 6 weeks after receiving a flu vaccine;

  • a weak immune system (or if someone in your household has a weak immune system);

  • heart problems;

  • kidney disease; or

  • diabetes.

If you are unable to receive FluMist due to a medical condition, you may be able to get an injectable influenza vaccine (flu shot) instead.

You can still receive a vaccine if you have a minor cold. In the case of a more severe illness with a fever or any type of infection, wait until you get better before receiving FluMist.

Tell your vaccination provider if you are pregnant or breastfeeding.

Nasal flu vaccine is not recommended for use in pregnant women. However, the Centers for Disease Control and Prevention recommends that pregnant women get a flu shot during any trimester of pregnancy to protect themselves and their newborn babies from flu.

How is FluMist given?

FluMist is given as a nasal spray into each nostril.

Children ages 2 to 8 years old may need a second dose, at least 1 month after the first nasal vaccine.

The influenza virus vaccine is usually given in October or November. Follow your doctor's instructions or the schedule recommended by your local health department.

Since the influenza virus vaccine is redeveloped each year for specific strains of influenza, you should receive a flu vaccine every year.

Dosing information

Usual Adult Dose for Influenza Prophylaxis:

Through 49 years old:
1 dose (0.2 mL), intranasally, once per influenza season - administer 0.1 mL per nostril.

Usual Geriatric Dose for Influenza Prophylaxis:

50 years and older: not recommended.

Usual Pediatric Dose for Influenza Prophylaxis:

2 to 8 years:
1 or 2 doses (0.2 mL), intranasally, per influenza season - administer 0.1 mL per nostril
-If using 2 doses, administer at least 1 month apart
-Use Advisory Committee on Immunization Practices annual recommendations to determine number of doses

9 years and older:
1 dose (0.2 mL), intranasally, once per influenza season - administer 0.1 mL per nostril.

What happens if I miss a dose?

Call your doctor if you forget to receive your yearly FluMistin October or November, or if your child misses a booster dose.

What happens if I overdose?

An overdose of FluMist is unlikely to occur.

What should I avoid before or after receiving FluMist?

For at least 2 weeks after receiving FluMist, avoid using antiviral flu medications (such as amantadine, oseltamivir, rimantadine, zanamivir, Flumadine, Tamiflu, Relenza).

For at least 7 days after receiving a nasal flu vaccine, avoid close contact with anyone who has a weak immune system caused by disease such as cancer or HIV, or by using steroids, chemotherapy, radiation, or other treatments that can weaken the immune system. People with weak immune systems can become ill if they are in close contact with you when you recently received a live vaccine.

FluMist side effects

Get emergency medical help if you have signs of an allergic reaction to FluMist: hives; difficulty breathing; swelling of your face, lips, tongue, or throat.

You should not receive a booster vaccine if you had a life threatening allergic reaction after the first shot.

Keep track of any and all side effects you have. If you receive a FluMistin the future, you will need to tell the vaccination provider if the previous shot caused any side effects.

Nasal flu vaccine is made from "live viruses" and may cause you to have mild flu-like symptoms. You may have flu-like symptoms at any time during flu season that could be caused by other strains of influenza virus.

Call a doctor at once or seek emergency medical attention if the person who has received FluMist has wheezing or trouble breathing.

Common FluMist side effects include:

  • fever over 100 degrees F;

  • chills;

  • runny or stuffy nose;

  • sore throat, cough;

  • loss of appetite;

  • muscle pain;

  • headache; or

  • feeling tired or irritable.

This is not a complete list of side effects and others may occur. Call your doctor for medical advice about side effects. You may report vaccine side effects to the US Department of Health and Human Services at 1-800-822-7967.

Influenza virus vaccine dosing information

Usual Adult Dose for Influenza Prophylaxis:

Through 49 years old:
1 dose (0.2 mL), intranasally, once per influenza season - administer 0.1 mL per nostril.

Usual Geriatric Dose for Influenza Prophylaxis:

50 years and older: not recommend

Usual Pediatric Dose for Influenza Prophylaxis:

2 to 8 years:
1 or 2 doses (0.2 mL), intranasally, per influenza season - administer 0.1 mL per nostril
-If using 2 doses, administer at least 1 month apart
-Use Advisory Committee on Immunization Practices annual recommendations to determine number of doses

9 years and older:
1 dose (0.2 mL), intranasally, once per influenza season - administer 0.1 mL per nostril.

What other drugs will affect FluMist?

Anyone 2 to 17 years old receiving a FluMistshould not take aspirin for at least 4 weeks after the vaccine. A possible interaction between nasal flu vaccine and aspirin can cause a serious or fatal condition called Reye's syndrome.

Before receiving this vaccine, tell your vaccination provider about all other vaccines you have recently received.

Other drugs may interact with influenza virus nasal vaccine, including prescription and over-the-counter medicines, vitamins, and herbal products. Tell your doctor about all other medicines you use.

More about FluMist (influenza virus vaccine, live, trivalent)

Patient resources

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FluMist Quadrivalent

Professional resources

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Further information

  • Your vaccination provider, pharmacist, or doctor can provide more information about this vaccine. Additional information is available from your local health department or the Centers for Disease Control and Prevention.

Remember, keep this and all other medicines out of the reach of children, never share your medicines with others, and use FluMist only for the indication prescribed.

Always consult your healthcare provider to ensure the information displayed on this page applies to your personal circumstances.