On June, 22, 2016, the U.S. Centers for Disease Control and Prevention’s (CDC) Advisory Committee on Immunization Practices (ACIP) recommended against using the live nasal spray version of the influenza vaccine known as FluMist during the 2016-2017 influenza season.
After reviewing data for 2013-2016, ACIP determined that the “FluMist Quadrivalent” live attenuated influenza vaccine (LAIV), was only three percent effective in protecting children two to seven years of age against influenza. The three percent figure is so low that, for all practical purposes, the vaccine provided no protection, or at least that “no protective benefit could be measured.”1 Last year, the ACIP again recommended against using the FluMist Quadrivalent vaccine.2
The decisions by the ACIP during the past two years have now been reversed. On February 21, 2018, the ACIP voted 12-2 to add FluMist Quadrivalent to the CDC’s list of recommended vaccines for the 2018-2019 influenza season.3 According to an article in STAT magazine, there had been “mounting concern” that MedImmune, the maker of FluMist, would “abandon the vaccine if it could not find a way back to the U.S. market.”3
The latest decision by the ACIP fell short of a resounding endorsement of FluMist Quadrivalent. The Committee left it up to doctors to decide whether or not do administer it. It stated:
For the 2018-19 season, immunization providers may choose to administer any licensed, age appropriate, influenza vaccine (including LAIV, IIV and RIV). LAIV4 is an option for influenza vaccination for persons for whom it is otherwise appropriate.4 5
LAIV4 (Live Attenuated Influenza Vaccine 4) refers to FluMist Quadrivalent.6
Some members of of the ACIP expressed concern about the new recommendation because they felt it would “confuse both the public and health care providers who administer flu vaccines.”3 ACIP member Henry Bernstein, MD of the Zucker School of Medicine at Hofstra/Northwell in Hempstead, NY said, “I’m a little concerned about whether it would be interpreted that we’re compromising our interpretation of the science.” Dr. Bernstein voted against the recommendation.3
2 Scutti S. CDC panel again advises against FluMist. CNN June 21, 2017.
3 Branswell H. FluMist is back: Vote reopens the way to wider use of popular vaccine. STAT Feb. 21, 2018.
4 Fox M. FluMist nasal flu vaccine can come back, vaccine advisers say. NBC News Feb. 22, 2018.
5 Leonard K. Nasal flu vaccine to make a comeback. Washington Examiner Feb. 25, 2018.
6 Brown T. Nasal Flu Vaccine Back on CDC List of Recommended Vaccines. Medscape Feb. 22, 2018.