FluMist: FluMist vs. flu shot, side effects, ages, and more

Here are answers to some frequently asked questions about FluMist.

Can FluMist spread or cause the flu through shedding?

Shedding is very common with the FluMist vaccine. However, it's very unlikely that this shedding will spread or cause the flu.

Shedding occurs when a virus in your body replicates (makes copies of itself) and is then released to the environment around you. For example, when you receive the FluMist nasal spray, the flu viruses will replicate in your nose. Then if you sneeze, you could spread the flu viruses.

In a study of children and adults ages 5 through 49 years, shedding occurred in 29% of adults and children ages 5 through 49. Another study looked at viral shedding in younger children, ages 6 to 59 months (about age 5 years).* In this study, shedding occurred in:

79% of children in the study
89% of children ages 6 months through 23 months old
69% of children ages 24 months through 69 months old

Another study looked at whether people actually catch the flu when others shed the virus after getting FluMist. Children ages 8 to 36 months received FluMist or a placebo (treatment with no active vaccine).

The researchers found that 80% of children who received FluMist shed the virus. However, the researchers found only one instance of a flu strain in a child who received a placebo. Based on these numbers, they estimated that the transmission rate of the virus from those who received FluMist vaccine was about 0.58%.

These study results indicate that it's unlikely that you would become infected with the flu from someone else who received the FluMist vaccine.

If you have questions about shedding or spreading flu viruses after receiving FluMist, talk with your doctor or pharmacist.

* The Food and Drug Administration (FDA) has approved FluMist for use in children and adults ages 2 to 49 years.

I have asthma. Can I still get FluMist?

It depends. If you have asthma, you may be at a higher risk for developing wheezing when you receive the FluMist vaccine. Children younger than age 5 years who have wheezing that keeps returning may also be at risk for wheezing with FluMist.

If either of these situations apply, the doctor may monitor you or your child for a longer time than usual after a dose of FluMist. This allows them to treat any wheezing that occurs. In some cases, the doctor may recommend that you or your child have a flu shot instead. Talk with your doctor about the best flu vaccine for you or your child.

How well does FluMist work?

FluMist is an effective vaccine to help prevent against infection with the influenza (flu) viruses.

FluMist was studied in clinical trials of adults ages 18 to 49 years. Researchers followed people in the study over the course of 7 weeks. People vaccinated with FluMist were 23.7% less likely to develop an upper respiratory infection with a fever compared with people who received a placebo. Upper respiratory infections include the common cold.

However, no vaccine is 100% effective. Although FluMist may decrease your risk for becoming infected with the flu viruses, you could still develop the flu.

Talk with your doctor about whether FluMist is right for you and what else you can do to help prevent the flu.

Does FluMist cause autism?

No, FluMist doesn't cause autism. There has been some speculation in the past that vaccines or ingredients in vaccines, such as thimerosal, may cause autism. However, there is no relationship between any vaccine and developing autism.

Many studies, such as one published in the Journal of Pediatrics, show that vaccines don't cause autism. The CDC also says that no link has been found between the development of autism and vaccines.

If you have questions about the risks of flu vaccines, talk with your doctor.

Is it OK to get FluMist if I have diabetes?

You may not be able to get FluMist if you have diabetes, including both type 1 diabetes and type 2 diabetes. This is because diabetes can weaken your immune system.

FluMist is a live vaccine, which means it has live flu viruses in it that have been weakened so that they shouldn't infect you with the flu. If your immune system is healthy, it should be able to fight the flu viruses in the vaccine. But if your immune system is weakened due to diabetes, you may not be able to fight the viruses in the vaccine.

If you have diabetes, your doctor will probably recommend that you get a flu shot instead of FluMist. Flu shots aren't live vaccines. For details, see "Live vs. inactive vaccine" in the "FluMist vs. flu shot" section above.

If you have questions about which flu vaccine is right for you, talk with your doctor.

Does FluMist protect me from COVID-19?

No, FluMist doesn't protect against COVID-19. No flu vaccine will protect against COVID-19 because influenza (flu) viruses are different from the coronavirus that causes COVID-19.

However, it's still important to be vaccinated against the flu. This is because it's possible to become infected with both the flu and COVID-19. Having both infections can increase your risk for serious effects such as trouble breathing and, in some cases, death.

Also, when you have an infection, such as the flu, your immune system tries to fight the infection. As a result, it may be harder for your immune system to fight off additional illnesses such as COVID-19.

So, although FluMist won't protect you from COVID-19, it should still protect you from the flu. And this could leave your body better prepared to fight off COVID-19 or other illnesses.

If you have questions about FluMist or COVID-19, talk with your doctor.

Can I receive the FluMist vaccine if I have or think I have COVID-19?

No. You shouldn't receive the FluMist vaccine if you have or think you have COVID-19.

If you have COVID-19, your doctor has likely told you to self-isolate. In this case, you shouldn't go out to receive the FluMist vaccine. Once your doctor has told you that you're no longer able to transmit COVID-19 to others, you can ask your doctor if FluMist is right for you. (To learn more, see "CDC recommendations" in the "How FluMist is given" section above.)

If you think you have COVID-19, talk with your doctor. They can recommend the right testing for you. If the tests show that you don't have COVID-19, your doctor may say that you can get FluMist or a flu shot.

If you have questions about FluMist or COVID-19, talk with your doctor.

Was FluMist discontinued at some point?

Yes, FluMist wasn't available during the 2016–2018 flu seasons. The CDC recommended against using FluMist at that time because studies showed that the vaccine was only about 3% effective from 2013–2016.

However, in 2018, the manufacturer of FluMist changed the vaccine so that it would be more effective. With that change, the CDC began to recommend FluMist as an option for flu vaccination in 2019. However, there was a limited supply of the vaccine available during the 2019–2020 flu season due to a manufacturing shortage.

FluMist is currently approved for the 2020–2021 flu season for use in children and adults ages 2 to 49 years. If you have questions about whether FluMist is right for you, talk with your doctor. You can also refer to "CDC recommendations" in the "How FluMist is given" section above.

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