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Nasal Flu Vaccine Common Questions

Here are some common questions and answers about the nasal influenza (flu) vaccine.

We’ve never vaccinated children against influenza before, why now?

Influenza (flu) can be dangerous in children too.  Younger children are at high risk of developing complications from influenza like pneumonia, ear infections, rarely an inflammation of the brain or worsening of a chronic disease like serious heart disease and asthma. In the last 10 years in Ireland almost 5000 children were admitted to hospital because of influenza, almost 200 were admitted to intensive care and sadly 40 children died from complications of influenza.

The flu vaccine is the best protection against influenza in children. The flu vaccine also reduces the spread of influenza to others. Other countries, including the UK have been offering flu vaccine to children for many years.

Is the nasal flu vaccine for children a new vaccine?

No. Although we haven’t used it before in Ireland, nasal flu vaccine (live attenuated influenza vaccine) has been licensed for more than 15 years. It was first licensed in 2003. Since then it has been given to millions of children in many countries around the world, including the US, Canada, Finland and the UK. In the UK, the nasal flu vaccine has been given to children since 2013.

I’ve heard that the nasal flu vaccine is a live vaccine. What does that mean?

The nasal flu vaccine is a live attenuated vaccine. The word “attenuated” means that the vaccine is made with influenza viruses that are weakened so that they cannot cause influenza infection.

All live vaccines contain weakened viruses or bacteria. They don’t cause disease but instead stimulate the body to produce proteins called antibodies that fight infection.

Live vaccines have been given to children in Ireland since the 1950s, when the oral polio vaccine was first introduced. Live vaccines are given to children in Ireland today and include the rotavirus vaccine given to babies at 2 and 4 months, and the MMR vaccine given to children at 12 months and in junior infants.

I’ve heard that the nasal flu vaccine has genetically modified influenza virus in it?

The flu viruses in the nasal flu vaccine are weakened and are also adapted to cold.

Because the viruses are weakened, they don’t cause influenza infection. And because the viruses are also adapted to cold, they can’t infect the lungs and other parts of the body that are naturally at higher temperatures

 

Is there aluminium in the nasal flu vaccine?

No, there is no aluminium in the nasal flu vaccine.

You can find a list of what is in the nasal flu vaccine by visiting the HPRA website and reading the patient information leaflet and the summary of product characteristics.

I’ve heard that children can shed flu vaccine after being vaccinated. What does this mean?

Vaccinated children can shed the weakened virus in the vaccine for a few days after vaccination but the virus does not survive for long outside the body. The weakened virus doesn’t cause disease, either in the person being vaccinated or in other people.

Since the vaccine was first licensed, there have been no reported cases of influenza passed from vaccinated children to their families or to their close contacts, including those who are pregnant.

I’ve heard that children can shed flu vaccine after being vaccinated. What does this mean for people with a weakened immune system?

Vaccinated children can shed the weakened virus in the vaccine for a few days after vaccination but the virus does not survive for long outside the body. The weakened virus doesn’t cause disease, either in the person being vaccinated or in other people.

As a precaution, if a child is living with someone who has a severely weakened immune system such as someone who has had a bone-marrow transplant, then the nasal flu vaccine isn’t advised for that child.  However, millions of doses of nasal flu vaccine have been given in the US for over 10 years and there have never been any cases reported of anyone with a severely weakened immune system becoming seriously ill with influenza because they were in contact with the nasal flu vaccine. 

If your child is living in the same house as someone who has a severely weakened immune system, talk to your doctor who will be able to advise you.

Do I need to keep my child out of school/childcare after the nasal flu vaccine because of shedding?

No. You do not need to keep your child out of school. 

Vaccinated children can shed the weakened virus in the vaccine for a few days after vaccination but the virus does not survive for long outside the body. The weakened virus doesn’t cause disease, unlike influenza infection, which spreads easily and causes infection.

There have never been any cases reported of influenza passed from children who received the nasal flu vaccine to their close contacts.

But, children who have influenza infection shed influenza virus and can easily infect people around them. That is why it is really important that children are vaccinated to protect them against influenza.

I’ve heard that the flu vaccine interferes with the immune system, and makes it more likely that you’ll get Covid. Is that true?

No. The flu vaccine doesn’t interfere with the immune system.  The flu vaccine doesn’t make any difference to your risk of getting Covid-19. It doesn’t protect you from Covid-19 and it also doesn’t increase your risk of getting Covid-19.

In Ireland, the National Immunisation Advisory Committee, which is a committee of experts on immunisations, continues to recommended flu vaccine for people at risk of influenza. This is also the recommendation from the World Health Organization and other national expert bodies. Getting the flu vaccine is especially important this autumn because if people at risk of influenza get influenza as well as Covid-19, they are likely to be seriously unwell. It’s also important because we want to reduce the pressure on our hospitals and other health services that are already under a lot of pressure from Covid-19.

I’ve heard that research shows flu vaccine can make you more susceptible to other respiratory viruses including coronaviruses.

This refers to a very small randomised control trial which concluded that flu vaccination led to an increase in the risk of non-influenza virus infections including coronaviruses.

However, further research with much larger numbers of people has shown no such increase and a large retrospective analysis from Canada published in May 2020 showed that flu vaccine does not increase the risk of coronavirus or other viruses that affect the lungs and airways.  

Click on the links below to read the studies.

https://www.ncbi.nlm.nih.gov/pmc/articles/PMC7107973/

https://academic.oup.com/cid/advance-article/doi/10.1093/cid/ciaa626/5842161

In Ireland, the National Immunisation Advisory Committee continues to recommended seasonal flu vaccine for people at increased risk of influenza and its complications. Flu vaccine is also recommended by the World Health Organization and other national expert bodies and is particularly important this season to reduce the impact of influenza and Covid-19 co-infections.

I’ve heard that the CDC in the USA doesn’t recommend the use of the nasal flu vaccine?

The nasal flu vaccine has been used in the USA for more than 10 years. Studies in the USA a few years ago found that the nasal flu vaccine was less effective against one strain of influenza than the injectable vaccine, so in 2016-17 and 2017-18, the CDC recommended that the injectable flu vaccine should be used for children. There was never a concern about the safety of the nasal flu vaccine. Studies of the effectiveness of the nasal flu vaccine in other countries over this time showed that the vaccine was effective against flu.

The USA CDC recommended the nasal flu vaccine for use in children again from the 2018-19 season and continues to do so.

 

This page was added 1 October 2020