This area is currently under development.
Is the nasal flu vaccine right for people over 50?
Q: The nasal flu vaccine is supposed to be for people up to
the age of 49. If a person is over 49, healthy, and not in any
of the eligible groups for the now scarce flu shots, is the
nasal flu vaccine better than nothing?
A: Though both the nasal vaccine (FluMist) and the flu shot
aim to do the same thing—prevent the flu—there are
important differences in the two that make one more
appropriate for certain people. First, FluMist was tested
primarily in children and younger adults. FluMist was not
approved for patients under 5 because in clinical trials
young children treated with the nasal mist had a higher rate
of asthma attacks and wheezing within 42 days of the
vaccination, compared to children who received a
placebo. Pregnant women, people over 50, and people
with chronic illnesses, including asthma, should not be given
FluMist because its safety and effectiveness in these groups
Second, FluMist uses a live but weakened virus, while the
flu shot uses a killed virus. Health-care workers who care
for severely immunocompromised patients should get the
flu shot instead of the nasal vaccine because of a
theoretical risk of passing the weakened live virus in FluMist
to patients with severely weakened immune systems.
There are also three antiviral drugs (amantadine,
rimantadine, and oseltamivir), that can be used to prevent
the flu, but these work differently than either the nasal
vaccine or the shot. Instead of taking them before you get
the flu, you have to take the antivirals within two days of
the first appearance of flu symptoms in order for them to
be effective. When taken during this time, they are about
70% to 90% effective for preventing illness in healthy
adults. Another drug, zanamivir, has also been approved
for treatment of the flu. These medicines can reduce flu
symptoms and help you get over the flu a few days
sooner. And they can make you less contagious to others.
Anthony Komaroff, M.D.
Editor in Chief, Harvard Health Letter