From Our 2007 Archives

U.S. Advisers OK Nasal Spray Flu Vaccine for Young Children

By Steven Reinberg
HealthDay Reporter

WEDNESDAY, Oct. 24 (HealthDay News) -- Children as young as 2 years old can be given the nasal spray influenza vaccine FluMist, U.S. vaccine advisers recommended Wednesday.

Currently, FluMist is only recommended for healthy people ages 5 to 49. Traditional flu shots have been recommended for children younger than 5, but the advisers said Wednesday that FluMist should prove useful for children ages 2 to 4 who might be frightened by needles.

Recent studies have shown that FluMist, which uses a live, weakened flu virus, is safe and effective in children as young as 2. The U.S. Food and Drug Administration last month approved its use for that age group.

Wednesday's recommendation, by members of U.S. Centers for Disease Control and Prevention's Advisory Committee on Immunization Practices, said children with a history of asthma or wheezing should choose a shot and not FluMist.

The advisory panel's recommendations are typically accepted by U.S. health officials, and they influence insurance companies' decisions on vaccination coverage. The committee also voted that a government program that pays for vaccines extend its FluMist coverage to the 2- to 5-year-old age group, meaning millions of additional children will now be eligible for FluMist doses, the Associated Press reported.

Dr. Henry Bernstein, a professor of pediatrics at Dartmouth Medical School and a member of the American Academy of Pediatrics' committee on infectious diseases, said he endorses the FluMist recommendation.

"It adds to the overall supply of flu vaccine for children, it's thimerosal-free, which some parents perceive as a problem, and it's a very effective vaccine and appears to have improved efficacy compared with the vaccine shot," he said.

The CDC recommends that all children age 6 months to 59 months receive a vaccination to protect against flu. Studies have shown that children younger than 5 years are hospitalized for flu at rates similar to adults 50 through 64 years old.

The FDA's approval last month of FluMist for younger children was based on studies of approximately 6,400 infants and children between the ages of 6 months and 59 months. Two studies compared FluMist to a placebo, and both trials demonstrated the vaccine's effectiveness in preventing flu illness, the agency said.

Children under the age of 2 should not receive FluMist, because there was an increased risk of hospitalization and wheezing for this age group during the clinical trials, the FDA said.

Common adverse reactions to the FluMist vaccine were generally mild and most often included runny nose and/or nasal congestion, as well as a slight fever in children 2 to 6 years of age, the FDA said.

One dose of FluMist costs about $18 -- about the same cost as a flu shot. One dose is recommended annually, but if it's the first time a young child was ever vaccinated against flu, two doses should be given, at least one month apart, the AP said.

Barbara Loe Fisher is co-founder and president of the National Vaccine Information Center, a national, nonprofit group that endorses informed consent on vaccination to help prevent vaccine injuries.

"There is a concern with FluMist for children who have asthma or respiratory problems," she said. "It is a live virus vaccine, and parents need to be aware of the differences between the killed flu vaccine and the live virus vaccine."

Fisher said parents of children with asthma or respiratory problems should opt for the flu shot, which contains a dead version of the flu virus.

Dartmouth's Bernstein also thinks the vaccine advisory panel should recommend pneumococcal conjugate vaccine for children 24 through 59 months of age who are not completely vaccinated.

"All the children that need it should get it," Bernstein said. "It's a very safe and effective vaccine, and pneumonia is a bacteria that can cause serious infection in young children," he said.

Also Wednesday, the Advisory Committee on Immunization Practices discussed a proposal to recommend flu vaccinations for all school-age children. Health officials believe vaccinating more children would reduce the spread of flu in general as well as protect the students themselves. But experts say they're concerned about the strain on pediatricians and schools if they tried to give annual flu shots to so many children, the AP said.

The discussion was tabled until the committee's next meeting in February, the news service said.

SOURCES: Henry Bernstein, M.D., professor of pediatrics, Dartmouth Medical School, Hanover, N.H., chief of general pediatrics, Dartmouth Children's Hospital, and member, committee on infectious diseases, American Academy of Pediatrics, Elk Grove Village, Ill.; Barbara Loe Fisher, co-founder and president, National Vaccine Information Center, Vienna, Va; U.S. Food and Drug Administration; Associated Press

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