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    CDC Rejects FluMist: Expert Q&A

    FluMist

    By Kathleen Doheny
    WebMD Health News

    It’s not good news for needle-phobes.

    A CDC committee said this week that the nasal spray flu vaccine, FluMist, should not be used for the upcoming flu season because it doesn’t work. It is the only non-injection flu vaccine available in the U.S. and it’s popular among children: about a third of vaccinated children used FluMist over the past few years, the CDC says.

    The CDC director must review the recommendation from the Advisory Committee on Immunization Practices (ACIP) before it is official. Final action is expected by late summer or fall.

    AstraZeneca, which owns MedImmune, the company that makes FluMist, says in a statement the CDC’s data on FluMist for the 2015-16 flu season contrasts with its studies, “as well as independent findings by public health authorities in other countries.” The company says it’s working with the CDC to understand the data and “help ensure eligible patients continue to receive the vaccine in future seasons in the U.S.”

    Public Health England, meanwhile, issued a statement saying FluMist will continue to be used in the U.K.

    But ”the CDC is recommending this coming year people get the shot instead of the spray,” says Joseph Bresee, MD, chief of the CDC epidemiology and prevention branch. WebMD asked Bresee to elaborate on the new recommendation.

    WebMD: Why isn’t the CDC recommending FluMist this year?

    Bresee: The ACIP voted not to recommend FluMist, the nasal spray, because of evidence that in the last few years FluMist hasn’t worked as well as the flu shots. If you got the flu vaccine [shot] last year, you were [about] 50% less likely to get the flu, but if you got the mist, we couldn’t find evidence of protection. In individual, it may have helped someone [avoid flu], but not overall [in the general population]. In the last three seasons, the CDC has failed to find evidence that the FluMist is effective at preventing flu.

    WebMD: What made FluMist ineffective?

    Bresee: We don’t know for sure. We do know the company is looking very aggressively into this.

    WebMD: Could FluMist be recommended by the CDC in the future?

    Bresee: I sure hope so. This vaccine has a very important place in the options we have for flu vaccination in this country. Any vaccine that doesn’t require a needle is more acceptable to some people. AstraZeneca is currently working in their own lab to figure out what went wrong and to improve it. The CDC over the last few weeks has been sharing our results with [vaccine maker] AstraZeneca and reviewing results of their studies to see how well the vaccine worked and what went wrong. If there could be compelling evidence that the vaccine works again, there is a chance it could be used in the future.

    WebMD: Public Health England says the nasal spray vaccine works and they will still use it. Can you explain the difference of opinion?

    Bresee: It is unclear what the differences are in the data [reviewed] from England and the U.S. We are in discussions with Public Health England to understand their data and for them to understand ours. I think we can look at the same data and come up with different conclusions.

    The ACIP reviewed data since the 2009 pandemic year. There was not evidence that the nasal spray was significantly effective in protecting against one type, called H1N1. This is the type that has predominated for two of the last three years.

    WebMD: What is the best advice now for adults and children to avoid the flu, especially for those fearful of needles?

    Bresee: I think it is important to remember, for those who have traditionally preferred the spray over the shot, that the flu is a serious disease. Getting a shot is far better than getting the flu.

     

     

     

     

     

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