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• Posted October 31, 2023

At-Home, Inhaled Flu Vaccine Could Be on Horizon

Getting a yearly flu shot is one of the best ways to protect yourself from infection or severe illness, but not everyone likes shots.

Now, there is some potentially good news for those who fear needles: A nasal spray flu vaccine that you can take or give at home is on the horizon.

The U.S. Food and Drug Administration is reviewing an application for the at-home use of a nasal spray flu vaccine called FluMist from AstraZeneca. The nasal spray has been on the market since 2003, but AstraZeneca is now asking the FDA to allow adults aged 18 to 49 to be able to give themselves the vaccine or give it to children aged 2 through 17.

The FDA is slated to make a decision during the first few months of 2024, said Lisa Glasser, head of U.S. Medical Affairs Vaccines-Infectious Disease at AstraZeneca. If approved, FluMist is expected to be available for self-administration for the 2024/2025 flu season.

“Self-administration of FluMist could increase access to flu vaccines outside of traditional settings, providing a convenient option to busy parents and caregivers for vaccine-eligible members of their whole family,” she said.

Research has shown that people older than 18 can use the nasal spray vaccine or administer it to others when given instructions without any additional guidance. In addition, nasal vaccines are as effective as other types of flu vaccines, Glasser said.

"Our goal is for eligible patients to be able to order FluMist Quadrivalent directly from an online partner and have it shipped to their home," she added.

Still, not everyone should use the nasal flu vaccine.

People who are allergic to eggs, or to any inactive ingredient in the vaccine, as well as those who have ever had a life-threatening reaction to flu vaccines should not use FluMist. Since it is a live vaccine, children younger than 2 and people with weakened immune systems should steer clear from it as well. The nasal flu vaccine is also not as effective as other flu vaccines for people over 50, according to the U.S. Centers for Disease Control and Prevention.

The availability of a nasal flu vaccine that could be used at home may save lives, said Dr. Otto Yang, an immunologist at the David Geffen School of Medicine at the University of California, Los Angeles.

“There's a lot of needle phobia in the community, and a simple nasal spray that you can use in the privacy of your own home can potentially be helpful in terms of addressing fears of people who don't like shots,” he said.

Overall, the nasal vaccine does appear to be very safe, Yang added.

There are some downsides, he said, noting that "this vaccine is a live, weakened virus, so it can't be used by toddlers or people with weakened immune systems.” The flu shot is not live so it can be safely used by a larger number of people, Yang explained.

Meanwhile, there is a big push for people to get the COVID booster and flu vaccine at the same time.

“If the COVID-19 vaccine and flu are co-administered on a yearly schedule, it might reduce the number of people who get the COVID-19 vaccine since they aren't showing up at pharmacies or doctor's offices for flu shots,” Yang noted.

Dr. Len Horovitz, a pulmonologist at Northwell Lenox Hill Hospital in New York City, is a big advocate of the annual flu shot, but he is on the fence about an at-home nasal vaccine. “It can cause you to develop a cold, which can then be transmitted to others, and that is a minus,” he said.

Also, some of the active ingredients can drip out of a person's nose.

“It's not like an injection where you know exactly how much vaccine was given,” Horovitz explained. “It is pretty easy to walk into a pharmacy and get a shot, so I am not sure that this benefit outweighs the minuses of potentially not getting a full dose or getting a cold.”

More information

HealthDay has more on annual flu shots.

SOURCES: Lisa Glasser, head, U.S. Medical Affairs Vaccines-Infectious Disease, AstraZeneca; Otto Yang, MD, immunologist, David Geffen School of Medicine, University of California, Los Angeles; Len Horovitz, MD, pulmonologist, Northwell Lenox Hill Hospital, New York City