The nasal spray influenza vaccine will be available to patients in the United States again.
In a 12-2 vote, the CDC’s Advisory Committee on Immunization Practices said today that providers should be able to offer FluMist Quadrivalent (MedImmune) during the 2018-2019 influenza season, reversing its last two recommendations.
Known as the live-attenuated influenza vaccine (LAIV), the nasal spray is preferred by some parents and children as an alternative to getting a shot, but the ACIP had voted against its use in the U.S. for the past two influenza seasons after data showed it had lost effectiveness against H1N1 viruses.
Experts worried that child immunization rates would go down, but research published last year showed they remained unchanged between the 2015-2016 and 2016-2017 influenza seasons. Still, William Schaffner, MD, Infectious Disease News Editorial Board member and professor of preventive medicine at Vanderbilt University, said he was pleased the committee recommended the spray again.
“I know parents will be pleased, and many children will be pleased that they don’t have to take a shot in the arm,” Schaffner said in an interview.
A study published in The New England Journal of Medicine last year supported the ACIP’s recommendations against using LAIV in the U.S., which were based on the unusual finding that the LAIV, despite containing live-attenuated viruses, did not protect patients the way that injectable vaccines containing killed viruses had. Other countries, including Canada, continued recommending the LAIV based on different research showing that it was effective.
According to AstraZeneca, the parent company of MedImmune, the ACIP vote followed a presentation that included positive study results demonstrating that the new 2017-2018 H1N1 post-pandemic strain (A/Slovenia) included in the LAIV performed significantly better than the strain used in the 2015-2016 vaccine that was associated with reduced effectiveness.
Gregory Keenan, vice president of U.S. medical affairs for AstraZeneca, said in a statement that the ACIP’s decision “validates the improvements we’ve made to our strain selection process and confirms an improved H1N1 LAIV strain was included in the 2017-2018 formulation.”
The ACIP’s vote on Wednesday came amid an intense influenza season in the U.S. that has been dominated by weeks of elevated activity. – by Gerard Gallagher and Joe Green
Disclosures: Schaffner reports being a consultant for Dynavax and Seqirus.