FluMist is OK to use again. The nasal flu vaccine is coming back in the market after a federal advisory group gives it a go-ahead.

In a vote of 12-2, the Advisory Committee on Immunization Practices panel agreed to recommend the use of the nasal vaccine for the next flu season.

The advisory committee provides advice and guidance to the director of Centers for Disease and Control and Prevention regarding the use of vaccines and related agents for control of vaccine-preventable diseases among the civilian population. The CDC director reviews the recommendations made by the ACIP.

FluMist Nasal Spray

FluMist is a type of live attenuated influenza vaccine. The use of nasal flu spray is still approved by the Food and Drug Administration but was removed from the U.S. market two years ago because of its inefficacy against flu strain H1N1.

FluMist, manufactured by AstraZeneca subsidiary MedImmune, is the only available needle-free flu vaccine administered to children and other patients who don't prefer injectable vaccines. It was first licensed in 2003 and has since then used in school-based flu immunization campaigns.

However, the advisory committee showed a lukewarm support to FluMist. The committee changed the wording of its decision and indicated that it is up to the doctors to decide on what licensed flu vaccine to use.

"This is not an easy decision," says Dr. Nancy Bennett chair of the Advisory Committee on Immunization Practices.

Now, FluMist is on the recommended list of flu vaccines, allowing insurance companies to pay for its use.

Different Opinions

The panel members of the advisory committee presented varying positions on FluMist. Two members of the panel said it could hurt public perception on the safety of flu vaccines if FluMist is returned to the market and does not work well.

"I have real mixed emotions about this because I think we want to protect as many people as we can, particularly, as a pediatrician, for children," says Dr. Henry Bernstein, a professor of Pediatrics at Cohen Children's Medical Center in New York.

Others say FluMist is better than no vaccination at all.

"It's better than nothing," says Dr. Grace Lee, a professor of Pediatrics at Stanford University School of Medicine.

The CDC says the brutal flu season has yet to peak and could go until April. Based on its latest flu surveillance report, pediatric deaths have climbed to 84. The agency recommends the use of injectable flu vaccination for this season for everyone including babies who are at least 6 months old.

New Formulation

ACIP did not recommend FluMist in 2016 and the current season after studies showed that the nasal spray had reduced the risk of acquiring influenza by only 3 percent over the past three flu seasons.

Although it was off the U.S. market, the nasal spray is still used in other countries, including Canada and the European Union.

MedImmune announced that it has reformulated the vaccine and tested it on 200 kids. AstraZeneca presented new data on the improvements it made to the strain selection process. The company said that an improved H1N1 LAIV strain is included in the 2017-2018 formulation.

"We are pleased that the ACIP has voted in support of a renewed recommendation FluMist Quadrivalent in the US and look forward to continuing to work with public health authorities to optimize protection against influenza," says AstraZeneca vice president for medical affairs Gregory Keenan.

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