We reported back in June—and then updated the story two days ago—about how the American Academy of Pediatrics (AAP) and the US-based Centers for Disease Control and Prevention (CDC) were recommending against the use of nasal mist flu vaccine for anyone, but particularly for kids. The AAP and CDC cite studies that show the nasal mist is ineffective and recommend the flu shot instead.
Here in Canada though, the nasal mist flu vaccine hasn't been ruled out as an option. Last week the Public Health Agency of Canada, via the National Advisory Committee on Immunization (NACI), released its own statement after reviewing data from the last several influenza seasons. It states that the current evidence doesn't support a recommendation for the preferential use of the nasal mist flu vaccine in children aged two to 17, and that both the flu shot and the nasal mist should be considered as options this flu season.
Confused? Why is there such a difference between the American and Canadian recommendations?
Joan Robinson, chair of the Canadian Paediatric Society's Immunization and Infectious Diseases committee, says the US recommendation is based on a single study, done by the CDC, that shows the nasal mist doesn't work. "But there have been other studies done in Finland, the UK and here in Canada that show it is effective," Robinson says. "For now, with the data we have, the evidence is sufficiently convincing to continue using the nasal mist flu vaccine."
Up until this year, Robinson says, the nasal mist was the preferred way of protecting kids aged two to six years against the flu. But based on current data, experts in Canada are now saying that it's no better—or worse—than the flu shot for this season. "Either one is available, it's up to parents to choose," Robinson says. While she acknowledges that parents and pediatricians might favour the nasal mist because it seems gentler and less invasive, Robinson says "Some kids may not like having something sprayed up their nose—they may prefer to have the shot."
The bottom line: everyone should get the flu vaccine—in whichever form they prefer—as soon as it becomes available (usually around the end of October). "We will continue to use the nasal mist until studies show otherwise," Robinson says. "It's up to parents to decide which is best for their child."