This past flu season saw a staggering increase in the number of pediatric fatalities, with more children succumbing to the virus than in any year since the swine flu pandemic of 2009. Alarmingly, many of these children were unvaccinated, highlighting the urgent need for improved vaccination rates. In an effort to combat this trend, healthcare professionals are optimistic about the introduction of the first at-home nasal flu vaccine designed to ease the anxiety associated with needle injections, particularly among children.
AstraZeneca's FluMist Home, which gained approval last fall, is now available via prescription for children aged 2 and older, as well as adults up to 49 years old. A significant review conducted by researchers at the University of Michigan in 2019 revealed that a majority of children, along with up to 30% of young adults, experience a fear of needles. Dr. Zachary Hoy, a board-certified pediatric infectious disease specialist at Pediatrix Medical Group in Nashville, Tennessee, emphasizes that many children are simply too young to understand the importance of vaccinations. “Most of the time, the anxiety and worry before the shot is scarier than the actual shot,” Dr. Hoy noted.
The FluMist vaccine was initially approved in 2003 for administration in doctor's offices. However, following the introduction of the new H1N1 strain during the 2009 swine flu pandemic, subsequent studies revealed that the nasal spray was less effective compared to traditional flu vaccines. This led the Centers for Disease Control and Prevention (CDC) to advise against its use in 2016. At that time, FluMist accounted for one-third of all flu vaccinations given to children. In response to this feedback, the manufacturers reformulated FluMist to better align with circulating strains, including H1N1, and it re-entered the market in 2018. AstraZeneca spokesperson Andrew Leone states, “FluMist’s efficacy is comparable to injectable flu vaccines and is a safe and effective needle-free option for flu protection.”
Experts caution that it is still too early to predict the severity of the upcoming flu season. Typically, flu vaccines have an effectiveness rate of between 40% and 60% in preventing severe illness, and FluMist Home is expected to offer similar protection. The doses for the 2026-2027 season include three virus strains: an A/H1N1 strain, an A/H3N2 strain, and a B strain from the B/Victoria lineage. The FluMist Home vaccine uses a weakened form of a live virus to stimulate the immune system, with pregnant women and those with compromised immune systems advised to consult their doctor prior to use.
FluMist Home is exclusively available online. Individuals interested in ordering the nasal spray must first complete a medical screening questionnaire at FluMist.com, which will be evaluated by a healthcare professional. The online pharmacy will then handle the collection of insurance information and directly bill the health plan. A temperature monitor included in the packaging ensures that the vaccine has been kept at the appropriate temperature during shipping and delivery, with a green indicator signifying safe usage. Christina Aungst, senior pharmacy editor at GoodRx, estimates that individuals with insurance will likely pay only an $8.99 shipping fee for the nasal spray. Currently, if patients lack insurance, FluMist is only available in healthcare settings. AstraZeneca's Leone mentions a potential cash pay option for FluMist Home in future seasons.
When administered in a healthcare setting, FluMist is generally covered by most insurance plans, including Medicare and Medicaid. However, Dr. Scott Roberts, associate medical director of infection prevention at Yale School of Medicine, expresses concerns regarding the proper administration of the nasal spray without a doctor's oversight. “What if they have a runny nose? How far back do they need to spray in the nose? What if they store it incorrectly in their house?” Roberts questioned.
Dr. Kristina Bryant, a pediatric infectious diseases physician at Norton Children’s in Louisville, Kentucky, and a member of the American Academy of Pediatrics Committee on Infectious Diseases, stresses that all available flu vaccines provide comparable protection. “The most important thing to know is that vaccines only work if they are actually administered,” Bryant stated. She hopes that the introduction of a home-administered vaccine will simplify the process for many individuals seeking protection against the flu.
