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influenza vaccine (nasal)

(in-floo-en-za vak-seen) ,


(trade name)


Therapeutic: vaccines immunizing agents
Pregnancy Category: C


Active live immunization for prevention of disease caused by Influenza A and B.


Active immunization with live virus produces antibodies against Influenza.

Therapeutic effects

Decreased influenzal illness, with fewer days lost from school or work.


Absorption: Virus replicates in nasopharynx causing production of antibodies.
Distribution: Unknown.
Metabolism and Excretion: Unknown.
Half-life: Unknown.

Time/action profile



Contraindicated in: Obstetric: Pregnancy; Hypersensitivity to FluMist, eggs, or egg products; History of asthma or reactive airways disease; Other live vaccine within 1 mo or inactivated vaccine within 2 weeks; Concurrent immunosuppressive therapy or disease causing immunosuppression or immunocompromise; Antiviral agents (not for 48 hr prior or 2 wk after); Pediatric: Children or adolescents (5–17 yr) receiving aspirin, aspirin-containing or salicylate therapy (risk of Reye syndrome); Chronic illness including cardiac/pulmonary disease, metabolic disease, renal impairment or hemoglobinopathy; History of Guillain-Barré.
Use Cautiously in: Obstetric / Pediatric: Lactation, children <2 yr, patients >50 yr (safety not established).

Adverse Reactions/Side Effects

Central nervous system

  • headache

Ear, Eye, Nose, Throat

  • rhinitis
  • nasal congestion


  • fever


Drug-Drug interaction

Concurrent use of aspirin or salicylates in children/adolescents may ↑ risk of Reye syndrome.Concurrent antiviral therapy (may affect desired immune response to FluMist).


Intranasal (Adults and Children 9–49 yr) One dose (0.5 mL)/season.
Intranasal (Children 2–8 yr) Previously immunized with FluMist—one dose (0.2 mL)/season; not previously immunized with FluMist—two doses (0.2 mL each)/30 days apart for initial season.


Pre-filled single-use intranasal sprayer: 0.5 mL/sprayer, 0.2 mL/sprayer

Nursing implications

Nursing assessment

  • Assess patient for history of asthma or reactive airway disease. Patients with positive history should not receive FluMist.
  • Lab Test Considerations: Monitor patient for signs of allergic reaction (rash, pruritus, laryngeal edema, wheezing) following administration. Keep epinephrine, an antihistamine, and resuscitation equipment close by in case of an anaphylactic reaction.

Potential Nursing Diagnoses

Deficient knowledge, related to medication regimen (Patient/Family Teaching)


  • Do not administer rimantidine or other antiviral agents within 48 hrs before or 2 wks after administration intranasal influenza virus vaccine (FluMist).
  • Store solution in refrigerator until just before use; do not freeze. Solution should be colorless to pale yellow and clear to slightly cloudy.
    • Do not administer FluMist concurrently with other vaccines, or in patients who have received a live virus vaccine within 1 mo or an inactivated vaccine within 2 wks of vaccination.
  • Intranasal: With the patient in an upright position, approximately 0.25 mL (half the dose of a single FluMist sprayer) is administered into each nostril. Insert the tip of the sprayer just inside the nostril and depress the plunger to spray. Remove the dose divider clip and administer the second half of the dose into the other nostril. Dispose of sprayer in routine for biohazard disposal.

Patient/Family Teaching

  • Explain to patient and parent the purpose of the vaccination.
  • Advise patient to avoid contact with patients who are immunocompromised for at least 21 days.

Evaluation/Desired Outcomes

  • Prevention of influenza resulting in fewer lost days from work and school.


Influenza vaccine, live, intranasal.
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References in periodicals archive ?
As such and as part of AstraZeneca's commitment to putting patients first, we work closely with healthcare providers, retailers and the public health community to make FluMist Quadrivalent broadly accessible to consumers.
The safety and effectiveness of the Flu Mist quadrivalent vaccine are supported by studies of the trivalent formulation conducted in the past, as well as three new studies of the quadrivalent vaccine in about 4,000 children and adults in the United States, which "demonstrated that the immune responses were similar between FluMist Quadrivalent and FluMist," the FDA statement said.
FluMist is contraindicated in individuals with history of hypersensitivity to eggs, egg proteins, gentamicin, gelatin or arginine or with life-threatening reactions to previous influenza vaccinations, and in children and adolescents receiving concomitant aspirin or aspirin-containing therapy.
The study was supported by MedImmune, the maker of the FluMist nasal flu vaccine.
They gave a similar group of volunteers the intranasal FluMist spray.
With FluMist doses available in time for back-to-school check-ups, physicians can now embrace the U.
1m doses of Flumist but, following Chiron's problems, stepped this up to 1.
Healthcare workers up to 49 years old who are not pregnant and do not work with patients who have suppressed immune systems can seek vaccination through the use of Medlmmune's FluMist, a nasal mist that contains weakened live flu virus.
If successful, MedImmune expects peak annual FluMist sales in excess of $500 million in the U.
Clinicians should remind healthy patients aged 5-49 years of the availability of live attenuated influenza vaccine, called FluMist.
With a nasty flu season and a vaccine shortage, some patients have turned to a new alternative - FluMist, the first flu vaccine administered as a nasal spray.
FluMist, based on technology developed by Hunein "John" Maassab, emeritus professor of epidemiology at the School of Public Health, is available for use by healthy individuals between the ages of five and 49.