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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 ?
Wilmington, Delaware-based prescription medicines specialist AstraZeneca has received a favorable vote from the Advisory Committee on Immunization Practices (ACIP) of the Centers for Disease Control and Prevention for a renewed recommendation for the use of Flumist Quadrivalent (Influenza Vaccine Live, Intranasal) in the US for the 2018-2019 season, the company said.
com: "We do these evaluations of the effectiveness of vaccines on an annual basis and it appears actually for the last three years that the FluMist has been substantially less effective than the injectable vaccine.
During the last two flu seasons, more than 1,000 service members and their families at military hospitals in San Diego and San Antonio either got FluMist from health workers or gave it to themselves, individually or in a group session.
The new vaccine will be marketed as "FluMist Quadrivalent" by MedImmune LLC, which also markets FluMist, the trivalent intranasal influenza vaccine.
Customers who visit a Jewel-Osco, Albertsons, Acme or other Supervalu store can opt for either a traditional flu shot or a needle-free FluMist nasal spray for $26.
NORDIC BUSINESS REPORT-23 December 2009-AstraZeneca recalls FluMist vaccine doses in USA on potency decline(C)1994-2009 M2 COMMUNICATIONS http://www.
Another option for people without medical problems is FluMist, a nasal spray vaccine.
Fielding said 80,000 to 90,000 doses of FluMist nasal spray vaccine are expected to arrive within the next day or two - just a fraction of the 5.
However, both the FluMist (influenza virus vaccine live, intranasal) prescribing information published September 2007 and the revised CDC vaccine management booklet that was published in November 2007 recommend that FluMist be stored in a refrigerator at 35[degrees] to 46[degrees]F (2[degrees]-8[degrees]C) upon receipt and until use before the expiration date on the sprayer label.
Made from a weakened form of the live influenza virus, FluMist offers another option for little ones squeamish about shots.
Note that people with HIV should get the flu shots (not the FluMist nasal spray, since that contains a weakened live virus and could be dangerous for persons with immune deficiency; it is only approved for healthy people between the ages of 2 and 49).