FluMist vs. a Flu Shot

Doctor giving injection to baby boy (2-5 months)

Science Photo Library - IAN HOOTON / Brand X Pictures / Getty Images

Most parents understand that it is a good idea to get their kids a flu vaccine to help them avoid the flu, but most kids don't like to get a flu shot each year. Fortunately, there has been an alternative—the FluMist nasal spray flu vaccine. Since 2010, it has been recommended that all children age 6 months and over, and all adults, get the seasonal influenza vaccine each year, except for those who have some specific contraindications. The FluMist vaccine, being made with a live attenuated influenza virus, has more restrictions on who should use it.


If you could avoid a shot, why wouldn't you jump on the chance of getting Flumist? This vaccine is best for healthy children, and there are many restricted groups, including many children who are at the most risk of serious complications if they get influenza.

Those who must avoid Flumist include:

  • Children younger than age 2
  • Adults older than 50 years old
  • Children with medical conditions, such as asthma or reactive airway disease, diabetes, chronic heart disease, chronic lung disease or a weakened immune system
  • Children younger than age 5 who have had problems with recurrent wheezing
  • Children who are taking aspirin
  • Pregnant women
  • People who care for or live with someone who is severely immunocompromised.
  • Children and adults who are allergic to eggs

FluMist vs. Flu Shots

There are also some differences between FluMist and flu shots that may influence a parent's decision between the two, such as:

  • Price - in general, FluMist is a little more expensive than a flu shot, although since it has been around for a while now, most insurance companies pay for FluMist, so your cost may not be any different.
  • Live vs. Killed Viruses - a big difference between FluMist and the flu shot is that FluMist is made with live influenza viruses. They are weakened and won't actually give your child the flu, though. As a live virus vaccine though, it should not be given to "People who care for severely immunocompromised persons who require a protective environment (or otherwise avoid contact with those persons for 7 days after getting the nasal spray vaccine)."
  • Nasal Congestion - since FluMist is given as a nose spray, some experts think that it may not be as effective if your child is very congested, such as if he has allergies or a cold.
  • Thimerosal - FluMist does not contain the preservative thimerosal. Although a preservative-free flu shot is available, it is not as widely available as the regular flu shot with thimerosal, so your pediatrician may not have it.


Is FluMist as good as a flu shot, though? Sure it is great to save your child the pain from a flu shot, even if FluMist is a little bit more expensive, knowing it is as good or better than a flu shot, would likely make the decision between the two easier for parents.

Several studies have shown that FluMist may actually work better than a flu shot. One that compared the two concluded that "live attenuated influenza vaccine was a safe and more effective alternative to inactivated vaccine."

Research also showed that it may offer longer and better protection against mismatched strains, such as when the flu vaccine doesn't exactly cover the flu virus strains that are going around that year.

The FluMist vaccine gave disappointing results against the 2009 H1N1 influenza strain, and so it was not recommended for use in 2015 through 2017. It was reformulated and returned to recommended use in 2018.

As with the flu shot, the effectiveness of Flumist will vary from year to year. This is because it includes the flu strains that are predicted to be circulating, and nature has a way of thwarting the best guesses of the experts. But they continue to work towards an effective vaccine for each flu season.

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