Choice between flu shot and nasal spray

Q: Should I get the flu shot or the nasal spray flu vaccine?

Dr. Chris Prakash, eParisExtra columnist

Dr. Chris Prakash, eParisExtra columnist

A: EVERYONE 6 month old and older should be vaccinated against the flu unless there is a medical reason not to! We do have a choice between the flu shot and the newer nasal spray (flu mist).

Either vaccine will help protect equally against the flu virus, but some people are better suited for one over the other. The main differences are that the flu nasal spray is easier to take; children (and many adults) might prefer it to getting a flu shot, and there is evidence that in young children, FluMist might offer somewhat better protection than the traditional flu shot. However the flu shot is indicated for and is safer for a larger group of people.

The flu shot can be given to:

  • Adults and children from age 6 months and up.

The flu shot should not be used in:

  • Previous reaction to flu vaccine (including Guillain-Barre syndrome)
  • Children less than 6 months old
  • People who have a serious illness with or without fever should delay getting the flu shot until they improve

The Nasal Flu Vaccine (Flu Mist)

This flu vaccine is sprayed into the nose. The major difference is that this contains a live virus (weakened). The side effects are usually minor, although they can be more severe than the side effects of the flu shot. These include runny nose, headache, sore throat, and cough, and rarely vomiting, fever, and muscle aches.

The nasal vaccine can be given to:

  • Anyone between the ages of 2 and 49 who is generally healthy and not pregnant. The nasal vaccine should not be used in (according to CDC)
  • Children under 2 years old
  • Children or adolescents who are taking aspirin
  • Adults 50 years old or above
  • Children or adults who have heart disease, lung disease (like asthma), diabetes, kidney disease, Guillain-Barré syndrome, or an immune system weakened by disease or by its treatmen
  • Anyone with a history of a severe allergic reaction to eggs or a previous flu vaccine
  • Pregnant women
  • People who are in contact with someone who has an immune system severely weakened by a treatment, such as a stem cell transplant.

Who Needs to Be Vaccinated Against the Flu?

All people 6 month and older should be vaccinated. However, there are some HIGH RISK groups who really should receive it:

  • Children between 6 months and 18 years old
  • Children on long-term aspirin therapy, who are at higher risk of Reye’s syndrome after getting the flu
  • Women who will be pregnant during flu season
  • Adults 50 years or older
  • Adults and children with diseases of the lungs (like asthma), heart, kidneys, liver, blood, or diabetes
  • Adults and children with immune systems suppressed by illness or its treatment
  • People who live in nursing homes or health care facilities
  • People who live with a person at high risk of flu complications
  • Caregivers of children under 6 months
  • Health care workers

By Sucharu Chris Prakash, MD, eParisExtra

This information is strictly an opinion of Dr. Prakash and is not intended to replace the advice of your doctor. Dr. Chris Prakash is a contributing columnist and author of eParisExtra’s “The Doctor is In” column. He is a medical oncologist at Texas Oncology Paris. He is board certified in Internal Medicine, Oncology and Hematology. He lives in Paris with his wife and two children and can be reached at (903) 785-0031 or 

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