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Are ‘Live’ Flu Shots Safe for Kids With Asthma?

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flu shots

Yearly flu shots are especially important for kids with asthma as any virus can trigger an asthma attack. But in the not-too-distant future, kids with asthma, the condition which disproportionately affects Black children, might be able to get a spritz instead of a jab, new research hints.

Inactivated flu shot vs. live nasal spray

Current recommendations suggest children with asthma get an inactivated flu shot (the flu virus is dead) instead of the live nasal spray vaccine to avoid wheezing and a potential full-blown asthma attack.

However, the latest study shows these kids do just as well with the live nasal mist as the inactivated flu shot, and most kids would gladly choose a nasal mist over a needle.

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“The most important thing we learned is that in this study of children with asthma, including severe asthma, the intranasal vaccine (FluMist) did not lead to wheezing events or asthma exacerbations,” study author Dr. C. Buddy Creech says. He is director of the Vanderbilt Vaccine Research Program and chair of pediatrics at Vanderbilt University Medical Center in Nashville, Tenn.

“While we have exercised caution historically, due to increased wheezing events in young children during the clinical trials of FluMist, we can now have a great deal more confidence that it does not do the same thing in children with asthma,” he shares.

For the study, 151 children with asthma, aged 5 to 17, received a flu shot or nasal mist vaccine for two flu seasons. Rates of wheezing and asthma attacks were the same for both groups 42 days after they got their vaccines, the study findings showed.

Flu Shot Vs. FluMist: Which Is Better For Your Child?

Benefits of the live nasal mist vaccine

There are many potential benefits to getting the live nasal mist vaccine, Creech says.

For starters, most kids would gladly opt for a nasal spray over a shot. “Previous data show that [the live flu vaccine] can trigger a broader array of immune responses than typical inactivated flu shots and may be more protective as a result,” he adds

Giving the vaccine as a nasal mist may also lead to additional defense around the lining of the nose, where most viruses enter the body, Creech notes.

“There are sometimes flu shot availability issues, and it may be easier to get one vaccine over another,” he shares.

Each year, the flu shot is a bit of a gamble as researchers scramble to predict what strain/s will circulate, and they don’t always get it exactly right. “There are data to suggest that when the vaccine strain we choose doesn’t match the strain that ends up circulating, live vaccines may be able to provide more protection than the inactivated vaccines,” Creech adds.

The findings were published online March 28 in Pediatrics.

RELATED: What’s Really in a Flu Shot?

Getting your child vaccinated

“Annual influenza vaccination for children with asthma is considered best practice and highly recommended to reduce influenza-related exacerbation and death in this population,” says Dr. Shilpa Patel. She’s the medical director of the Children’s National Hospital asthma clinic in Washington, D.C.

“Although it was a small study, it was well designed, and the findings are consistent with prior studies supporting the safety of live attenuated influenza vaccine in children with persistent asthma,” Patel adds.

Next flu season, the U.S. Centers for Disease Control and Prevention’s advisory committee on immunization practices can consider this evidence when they update their annual influenza vaccination recommendations, she says.

Currently, the CDC suggests that people with asthma should not receive the live nasal mist vaccine. If you have questions about how the vaccine may affect your child, consult with your child’s doctor.

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