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Flu Shot or Nasal Spray?

For decades we only had one type of flu vaccine, but these days we have a choice: the traditional flu shot or the newer nasal spray flu vaccine, FluMist. Either vaccine will help protect against the flu virus, but some people are better suited for the flu shot, while others will do better with the nasal spray. They offer about the same level of protection against the flu.

What’s the Difference Between the Flu Vaccines?

Both flu vaccines protect against various strains of the flu. The most significant differences are in how the vaccines are given and who is eligible to get them.

The Flu Shot

This vaccine is given by injection, usually into the upper arm. The flu shot is made from dead influenza virus and cannot give you the flu.

Side effects: Usually very minor. The most frequent side effect of the flu shot is soreness in the arm; less common symptoms are mild fever and achiness. They may last one to two days.

The flu shot can be used in:

Adults and children from age 6 months and up

The flu shot should not be used in:

Anyone with a history of a severe allergic reaction to eggs or a previous flu vaccine
Anyone who developed Guillain-Barré syndrome within six weeks of getting a flu vaccine previously
Children less than 6 months old
People who have a an illness with fever should delay getting the flu shot until their symptoms lessen

Pros: The flu shot has fewer potential side effects and is considered safe for a larger age group than the nasal vaccine.

Cons: The flu shot requires injection with a needle, which makes it a tough sell for many children.

The Nasal Flu Vaccine (FluMist)

This flu vaccine is sprayed into the nose. While it is a live vaccine, the virus has been weakened so that it cannot cause the flu, though you may experience flu-like symptoms.

Side effects: Usually minor, although they can be more severe than the side effects of the flu shot. In adults, side effects include runny nose, headache, sore throat, and cough; in children, side effects also include wheezing, vomiting, fever, and muscle aches.

The nasal vaccine can be used in:

Anyone between the ages of 2 and 49 who is generally healthy and not pregnant

The nasal vaccine should not be used in:

Children under 2 years old
Children under 5 who have a history of wheezing
Children or adolescents who are taking aspirin
Adults 50 years old or above
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 treatment
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; it is safe to get this vaccine if you're in contact with people who have less severely suppressed immune systems, like people with diabetes or HIV.