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American Academy of Pediatrics recommends flu shot instead of nasal spray

American Academy of Pediatrics recommends flu shot instead of nasal spray

Like it or not, kids — well, everyone, really — will have to brace for the needle again this year when it’s time for their flu vaccines.

The American Academy of Pediatrics is recommending for the second year in a row that everyone 6 months and older get a good old-fashioned flu shot rather than the nasal spray, FluMist.

The statement supports a similar recommendation that the federal Centers for Disease Control and Prevention issued several months ago for all Americans. Reviews indicated that the nasal spray performed poorly against certain strains of the flu virus in the 2013-14 and 2015-16 seasons, leading to last year’s advisory benching it as an option.

“I just wonder if we’ll ever see it again,” said Cindy Ruma, immunization coordinator for the Visiting Nurse Association in Omaha.

That said, Ruma noted that the lack of the needle-free option last year did not appear to have had a big impact on vaccination rates, as some had feared.

The Visiting Nurse Association, she said, had just a few kids who balked at getting the shot at its clinics. The agency’s overall vaccination numbers were pretty similar to previous years.

While one study in Pennsylvania showed a reduction in vaccination rates among children, preliminary national data from the CDC indicates that vaccination rates among kids ages 6 months to 17 years were virtually the same in 2016-17 — 58.2 percent — as they were the year before — 59 percent.

Dr. Jessica Snowden, a pediatric infectious disease specialist at Children’s Hospital & Medical Center, said that distraction techniques the health system’s clinics had on hand last year worked quite well, according to all of the doctors she has spoken with.

Children’s Physicians implemented a new pain management policy not long before flu clinics began last year. The options include a sugar water solution for babies, a vibrating “buzzy” that pediatricians apply to the injection site before shots, and a cooling spray, which also is applied to the shot site.

“It certainly did for my son,” said Snowden, noting that Oliver, a first-grader, tells kids at school how the shot will help his body’s “army” fight better. “He thought the cooling spray was pretty cool.”

Ruma said it’s important for parents to prepare kids any time they’re going to get a shot. Most importantly, parents shouldn’t tell them that they’re not going to get a shot or that they won’t notice it.

“It’s going to feel like a little pinch in your arm,” she said. “It might hurt for a little bit.”

FluMist, however, was a popular option, and one that worked well in prior seasons. The nasal spray accounted for about one-third of all flu vaccines given to children during the later seasons in which it was recommended.

Kids weren’t necessarily alone in their preference for the mist, which had been recommended up to age 49.

Dr. Scott McPherson, a retired Air Force doctor who now practices at Nebraska Medicine-Clarkson Family Medicine, said a lot of younger recruits also preferred FluMist because they had to get so many other vaccinations.

But he and Snowden stressed that a temporary twinge shouldn’t deter people from getting the shot. Influenza can lead to serious illness and serious complications, even death.

“My concern is we don’t get enough people getting it,” McPherson said of the flu shot.

A lot of patients don’t think the flu is a big deal, he said. But health professionals never know how bad it’s going to be or who will get the sickest until it hits. “I think it’s one of the more important things to offer them,” he said.

Nebraska’s overall flu vaccination rate in 2015-16 was 49.1 percent, according to the CDC. The rates were higher among children — 62.3 percent of those ages 6 months to 17 years, reaching 77.5 percent among the youngest kids, those ages 6 months to 4 years. They were lowest — 33.9 percent — among Nebraskans ages 18 to 49 who are considered at low risk for complications. The goal for all age groups under the nation’s Healthy People 2020 initiative is 70 percent.

The pediatricians group’s recommendation comes as doctors and other health care providers are preparing to launch flu shot clinics for the year. The Visiting Nurse Association clinics begin in mid-September, Ruma said. The vaccine appears to be in good supply. Children’s Physicians offices have scheduled clinics beginning mid-October, according to office websites.

Snowden said she has not seen indications that the vaccine will wear off before the season ends if people get it early in the fall. The CDC generally recommends getting the shot between October and April. People definitely should get it before the disease arrives in the area. Flu hasn’t appeared yet in the United States, but outbreaks have been reported in India and the Philippines.

“If you’re somewhere that has the flu shot available,” she said, “go ahead and get it.”

julie.anderson@owh.com, 402-444-1066

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Julie Anderson is a medical reporter for The World-Herald. She covers health care and health care trends and developments, including hospitals, research and treatments. Follow her on Twitter @JulieAnderson41. Phone: 402-444-1066.

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  • Updated

The VNA, backed by guidelines from the federal Centers for Disease Control and Prevention, recommends that everyone 6 months and older get vaccinated against influenza each year, unless otherwise indicated. Vaccination is particularly important for those at high risk for complications, as well as for the people who care for them. It takes about two weeks after vaccination for antibodies to develop and protect against the flu.

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