Flu Mist Vindication?

iStock_27891038_MEDIUMHutterites have been figuring large in the medical research lately, with PodMed two weeks ago featuring a study on asthma and allergy in children in this community, while this week on the podcast Rick and I talk about a study comparing intramuscular flu vaccine to intranasal vaccine in two groups of these folks, as published in Annals of Internal Medicine. So we extend our thanks to the Hutterite people for agreeing to be a part of studies that advance knowledge for us all, in this case relative to flu vaccination methods.

The study was conducted over three influenza seasons among 52 Hutterite colonies in Alberta and Saskatchewan, Canada. Almost 1200 children ranging in age from 36 months to 15 years received a vaccine, while just over 3400 community members did not.  The study was designed to assess whether the live intranasal vaccine was superior to the inactivated intramuscular vaccine in providing protection for both the community (herd immunity) as well as the children.

Children were randomized to either the live attenuated intranasal flu vaccine against three strains of influenza, or to an inactivated vaccine containing the same three strains. About three quarters of the children in each group received the vaccine. There was no difference in the rate of influenza infection among either those vaccinated or persons in their community, with the authors concluding that there was no advantage to the intranasal live attenuated vaccine with regard to community protection.

I point out to Rick in the podcast however, that it also appears that the vaccine, marketed as FluMist, did work as well as the intramuscular vaccine, and may call into question the CDC's action of late June panning the intranasal vaccine for the upcoming flu season.  While I really did not like the one administration of this vaccine I received I am sympathetic to children who really don't like injections at all.  Time will tell, I suppose, on whether intranasal vaccines will return to favor.

Other topics this week include scrutiny of beta blocker use in those who've had stents in the Journal of the American College of Cardiology, a new osteoporosis drug in JAMA, and an association between Tylenol use during pregnancy and behavior problems in offspring.  Until next week, y'all live well.

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