Nasal Flu Vaccine Ineffectiveness

sick-child-photo-020647220_iconm-120x86Sounded like a great idea at the time: a flu vaccine that could be given via nose droplets rather than an injection, especially for kids. Now, as Rick and I discuss on PodMed this week and published in the New England Journal of Medicine, turns out kids are the very persons for whom this vaccine is essentially ineffective.  Sorry parents, it's back to the tried but true along with the tears, at least for now. What happened?

Vaccines against influenza are routinely assessed for their ability to prevent the infection. The two types of vaccines, killed or inactivated, which is administered by injection, and live attenuated, given by the nasal droplet method, are most often used in adults and children, respectively. In the 2013-14 flu season it was detected that the live attenuated vaccine was essentially ineffective in the pediatric population. The vaccine was reformulated and used in the 2015-16 season, where once again, data from this analysis indicate it was ineffective in preventing flu in those who received it, only providing an effectiveness of about 15%. This lackluster performance has caused the powers that be, including the WHO and the CDC, to advise parents to go back to the injection for their children.  What's still not known is why this happened, as early use of the live attenuated vaccine did seem efficacious. Only more study will tell.

Other topics this week include Screening for Nasopharyngeal Carcinoma, also in NEJM, Expansion of Treatment for Hepatitis C Virus Infection by Task Shifting to Community-Based Nonspecialist Providers: A Nonrandomized Clinical Trial in Annals of Internal Medicine, and in JAMA: Cerebral Embolic Protection in Patients Undergoing Surgical Aortic Valve Replacement. Until next week, y'all live well.



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