Flu shot vs. mist?

pinottoparenthood · November 2015

Does anyone have any medical expertise on this? I still haven't gotten my 2.5-year-old vaccinated for the flu this year (I know!! I work full time so it's hard)... trying to decide which route I should go.

BreannaaaMarieee · November 2015

The flu shot is a dead virus while the mist is a weakened virus. Both shot & mist say you're not suppose to get the flu from either but I've always heard of people getting more sick off of the mist or worse symptoms I should say.

MrsCayEye · November 2015

DS (2) got the shot. They didn't offer the mist option so my decision was easy. He had no adverse reactions.

jonesl12 · November 2015

The mist is a live virus and we typically only give it to the kids who can't settle down enough to get the shot. Both work but I always suggest the shot because if the kid has a runny nose or sneezes etc.. It gets all over the place. Still effective but messy

imrachellea · November 2015

So kind of related...I live in Florida so we're not really in flu season yet, so DD and I have not gotten our shots. I will be going this weekend to get mine. My question is for her. Do I need to take her to the pediatrician (we have her 2 year appt in a little over a month) or can she come with me to Walgreens? I would have her with me at Walgreens anyway, and would just ask, not sure if at 2 they do the double shot like they did when she was 1 or if its a one shot deal now?

MrsCayEye · November 2015

@imrachellea it's a 2 part deal for DS, idk if that's universal though. We got part 1 at his 2 yr appt a week or so ago.

reisnersr · November 2015

I got the shot and my dr recommended those in my family get the same one (dead virus).

cortney626 · November 2015

My daughter (8 yo) just got the mist last week. She hates shots but has had the flu shot every year aside from the mist a few years back. Our Dr usually runs out of the mist. They offered the mist to my daughter this year and she was relieved. She has had no reactions to either. She has not gotten sick either.

spatter1 · November 2015

At one point CDC actually recommended the mist over the shot for young kids. They have since removed that preferential recommendation bc studies have shown its no more effective than the shot. What I hear from CDC is to get whatever's available and recommended by your doctor.

As for the pharmacy, each state has different laws and each pharmacy has different policies on the age groups they can vaccinate. I think most won't vaccinate kids under 8 but you just have to check your specific location in your specific state.

spatter1 · November 2015

Also the shot for kids is only "2 part" if they have never gotten the flu shot before. There's an algorithm to determine if your child needs one or two doses: https://www.cdc.gov/mmwr/preview/mmwrhtml/mm6430a3.htm#Fig1

rebelone · November 2015

Thanks for reminding me the rest of my family needs to get a flu shot, including my 2 year old. At one time I heard mist for small children, but I believe because of advances they can now get a shot.

imrachellea · November 2015

spatter1 said:

Also the shot for kids is only "2 part" if they have never gotten the flu shot before. There's an algorithm to determine if your child needs one or two doses: https://www.cdc.gov/mmwr/preview/mmwrhtml/mm6430a3.htm#Fig1

Thank you for this! Good to know

I will be following up with a call to my pedi today to check what they prefer, it would be really helpful if I could get her immunized when I get my own.

pinottoparenthood · November 2015

imrachellea said:

spatter1 said:

Also the shot for kids is only "2 part" if they have never gotten the flu shot before. There's an algorithm to determine if your child needs one or two doses: https://www.cdc.gov/mmwr/preview/mmwrhtml/mm6430a3.htm#Fig1

Thank you for this! Good to know I will be following up with a call to my pedi today to check what they prefer, it would be really helpful if I could get her immunized when I get my own.

I got mine at my OB-GYN so that wasn't an option for me. I think a lot of places won't do toddlers. I'm calling the pediatrician's office now :-) Just not sure if I'll be able to get him there while the office is open!!

Achieverjo · November 2015

Has to be the shot, and you should opt for preservative-free, if available.

NachosAndPeaches · November 2015

There's a min age for the pharmacy, either 3 or 4. Don't Remember, so a 2 year old would have to go to the pedi.

spatter1 · November 2015

Achieverjo said:
Has to be the shot, and you should opt for preservative-free, if available.

I think you are thinking about pregnant women - yes, we have to get the shot. But kids 2 and older can get either

kalanieileen · November 2015

@spatter1 and @jonesl12 are right! Children can get either the shot or the mist. The mist is a live virus, so one may experience symptoms. I even felt slight feverish after I got my flu shot.

For 6 year old DSD (darling step daughter..? Idk I may have just made that up lol) we were going to the mist route until she freaked out. So we opted the shot route because she wanted to watch it. It comforted her, weirdo.

So I believe it's all preference. Both are safe for the kiddos

NachosAndPeaches · November 2015

I think the most important is to make sure they get the quadrivalent one to protect them from as many strains as possible.

spatter1 · November 2015

NachosAndPeaches said:
I think the most important is to make sure they get the quadrivalent one to protect them from as many strains as possible.

I agree! I think flumist only comes in quadrivalent so that's easy. CDC doesn't actually have a preferential recommendation for quadrivalent over trivalent, but I think that's mostly political since not all vaccine manufacturers make quadrivalent versions of the shot yet and they can't appear to favor one manufacturer over another. But IMO, more strains covered is better so I say quadrivalent all the way if you can find it!

Achieverjo · November 2015

@spatter1 No, I meant for small kids too. The preservative is a mercury derivative. It's probably ok, but my recommendation is not to use a preserved vaccine on a small child if its been removed from their other vaccines.

I'm not an anti-vaxer or someone that thinks it will cause autism. Just seems reasonable to think maybe it's better not to have the preservative of its not in their other shots.

And I'm hesitant about the mist, because it's an active virus that could make them sick. Rather it be a dead virus.

https://www.cdc.gov/vaccinesafety/concerns/thimerosal/faqs.html

spatter1 · November 2015

@Achieverjo that's your opinion, but the way you stated that children "HAVE to get the shot" implies that the mist is not safe or recommended for them which is just not true. I know quite a bit about immunizations and have a full understanding of thimerosal in vaccines and their purpose. For the record, the mist doesn't contain thimerosal. You can see for yourself on this FDA website:
https://www.fda.gov/BiologicsBloodVaccines/SafetyAvailability/VaccineSafety/UCM096228#t1

Scroll down to "Seasonal Influenza, live". Medimmune is the only manufacturer of a nasal spray flu vaccine.

NachosAndPeaches · November 2015

@Achieverjo I know the preservatives sound scary but I think some numbers and facts may help you realize how perfectly safe the preservatives in this vaccine are.

1. Thimerosal is not mercury in its elemental form. But the mercury in tuna is and kids can still eat that safely.
2. The flu vaccine has a max dose of 25 mcg (micrograms aka 1/1000 of a mg) of thimerosal. The LD50 of thimerosal is 98 mg per kg of body weight (1 kg is 2.2 lb). So let's say a child weighs 25 lb, that's just over 11 kg. That means that a child could safely have over 1100 mg (or 1,100,000 mcg) of thimerosal. So basically, I could give my child 43,000 flu shots in one day, and they would still be under a safe limit of thimerosal.

spatter1 · November 2015

NachosAndPeaches said:
@Achieverjo I know the preservatives sound scary but I think some numbers and facts may help you realize how perfectly safe the preservatives in this vaccine are.

1. Thimerosal is not mercury in its elemental form. But the mercury in tuna is and kids can still eat that safely.
2. The flu vaccine has a max dose of 25 mcg (micrograms aka 1/1000 of a mg) of thimerosal. The LD50 of thimerosal is 98 mg per kg of body weight (1 kg is 2.2 lb). So let's say a child weighs 25 lb, that's just over 11 kg. That means that a child could safely have over 1100 mg (or 1,100,000 mcg) of thimerosal. So basically, I could give my child 43,000 flu shots in one day, and they would still be under a safe limit of thimerosal.

This. AND even if you're still concerned, it's not even in most flu vaccines anyway!

NachosAndPeaches · November 2015

spatter1 said:

NachosAndPeaches said:
@Achieverjo I know the preservatives sound scary but I think some numbers and facts may help you realize how perfectly safe the preservatives in this vaccine are.

1. Thimerosal is not mercury in its elemental form. But the mercury in tuna is and kids can still eat that safely.
2. The flu vaccine has a max dose of 25 mcg (micrograms aka 1/1000 of a mg) of thimerosal. The LD50 of thimerosal is 98 mg per kg of body weight (1 kg is 2.2 lb). So let's say a child weighs 25 lb, that's just over 11 kg. That means that a child could safely have over 1100 mg (or 1,100,000 mcg) of thimerosal. So basically, I could give my child 43,000 flu shots in one day, and they would still be under a safe limit of thimerosal.
This. AND even if you're still concerned, it's not even in most flu vaccines anyway!

But I wanted to give DS 40,000 vaccines tomorrow morning at his appointment though!

Achieverjo · November 2015

Thanks for the information. But this definitely got way more blown up than I thought it would. And I'm kind of having a bad day so even though they were meant to be informative comments... It made me cry a little. Pregnancy hormones suck.

I didn't say that the mist has thimerosol in it. I said it has a an active virus in it. I do have a preference for the shot because of this.

With regard to thimerosol, I was just explaining my opinion about why I thought it was better to request a preservative-free shot, since the the other children's shots don't have it in it. I just think it's a better option.

Sometimes people write or say shit without really thinking through sentence structure. I never meant the shot to come across as a hard and fast rule. But I see that's how I wrote it.

Achieverjo · November 2015

Also, I'm glad you both made your points so excessively well. The sarcasm stung, but at least there is benefit the knowledge you provided.

NachosAndPeaches · November 2015

Omg I really was not trying to be hurtful or even sarcastic with my first comment, I was just trying to show the depths of how safe it is in case it's the only option in the future, etc. my second comment was sarcastic but NOT at you.

I agree that the pregnancy hormones can go fuck themselves. And sorry you're having a bad day :-( The other day I got an email from a Sunday school mom saying she wanted to volunteer with an event I asked her about but couldn't take on being a room parent. It made me want to cry. For literally no reason. I don't even need a room parent. But I felt like waking up DH and sobbing. Ridiculous.

spatter1 · November 2015

@Achieverjo I don't think anyone was being sarcastic, and I'm certain it wasn't anyone's intention to make you cry. I was sharing information, just like you did. Your posts came off very prescriptive as if fact, but they are really just your personal beliefs, which of course you are entitled to but just be prepared that people are going to follow up with facts to clarify for others who may not have as much knowledge on the subject. You responded to my post about pregnant women by saying kids need the shot and immediately following that with talk about preservatives which lead me to believe you thought preservatives were in the mist, which is why I clarified and shared information on that. I guess I just don't understand why you are against the mist and preservatives, but the shot version is actually the one that can contain preservatives.

Most of all I just didn't want someone to read your post and think they were given bad medical advice by getting their child the mist b/c you stated it has to be the shot. Maybe that's your rule, which is fine, but certainly is not the national guideline and might not be the right choice for others.

Also, the mist is a live-attenuated virus which means it's severely weakened and unable to cause influenza disease. Yes, you might still have some side effects (low fever, icky feeling) but that's the same with the shot. Again, these are just facts anyone can find on the CDC website and I'm sharing to help others make an informed decision. You do what's right for you.

NachosAndPeaches · November 2015

@spatter1 I have a question since you seem really informed. The live one causes more "cold" like side effects in be couple days following right? Did the shot use to be live? I've gotten one every single year since I was about 8 or 9 (I'm 30), and the last 2-3 years, I have had ZERO side effects, my arm wasn't even sore this ear. But in hears last, I definitely had a cold as a reaction, pretty consistently. Just curious if there's a reason for that or total coincidence.

cosmobella · November 2015

Keep in mind there's a national backorder on Flumist so the decision may not be yours to make. My pedi's office was out of it and DS2 had to get the shot this year although he usually gets the mist. DS1 has to get the shot because he has asthma and uses inhalers; a contraindication (for now) for using the mist. I trust both products and would have welcomed the chance to save my kid a shot if I could.

spatter1 · November 2015

NachosAndPeaches said:
@spatter1 I have a question since you seem really informed. The live one causes more "cold" like side effects in be couple days following right? Did the shot use to be live? I've gotten one every single year since I was about 8 or 9 (I'm 30), and the last 2-3 years, I have had ZERO side effects, my arm wasn't even sore this ear. But in hears last, I definitely had a cold as a reaction, pretty consistently. Just curious if there's a reason for that or total coincidence.

You know I'm not totally sure on this. My guess would be that the virus strains in the vaccine change almost every year (with the exception of a couple of years after H1N1) so your body may just react differently to different strains over the years. Some years seem to generate more side effects than others but I'm going of annecdotal info on that statement, not necessarily fact. I do know that in the early days of flu vaccine (well before we were born; I'll be 30 in July!) they werent as purified which tended to generate more cold-like reactions. For what it's worth I didn't have any reaction at all this year and I usually get at least a sore arm!

NachosAndPeaches · November 2015

Yeah I didn't even have a sore arm this year either!!!

BrittnyS10 · November 2015

NachosAndPeaches said:
Yeah I didn't even have a sore arm this year either!!!

You lucky ducks! My arm was super sore for 24 hours. Also I had the flumist a few years ago and ended up with a sore throat for 2 days but no other side effects. And really the only reason I got that instead of the shot was just because I wanted to try something different.

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