FluMist, a nasal spray version of the flu vaccine, is now available for many people for home delivery. The vaccine alternative has been used in clinics for years and was approved by the Food and Drug Administration for at-home use in 2024.
“It’s the same vaccine as the one that you get in the healthcare setting,” a spokesperson from AstraZeneca, the manufacturer, told Health. “The difference is simply that it is shipped to your door at a time of your choosing and [it comes with] appropriate guidance around how to take it effectively.”
Here’s what to know about FluMist—and whether doctors recommend it over the traditional flu shot.
Like in-office FluMist, the at-home version—called FluMist Home—is approved for most people ages 2 to 49. It’s available for delivery this flu season in 34 states.
Unlike traditional flu shots, which contain inactive influenza, the nasal spray includes a weakened version of the live virus. “When you get the nasal spray in the nose, it’s a live virus that’s been tamed so it just stays in the nose and can’t get down into the lung and cause influenza,” William Schaffner, MD, a professor of preventive medicine and infectious diseases at Vanderbilt University, told Health.
You can store FluMist in your refrigerator until you’re ready to use it. To administer it, you have to spray about half of the pre-filled bottle into each nostril.
“The biggest advantage is convenience,” Schaffner said. “A parent doesn’t have to take their children to the pediatrician’s office or a public health clinic to get the vaccine. It puts the power in the hands of the patient.”
The Centers for Disease Control and Prevention didn’t recommend FluMist for the 2016-2017 and 2017-2018 flu seasons because studies showed it wasn’t as effective as the traditional flu shot at protecting against H1N1, a strain of influenza A that caused the 2009 swine flu pandemic. Since then, however, AstraZeneca updated FluMist with new ingredients that better target that specific virus.
But according to Asha K. Shah, MD, MS, the director of infectious diseases and hospital epidemiologist at Stamford Health, there have been “limited effectiveness estimates” in the United States regarding FluMist. “Based on data from other countries,” she told Health, “protection from the nasal spray vaccine is similar to that of standard inactivated flu vaccine in children.”
That’s specifically the case for children eight and younger, Schaffner said. “Beyond that, it’s less certain,” he agreed.
It’s also important to keep in mind that the effectiveness of any flu vaccine depends on how well the strains match the ones circulating that particular season. Even when the strains are well matched, the traditional flu vaccine only reduces the risk of illness by about 40% to 60%.
According to the FDA, the most common side effects of FluMist are:
- Fever over 100°F in children ages 2 through 6
- Runny nose and nasal congestion
- Sore throat in adults
FluMist is “a miracle of modern science, but it can cause a little bit of a runny nose and sore throat,” Schaffner said.
To receive FluMist, you must order it online from AstraZeneca. After filling out information about your medical history and insurance (if applicable), a healthcare provider reviews the information and determines if you’re eligible to receive the vaccine.
Per AstraZeneca, FluMist is free under most commercial insurance, but you’re required to pay a processing and shipment fee of $8.99.
It’s best to consult your doctor to determine if you or a loved one is a good fit for FluMist.
The Centers for Disease Control and Prevention recommends that certain people not use FluMist, including:
- Children aged 2 to 4 with asthma or a history of wheezing in the past year
- Children aged 2 to 17 taking salicylate- or aspirin-containing regimens
- Those who are immunocompromised, have cerebrospinal fluid leaks, or have cochlear implants
For all other adults, the traditional flu vaccine is also more appropriate—but because it’s been shown to be more effective, said Shah.
Still, Shah doesn’t discount FluMist entirely. It “may be a good option in healthy patients who have an aversion to needles or may have barriers to receiving an in-office traditional flu vaccination,” she told Health. “It is better to get a FluMist vaccine than no flu vaccine at all.”
