Health officials warn against use of FluMist

Heather Rawlyk

Tuesday, Nov. 11, 2003 | 9:07 a.m.

Clark County Health District officials are not recommending the new FluMist vaccine this season and are encouraging locals to stick with the traditional shot.

The FluMist nasal spray, which the federal Food and Drug Administration approved this summer, is not only more expensive, but also not as good, Dr. Donald Kwalick, chief health officer for the Clark County Health District, said.

Kwalick said the Clark County Health District is not offering the nasal spray because it is aimed for healthy individuals outside their high-risk category -- people 65 years old and older, women in their second or third trimester of pregnancy and people with chronic health problems such as diabetes.

"It's only recommended for healthy people between 5 and 49 years of age," he said. "Most of the people that need to get a flu shot are above 49 years of age, so it doesn't work for them."

A key difference between the vaccinations is that FluMist uses live, weakened flu virus, rather than dead virus cells, as the flu shot does. After taking FluMist, a person can have the weakened, but still live, virus in their nasal passages and could spread it to others by coughing or sneezing.

That has left doctors concerned that FluMist patients could spread the influenza virus to others who have a weakened immune system.

Some hospitals have even told their employees that if they get FluMist, they can't come to work for three weeks.

They're taking those steps -- in some cases going far beyond federal health care guidelines -- because of the small risk that people who take FluMist could infect someone with immune system problems, such as cancer, HIV or an organ transplant.

Other hospital precautions include planning to keep some patients who have had FluMist in isolation.

Influenza kills about 36,000 Americans each year.

But a greater determining factor seems to be price, health district officials and private pharmacists said. A Sav-On Drug pharmacist said FluMist is $60 and is not covered by any insurance. The traditional flu shot is $20 and is covered by most types of insurance.

"It's a lot more expensive," Kwalick said. "We are only giving the intramuscular flu shots because they are cheaper and recommended for everyone."

Rachel Cox, a registered nurse at Fremont Medical Center said parents are opting for shots instead of FluMist to save money.

"We just got FluMist in last week, but so far no one has gotten it," Cox said. "When parents come in, we're giving the option of flu shot or FluMist. Everyone has gotten the shot because FluMist is more expensive and (the shot) is for all ages."

A Sav-On Drug pharmacist said that although they have had FluMist in stock for a month, they have not administered it to anyone yet.

"People are getting the flu shot instead," she said. "People are worried about it because it uses live flu virus and they don't want to spread it."

FluMist made its debut this summer, when FDA approved the spray vaccine. The company that makes it, MedImmune Inc., is making 4 million to 5 million doses of the spray this season.

FluMist is marketed as an option for healthy people who don't like needles. The company has said from the beginning that people shouldn't use it if they have vulnerable immune systems or are in close contact with such patients.

The CDC estimates the risk of transmitting flu virus after getting FluMist at 0.6 percent to 2.4 percent. Even then the risk of the infected person getting flu symptoms is unlikely because the virus has been weekend, the CDC says.

While some doctors say FluMist shows promise at fighting the flu- for the right people, Kwalick encourages the intramuscular flu shot for everyone.

Kwalick said the intramuscular shot does not hurt and is a quick and easy way to protect loved ones of all ages.

"The only reason they have FluMist is because people are afraid of needles," he said. "People need to know that the injection doesn't hurt and it's a better way to make sure you protect family and everyone."

The Associated Press contributed to this story.