If the H1N1 mist can't cause flu...

[Jumping In Puddles]

and is temperature sensitive so it can't live outside the nose or anywhere in your body like your lungs, then why can't pregnant women get it or children who have very mild allergy induced asthma?

 

If the only option for the vax is the flu mist, wouldn't it be better to get the mist than get the actual swine flu for pregnant women or children with asthma?

[WishboneDawn]

I haven't heard that pregnant women or asthmatics can't have the mist.

 

Edit: I should add that none of the concern around pregnant women and other groups that I've heard of isn't a matter of doctors thinking it's not safe, rather that the adjuvants haven't been clinically tested on those groups to the satisfaction of the medical community yet. Most think they'd be fine but are just deciding to fall on the side of caution.

 

The vaccines and, I assume, the mists contain dead, chopped up viruses. That's why they can't cause the flu. They simply provide a bluff so your immune system builds a response.

Edited October 27, 2009 by WishboneDawn

[Jumping In Puddles]

Nasal Spray guidelines for my county.

 

2009 H1N1 LAIV should not be given to the following groups.

 

children younger than 2 and adults 50 years and older

pregnant women,

anyone with a weakened immune system,

anyone with a long-term health problem such as

- heart disease - kidney or liver disease

- lung disease - metabolic disease such as diabetes

- asthma - anemia and other blood disorders

children younger than 5 years with asthma or one or more episodes of wheezing during the past year,

anyone with certain muscle or nerve disorders (such as cerebral palsy) that can lead to breathing or swallowing problems,

anyone in close contact with a person with a severely weakened immune system (requiring care in a protected environment, such as a bone marrow transplant unit),

children or adolescents on long-term aspirin treatment.

anyone who is allergic to Gentamycin

anyone who has used an inhaler within the past 12 months

 

[Jumping In Puddles]

The only thing that I can make of this is that the mist can, in fact, cause the flu. CDC says it can't. They offer NO reason at all why certain groups cannot get the mist.

 

My ds (very mild asthma - has coughing fits if he is exposed to dust mites) and takes a few puffs of an inhaler a few times a year can not get this vax. There is no other vax available.

 

So I'm guessing the CDC thinks it is safer for my son to actually get H1N1 than to get the nasal mist. That is the only conclusion I can come to, right? It also makes me think the nasal mist is not as safe as they say it is.

[Perry]

The only thing that I can make of this is that the mist can, in fact, cause the flu. CDC says it can't. They offer NO reason at all why certain groups cannot get the mist.

 

My ds (very mild asthma - has coughing fits if he is exposed to dust mites) and takes a few puffs of an inhaler a few times a year can not get this vax. There is no other vax available.

 

So I'm guessing the CDC thinks it is safer for my son to actually get H1N1 than to get the nasal mist. That is the only conclusion I can come to, right? It also makes me think the nasal mist is not as safe as they say it is.

The Flumist contains attenuated vaccine, which means it's weakened by growing it over and over in a culture, known as "passing". Each time it passes, it loses virulence. Eventually, it will have gone through enough genetic changes that it can't cause flu, unless it reverts to its original genome, which has never been shown to happen.

 

But it is still a live virus, and it can cause what's called a "vaccine-virus" infection. It's different from influenza, but it doesn't have a name. I'm going to call it Mistuenza. Mistuenza frequently causes a mild runny nose or sore throat, but it is not the same as a full blown case of the flu.

 

In safety trials, they found an increased rate of wheezing in kids under 2. There is a theoretical risk of worsening of symptoms in asthmatics. There is also concern that people with compromised immune systems could have a worse case of mistuenza, although it hasn't been shown to happen. In fact, several studies have been done that show it's safe in people with asthma, cancer, and HIV. But it's a liability issue, and the CDC isn't recommending it.

 

Here's the package insert.

 

5.1 Risks in Children <24 Months of Age

Do not administer FluMist to children <24 months of age. In clinical trials, an increased risk of

wheezing post-vaccination was observed in FluMist recipients <24 months of age. An increase

in hospitalizations was observed in children <24 months of age after vaccination with FluMist.

[see Adverse Reactions (6.1).]

5.2 Asthma/Recurrent Wheezing

FluMist should not be administered to any individuals with asthma or children <5 years of age with

recurrent wheezing because of the potential for increased risk of wheezing post vaccination unless the

potential benefit outweighs the potential risk.

Do not administer FluMist to individuals with severe asthma or active wheezing because these

individuals have not been studied in clinical trials.

5.4 Altered Immunocompetence

Administration of FluMist, a live virus vaccine, to immunocompromised persons should be based on

careful consideration of potential benefits and risks. Although FluMist was studied in 57 asymptomatic

or mildly symptomatic adults with HIV infection [see Clinical Studies (14.3)], data supporting the

safety and effectiveness of FluMist administration in immunocompromised individuals are limited.

5.5 Medical Conditions Predisposing to Influenza Complications

The safety of FluMist in individuals with underlying medical conditions that may predispose them to

complications following wild-type influenza infection has not been established. FluMist should not be

administered unless the potential benefit outweighs the potential risk.

Since the shot form of the vaccine should be available now or soon, most clinicians are going to want people to wait. If we were in a situation where only the mist was available, and the flu was causing much higher death rates, I would imagine those recommendations would change.

[Perry]

BTW, None of the influenza vaccines in the US have an adjuvant. Flumist does NOT have an adjuvant.

[Jumping In Puddles]

Thank you Perry, that was very informative :)

 

I keep reading that the mist won't cause sickness (or very rarely) but then if a child has wheezed in the past year, they can't get the mist. It just seems like double talk to me and I'm getting tired of researching it.

[Perry]

Thank you Perry, that was very informative :)

 

I keep reading that the mist won't cause sickness (or very rarely) but then if a child has wheezed in the past year, they can't get the mist. It just seems like double talk to me and I'm getting tired of researching it.

It is confusing. I guess in summary I would say it can't cause flu but can cause a mild illness. Very mild (or no illness, usually) in healthy people, with the theoretical, NOT demonstrated risk of more severe illness in the immunocompromised, and known wheezing in the very young. HTH

[babysparkler]

I was told by my doctor's office that the seasonal flumist contains a "live virus" as opposed to the "dead virus" in the shot. That was their explanation on why my family of asthmatics can not ever have the flu mist. I still don't understand it. I didn't bother to ask about h1n1 mist since we did't even have those in my area yet by the time we all contracted h1n1.