HIVers Should Not Take Nasal Flu Vaccine
The FDA has approved a new form of flu vaccination for fall: The vaccine is sprayed inside the patient’s nose, so no injection is required — no shots! However, because the product (FluMist) contains live influenza germs, immunocompromised persons should not take it. That would include people with advancing HIV disease, the elderly, babies, and transplant patients, among others. There is a risk of FluMist giving those individuals a very bad case of the flu, which they may not be able to fight very well. They should continue to be vaccinated, but the older injected vaccine should be used.
All flu vaccines contain influenza germs, so that the inoculated person’s immune system will make an influenza antibody, or anti-flu warrior, response. Since nobody likes getting shots, especially kids, having an “intranasally administered” vaccine option will be useful. Using the live flu virus (live attenuated influenza vaccine, or LAIV) was necessary, because the traditional dead (“inactivated”) germs only produce the needed antibody response when injected, not when sprayed in the nasal tissues.
Care givers, health care personnel, and household members of an immune-suppressed person should also take the traditional flu shot. Since LAIV causes the vaccinated person to produce flu germs in the nasal passages for several days, there is concern that he/she might pass the virus to the person lacking immune protection.
Since the new HIV medicines have dramatically reduced AIDS deaths in the U.S., today more folks die each year from the flu, so everyone should get their flu shots! However, people with AIDS should steer clear of the new LAIV FluMist.
For details, see the CDC MMWR, Sept. 26, 2003.
Sandy Bartlett
Community Education Coordinator, AIDS Services of Austin
This article appears in October 17 • 2003.