english.prescrire.org > Spotlight > Archives : 2013 > Intranasal influenza vaccine for children (Fluenz°): it is better to keep to the injectable vaccine

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Intranasal influenza vaccine for children (Fluenz°): it is better to keep to the injectable vaccine

In children where vaccination against influenza is advisable, the live attenuated influenza intranasal vaccine has not been evaluated in terms of influenza complications. It is better to keep to the injectable vaccine.

Vaccination of children against influenza is offered when there is an increased risk of complications: severe congenital abnormalities, especially pulmonary or cardiac, cystic fibrosis, severe asthma, poorly controlled diabetes and some immune deficiencies.

In 2012, the European Commission granted a marketing authorisation to a live attenuated influenza intranasal vaccine for individuals aged 2 to 17 years.

In the frailest children, i.e. those who most need an effective vaccine with no adverse effects, there is no record of any clinical trial to evaluate this vaccine’s efficacy in preventing complications.

In infants under the age of one and children with a history of severe respiratory problems, the live intranasal influenza vaccine is countraindicated due to its adverse effects: wheezing, respiratory infections and frequent hospitalisation. The vaccine should also be ruled out in cases of immune deficiency, since it is a live vaccine. In short, this vaccine is a little easier to administer, but is not appropriate for the children most at risk from influenza complications.

When an influenza vaccination seems justifiable in children, it is better to keep to injectable inactivated vaccines and avoid exposing a child to an increased risk of adverse effects from the live vaccine.

©Prescrire 1 September 2013

"Intranasal live attenuated seasonal influenza vaccine. Does not challenge current practice" Prescrire Int 2013; 22 (141): 201-204. (Pdf, subscribers only).
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