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For many of us, we are still somewhat shocked that the Advisory Committee on Immunization Practices (ACIP) has told us not to use FluMist® during the 2016-17 flu season. There are many questions and much speculation about why this product went from the preferred flu presentation for age-appropriate patients to a “do not use” in such a short time span. Unfortunately, as parents learn that their child can’t have FluMist® this season, it may create uninformed speculation about broader vaccine safety. That is truly unfortunate. To help quiet fears, here is the latest from AstraZeneca:

AstraZeneca today confirmed that the Advisory Committee on Immunization Practices (ACIP) of the Centers for Disease Control and Prevention (CDC) has provided its interim recommendation on the use of FluMist® Quadrivalent Live Attenuated Influenza Vaccine (FluMist Quadrivalent) in the US for the 2016-2017 influenza season. The updated guidance states the vaccine should not be used in any setting, based on CDC vaccine effectiveness data from the last three influenza seasons in the US, which indicated FluMist Quadrivalent did not demonstrate statistically significant effectiveness in children 2-17 years of age.

The US CDC effectiveness data for 2015-2016 season contrast with studies by AstraZeneca as well as preliminary independent findings by public health authorities in other countries. These findings demonstrate FluMist Quadrivalent was 46-58% effective overall against the circulating influenza strains during the 2015-2016 season. As influenza vaccine effectiveness varies from season to season, it is evaluated in annual observational studies. The CDC states that when there is a good match between the strains in the vaccine and those that circulate during the influenza season, vaccines are typically 50-60% effective. AstraZeneca is working with the CDC to better understand its data to help ensure eligible patients continue to receive the vaccine in future seasons in the US.

The distribution and use of the vaccine in other countries are progressing as planned for the forthcoming influenza season, pending the annual release process from relevant regulatory authorities.

So, the bottom line is that we have conflicting data regarding the current effectiveness of FluMist®. We don’t know if this is the result of specific flu stains included in the current vaccine, stability of those particular stains in a live virus vaccine, storage and/or administration practices or something else.

Based on observational data in the United States, it appears that injected flu vaccines were more effective last season than FluMist® and given the importance of protection against the flu, the ACIP wants us all to use what currently appears to be the most effective vaccine.

So, how should you respond to concerned parents? We would tell them that vaccines continue to improve to provide better protection. We only use those vaccines that are currently best in class. This year, Fluzone® is the best flu vaccine.

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