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A shot up the nose

MagazineJanuary 2004 (Vol. 14 Issue 10)A shot up the nose

No rolling up your sleeve for a painful shot in the arm

No rolling up your sleeve for a painful shot in the arm. Just a couple of sniffs and you are protected from the dreaded flu.

That's the sales pitch for the latest flu vaccine FluMist, approved earlier this year by the US Food and Drug Administration (FDA) for use in people aged 5-49 years. It may seem like a good idea, but FluMist contains live, albeit weakened viruses. Apart from being expensive, it cannot be used by those at highest risk for the worst complications of the flu - the elderly, infants, diabetics, pregnant women, anyone with a lung disease such as asthma, and those whose immune systems are in any way compromised. It is also not recommended for healthcare workers.

Its most common side-effects, according to the manufacturer, include 'cough, runny nose/ nasal congestion, irritability, headaches, chills, muscle aches and fever > 100^0 F' - symptoms nearly identical to the flu. Also, live vaccine can be shed for up to two weeks - for instance, through sneezing or coughing - possibly affecting others around the vaccinated person. Thus, the precautions included in the FluMist pack state that 'recipients should avoid close contact with immunocompromised individuals for at least 21 days.' Such individuals include those with eczema, cancer, undiagnosed HIV/AIDS and organ-transplant recipients.

MedImmune, which makes FluMist, recently entered into an agreement with Wal-Mart, the world's biggest retailer. US consumers can now get a quick blast of FluMist while they shop. The product is not yet licensed in the UK but, as with all medical 'innovations', forewarned is forearmed.

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