I had a phone call last week from my doctors surgery last week offering my three year old daughter the flu nasal spray. I had recently read allergybabe’s blog, advising that the new spray contained egg, so I asked the nurse who was calling (and would be administering the spray) if she knew that it contained egg and that my daughter had an egg allergy. She wasn’t aware of either. She said she would call me back, but to date she hasn’t.
This is the first time they have offered the nasal spray against influenza in the UK, but it has been used in the US for 10 years now. The current NHS programme of vaccination is for 2 to 3 year olds only.
The main differences between the flu jab and the nasal spray aside from their modes of delivery is the viruses within the nasal spray are live (albeit altered ones unable to reproduce in the lungs) compared with the inactive viruses in the jab. Due to this they do not recommend that children with weakened immune systems or severe asthma have the nasal spray.
My favourite part, the ingredients list. What is actually in the spray?
Reassortant live attenuated influenza virus (propagated in fertilised hen’s eggs) of the following strains:
A/<Official strain> (H1N1) like strain (<actual strain>) 107.0±0.5 FFU*:
A/<Official strain> (H3N2) like strain (<actual strain>) 107.0±0.5 FFU*
B/<Official strain> like strain (<actual strain>) 107.0±0.5 FFU*
………………………………………………………………………………………..per 0.2 ml dose* fluorescent focus units
Dibasic potassium phosphate
Monobasic potassium phosphate
Gelatin (porcine, Type A)
Monosodium glutamate monohydrate
Water for injections
Who should avoid the Nasal Spray?
It seems to be well advertised that like most flu vaccinations it contains traces of egg, egg protein and gelatin, but did you spot that the source of the gelatin in the spray is pork (porcine). So in addition to vegetarian and vegans avoiding the spray, it should be noted that some parents may want to avoid use of this due to religious reasons (although it is has been stated on the NHS website that Jewish laws state there is no problem using pork products in vaccines, and Islamic clerics have stated the the spray is in fact halal).
In summary, children who should not have nasal spray (or should consult with their GP for alternatives) are
- children with allergies to egg, gentamicin or gelatin
- children with weakened immune systems
- children who have contact with others with weakened immune systems (as there is a small chance of infection)
- children avoiding pork products
- severley asthmatic children, or children actively wheezing at time of treatment
- vegetarians and vegans
- children using high dose corticosteroids (e.g. prednisolone)
- children undertaking salicylate therapy
As ever I think it should be up to you, the parent, to weigh up the risks and benefits and decide on whether to have your children vaccinated against flu in this way, there are alternatives for those not wanting to take the risk. I think this year we will decline.
- All children offered flu nasal spray (bbc.co.uk)