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FluMist

Pronunciation: FLEW-mĭst 
Generic name: influenza virus vaccine (nasal)
Brand name: FluMist 
Dosage form: nasal spray
Drug class: Viral vaccines

Medically reviewed by Melisa Puckey, BPharm. Last updated on Oct 29, 2024.

What is FluMist Vaccine?

FluMist vaccine is a nasal spray vaccine used to prevent the flu (influenza). FluMist nasal spray contains a small dose of the weakened influenza virus, which helps your body develop immunity to the disease, without causing infection. FluMist can be used for people from 2 to 49 years of age and is available from doctors and pharmacies, and the next flu season will be available for home use. FluMist vaccine nasal spray is a prescription medicine.

FluMist 2024-2025 formula contains 3 influenza virus strains that are weakened, including A(H1N1), A(H3N2), and B Victoria lineage. The vaccine is redeveloped each year to contain specific strains of activated (live) flu virus that public health officials recommend for that year. FluMist is a live attenuated influenza vaccine (LAIV).

FluMist Quadrivalent 2023-2024 Formula contained two influenza A subtype viruses (A/H1N1 strain,  A/H3N2 strain) and two influenza B strains (B/Yamagata/16/88 lineages, B/Victoria/2/87 lineages).

FluMist may not protect all individuals receiving the vaccine.

Influenza (commonly known as "the flu") is a serious disease caused by a virus. Influenza virus can spread from one person to another through small droplets of saliva that are expelled into the air when an infected person coughs or sneezes. The virus can also be passed through contact with objects the infected person has touched, such as a door handle or other surfaces.

FluMist side effects

Common FluMist side effects

Common FluMist side effects include runny nose or nasal congestion in patients aged 2 years through 49 years, fever over 100°F in children ages 2 years through 6 years, and sore throats in (adults ages 18 years through 49 years. This side effects occured in 10% or more of patients and at least 5% greater than in placebo recipients, in clinical trials.

This flu vaccine is made from "live viruses" and may cause you to have mild flu-like symptoms. You may have flu-like symptoms at any time during flu season that could be caused by other strains of the influenza virus.

Other possible FluMist side effects are low appetite, muscle pain, headache, feeling irritable, chills or feeling tired (fatigue).

Serious FluMist side effects 

FluMist can cause severe allergic reactions. Get emergency medical help if you have signs of an allergic reaction to this nasal spray hives or a bad rash, difficulty breathing; swelling of your face, lips, tongue, or throat.

You should not receive a booster vaccine if you had a life-threatening allergic reaction after the first shot.

This is not a complete list of side effects, and others may occur. Call your doctor for medical advice about side effects. You may report vaccine side effects to the US Department of Health and Human Services at 1-800-822-7967.

Warnings

Who should not use this FluMist vaccine nasal spray?

You should not have the FluMist vaccine if you have:

Please talk to your healthcare provider if you are not sure if the items listed above apply to you or your child.

Children under 2 years old have an increased risk of wheezing (difficulty with breathing) after getting this vaccination. 

Who may not be able to get FluMist vaccine? 

You may not be able to have a FluMist in some circumstances. Tell your healthcare provider if you or your child: 

You can still receive a vaccine if you have a minor cold. In the case of a more severe illness with a fever or any type of infection, wait until you get better before receiving this vaccine.

If you or your child cannot take the FluMist nasal spray vaccine, you may still be able to get an influenza shot. Talk to your healthcare provider about this.

Before taking this medicine

Inform vaccine recipients or their parents/guardians that FluMist is an attenuated live virus vaccine and has the potential for transmission to immunocompromised household contacts.

Pregnancy

Talk to your doctor if you are pregnant or planning a pregnancy, you may not be able to have the nasal spray. FluMist Quadrivalent is not absorbed systemically following intranasal administration and is not expected to result in exposure to the vaccine to the unborn baby.

Breastfeeding 

Talk to your doctor if you are breastfeeding. FluMist is not absorbed systemically by the mother after being given in the form of a nasal spray, and breastfeeding is not expected to result in the exposure of the child to this vaccine.

How is the FluMist vaccine given?

FluMist vaccine is given as a nasal spray, one spray into each nostril.

FluMist vaccine directions

Removed rubber tip protector, but do not remove the dose divider clip at the other end of device.
The patient should be in an upright position. Then, the tip of the device should be placed just inside the nostril so that the vaccine is delivered into the nose.

In a single motion, depress the plunger as rapidly as possible until the dose-divider clip prevents you from going further.

Remove the dose-divider clip from the plunger. 

Then, repeat the spray in the other nostril. In a single motion, as rapidly as possible, depress the plunger.

Sniffing is not required by the patient during spraying.

This medicine should not be injected. Do not use a needle.

Since the influenza virus vaccine is redeveloped each year for specific strains of influenza, you should receive a flu vaccine every year.

FluMist Dosing information

Usual FluMist Dose for 9 years to 49 years for Influenza Prophylaxis:
A single dose = One spray (0.1 mL) into each nostril. 

Usual Pediatric Dose (2 to 8 years) for Influenza Prophylaxis:
1 or 2 doses. Use Advisory Committee on Immunization Practices annual recommendations to determine the number of doses.
First dose = One spray (0.1 mL) into each nostril.
Second dose (if required) = One spray (0.1 mL) into each nostril at least one month after the first dose.

What happens if I miss a dose?

Call your doctor if you forget to receive your yearly vaccine in October or November or if your child misses a booster dose.

What happens if I overdose?

An overdose of FluMist is unlikely to occur.

What to avoid?

Antiviral medicines. Avoid using antiviral flu medications (such as amantadine, oseltamivir, rimantadine, zanamivir, Flumadine, Tamiflu, Relenza) for at least 2 weeks after receiving FluMist,

Immunosuppressed individuals. Avoid close contact for at least 7 days after receiving a nasal flu vaccine, with anyone who has a weak immune system caused by a disease such as cancer or HIV, or by using steroids, chemotherapy, radiation, or other treatments that can weaken the immune system. People with weak immune systems can become ill if they are in close contact with you when you recently received a live vaccine.

What other drugs will affect FluMist?

Anyone 2 to 17 years old receiving this nasal spray vaccination should not take aspirin for at least 4 weeks after the vaccine. A possible interaction between the nasal flu vaccine and aspirin can cause a serious or fatal condition called Reye's syndrome.

Before receiving this vaccine, tell your vaccination provider about all other vaccines you have recently received.

Other drugs may interact with influenza virus nasal vaccine, including prescription and over-the-counter medicines, vitamins, and herbal products. Tell your doctor about all other medicines you use.

Does FluMist interact with my other drugs?

Enter medications to view a detailed interaction report using our Drug Interaction Checker.

Flumist Ingredients

FluMist Active Ingredients 2024-2025 formula: 3 influenza virus strains that are weakened (A(H1N1), A(H3N2), and B Victoria lineage).

FluMist Inactive Ingredients: FluMist also contains monosodium glutamate, gelatin, arginine, sucrose, dibasic potassium phosphate, monobasic potassium phosphate, and gentamicin.

FluMist does not contain preservatives.

The single-use intranasal sprayer is not made with natural rubber latex.

FluMist Quadrivalent does not contain preservatives.

Storage

Store in a refrigerator between 35-46°F (2-8°C) upon receipt. 

Nasal spray must be kept in the carton until use in order to protect from light. 

Nasal spray must not be used after the expiration date on the sprayer label.

Company

Flumist is Manufactured by: MedImmune, LLC Gaithersburg, MD 20878 

Popular FAQ

Does FluMist contain egg protein?

Yes, Flumist is made using an egg-based manufacturing process and contains a small amount of egg protein. If you or your child cannot use FluMist nasal spray, you may be eligible to get an influenza (“flu”) shot instead.

What's the recommended age range for FluMist?

FluMist can be used in children and adults 2 through 49 years of age if they otherwise qualify for the nasal flu vaccine. Children under 2 years of age have an increased risk of wheezing (difficulty with breathing) after getting FluMist. Tell your doctor if you or your child are currently wheezing, have a history of wheezing and are under 5 years of age, or have asthma.

Is FluMist a live vaccine?

Yes, FluMist contains a live, but weakened (attenuated) flu virus. It will not cause or “give” you the flu, but you may have temporary, mild side effects like a runny or stuffy nose, headache, muscle aches, fever, or sore throat.

Who should not get FluMist?

Don’t use FluMist if you’ve had a severe or life-threatening allergic reaction to any ingredient in FluMist, to egg proteins, or to any other flu vaccine; or if you are 2-17 years of age and take aspirin or medicines containing aspirin. Children or adolescents should not be given aspirin for 4 weeks after getting FluMist unless your healthcare provider tells you otherwise.

How and where is a flu shot injection given?

The flu shot is usually given as an intramuscular (IM) needle injection into the upper, outer arm muscle called the deltoid muscle in people 3 years of age and older. The preferred injection site for infants and young children is the front, outer area of the thigh. The CDC recommends that everyone 6 months of age and older receive a flu vaccine every year, typically in Sept. or Oct. Continue reading

What flu vaccine can I use with an egg allergy?

Egg-free vaccines include Flublok Quadrivalent, for people 18 years and older and Flucelvax Quadrivalent for people 6 months and older. The CDC now states that people with egg-allergy may receive any flu vaccine appropriate for their age and health status. Continue reading

FluMist or Flu Shot: Which is more effective?

Both FluMist nasal flu vaccine and the flu shot offer good protection against influenza when vaccines are well-matched to the year’s circulating virus. In 2023-2024, the flu vaccine was 52% to 61% effective in preventing hospitalization in children 6 months to 17 years and 41% to 44% effective in preventing hospitalization in adults ages 18 years and older. Continue reading

How well does the flu vaccine work?

Flu vaccination typically reduces the risk of flu illness by between 40% and 60% during seasons when the flu viruses are well-matched to the flu vaccine. But if you are infected with the virus, the vaccine reduces your chances of getting the flu and passing it on to others and lessens the severity of symptoms, hospitalizations and death. Continue reading

How can I get a flu vaccine without a needle?

Options that are available for a needle-free flu vaccine are the FluMist nasal spray for people 2 to 49 years of age and the Afluria vaccine given with the Stratis needle-free jet injector for ages 18 through 64 years. Check with your healthcare provider to see if you are eligible. Continue reading

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Further information

Always consult your healthcare provider to ensure the information displayed on this page applies to your personal circumstances.