2024-25 FluMist Nasal Flu Vaccine — The First Flu Vaccine Approved for Self-Administration

If you have a fear of needles and are nervous about getting the flu shot, you’re not alone. It’s estimated that 25% of adults have a strong fear of needles. Enter FluMist, the nasal flu vaccine.

FluMist has gone through quite the journey over the years. The nasal flu vaccine made headlines when researchers found that it was less effective than injectable flu vaccines in children during the 2012-13 and 2013-14 flu seasons. Because of this, the CDC didn’t recommend it during the 2016-17 and 2017-18 seasons.

But after being reformulated, it was added back to the lineup for the 2018-19 through 2023-24 seasons. For the 2024-25 flu season, FluMist is once again recommended by the CDC and their Advisory Committee on Immunization Practices (ACIP).

But how do you know if the nasal flu vaccine is a good option for you? Here’s what we know about FluMist for the 2024-25 flu season and how it compares to other flu vaccines.

What is FluMist?

FluMist is a nasal flu vaccine and one of several types of flu vaccines available. It’s known as a live, attenuated influenza vaccine, which means it contains weakened versions of the flu viruses that are predicted to cause flu infections this year. FluMist is a trivalent vaccine (as are the other flu vaccines for the 2024-25 season). This means that it targets three flu virus strains: two influenza A viruses and one influenza B virus.

FluMist is FDA approved for healthy individuals ages 2 through 49 who aren’t pregnant. We’ll discuss more about who shouldn’t get FluMist below.

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FluMist vs. flu shot

The most obvious difference between FluMist and the flu shot is how they’re given. FluMist is sprayed into the nostrils. The flu shot is injected into a muscle.

FluMist and the flu shot also have slightly different side effects. Both can make you feel under the weather shortly after you receive them. But FluMist can also cause a runny nose or sore throat. On the other hand, the flu shot can cause pain in the arm where it was injected. Side effects from either type of flu vaccine should resolve within 1 to 2 days of getting them.

FluMist also has more restrictions than the flu shot. As we’ll detail more below, only healthy individuals between 2 and 49 years old who aren’t pregnant should receive FluMist. The flu shot is recommended for almost everyone ages 6 months and older. There are also flu shot options recommended for adults 65 and older that offer better protection.

Who should not get FluMist?

While FluMist is a convenient option for people who don’t like needles, it’s not for everyone. People who should avoid FluMist include:

• Children younger than 2 years old

• Adults 50 years and older

• People with weakened immune systems

• People who will have close contact with a person with a severely weakened immune system within 7 days after vaccination

• Pregnant women

• People with cochlear implants (implantable devices that can help provide sound for certain people who are Deaf or have severe hearing difficulties)

• People who have recently taken antiviral flu medications, such as oseltamivir (Tamiflu), baloxavir marboxil (Xofluza), and zanamivir (Relenza) — but consult a healthcare professional to see how recent is too recent

• People who have previously experienced a severe allergic reaction to a flu vaccine

• Children ages 2 through 4 who have asthma

Good to know: FluMist is made with chicken eggs. However, most people with egg allergies can safely receive any flu vaccine that’s approved for their age range. If you're concerned about your personal risks, discuss it with your primary care provider. There are egg-free alternatives available, but they’re not nasal spray flu vaccines.

How is FluMist administered?

FluMist comes in a prefilled sprayer, which is first sprayed into one nostril and then into the other. But up until the 2024-25 flu season, you needed to visit a healthcare professional to receive it.

In September 2024, the FDA approved FluMist for self-administration and caregiver administration. This means it’s the first flu vaccine that you can give to yourself or your child at home. Only adults age 18 and older should give FluMist to themselves. A parent or caregiver who is at least 18 years old should administer the vaccine to children and adolescents ages 2 to 17.

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Keep in mind you can still visit a healthcare professional to receive FluMist if preferred. This approval just allows people the option to give it to themselves or their children.

Children ages 2 through 8 may need to get FluMist twice, with at least 4 weeks in between each dose. This will depend on how many times the child has received the flu vaccine before and when. People between the ages of 9 and 49 will only need one dose.

How effective is FluMist compared to other flu vaccines?

All flu vaccines (including FluMist) are about 40% to 60% effective against needing to see a healthcare professional for flu treatment.

FluMist targets the same flu viruses as other flu vaccines. Flu vaccines are developed based on a prediction of which flu viruses may be circulating each year. Because of this, we won’t have effectiveness data on this year’s flu vaccines until after flu season is over.

Despite not knowing effectiveness ahead of time, the CDC recommends getting a flu vaccine every year. Flu vaccines have other benefits besides potentially preventing you from getting sick with the flu. They can also reduce the severity of your flu symptoms and lower the risk of flu complications if you do get sick.

The type of flu vaccine that’s best for each person will depend on their age and health. Talk to your primary care provider or pharmacist if you’re unsure which vaccine is right for you.

Quiz: Test your flu shot knowledge

FluMist side effects

FluMist is generally well tolerated. In fact, many people that receive it experience little to no side effects at all. But it’s still good to know what to expect.

Common side effects of FluMist include:

• Runny or stuffy nose

• Fever

• Sore throat

• Headache

• Muscle aches

• Smaller appetite

• Wheezing

Allergic reactions to FluMist are rare but possible. If you’ve ever had an allergic reaction to any vaccine, let your healthcare professional know. They’ll likely take extra precautions when deciding which flu vaccine is right for you.

Guillain-Barré syndrome (GBS) is a very rare complication that’s been reported by people who’ve received vaccines. GBS causes your immune system to attack your nerves. It can cause muscle weakness or pain and, in severe cases, permanent nerve damage.

The risk of GBS after receiving FluMist is very low. In fact, experts debate whether most vaccines are truly linked to this complication. But to be safe, if you have a history of GBS, let a healthcare professional know.

Can FluMist give you the flu?

For healthy individuals in the approved age range, FluMist cannot give you the flu. The virus inside FluMist is too weak to cause illness in these groups. This common misconception often stems from two situations:

• People experience flu-like symptoms as a side effect within 1 to 2 days after vaccination.

• People are exposed to and get sick with the flu shortly after vaccination, before the protection from the vaccine kicks in.

But people with weakened immune systems could, in theory, get sick from live vaccines. That’s because even a weakened virus can wreak havoc if your immune system isn’t working the way it’s expected to. Similarly, live vaccines given during pregnancy may cause harm to the fetus, since they don’t have an immune system of their own yet.

How to save on FluMist

There are ways to save on FluMist. Many health insurance plans fully cover the cost of flu vaccines. But if you’re uninsured or underinsured, GoodRx can help you save. You can find FluMist prices as low as $31.22 with a free GoodRx discount. There are also many programs available to help you access low-cost or free flu vaccines.

Where can you get FluMist?

FluMist is available at select pharmacies, health clinics, and healthcare professionals’ offices. But not all vaccination locations regularly carry it. So be sure to call your preferred location ahead of time to check if they have FluMist in stock. You can also use the CDC’s Vaccine Finder tool to search for nasal spray flu vaccines near you.

How do you get FluMist for self-administration?

FluMist’s manufacturer has stated they’ll partner with an online pharmacy to provide the vaccine for self-administration. Those interested would complete an eligibility questionnaire that’s sent to a pharmacist who works with the online pharmacy. If the pharmacist determines that you or your child are eligible for FluMist, they’ll send a prescription to the pharmacy who will ship the vaccine(s) to you.

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Written by:

Christina Aungst, PharmD

Christina Aungst, PharmD, is a pharmacy editor for GoodRx. She began writing for GoodRx Health in 2019, transitioning from freelance writer to editor in 2021.

Reviewed by:

Joshua Murdock, PharmD, BCBBS

Joshua Murdock, PharmD, BCBBS, is a licensed pharmacist in Arizona, Colorado, and Rhode Island. He has worked in the pharmacy industry for more than 10 years and currently serves as a pharmacy editor for GoodRx.

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