Concerns of the At-Home FluMist Emphasize Need for Patient Safety, Proper Administration

With the increasing accessibility of vaccines, including FluMist (AstraZeneca), a live and intransal influenza vaccine approved in September 2024,¹ the prospect of at-home administration presents both opportunities and challenges. The potential concerns surrounding the at-home vaccination of FluMist emphasizes the implications for patient safety, proper administration, and monitoring. These issues need careful consideration from pharmacists and other health care providers involved in vaccination efforts.

Image Credit: PixieMe - stock.adobe.com

The COVID-19 pandemic has accelerated the acceptance of at-home health care solutions, including vaccination. While increasing access to vaccines is beneficial, the at-home administration of FluMist warrants caution due to specific concerns that could impact patient outcomes and safety. FluMist is a live attenuated influenza vaccine that requires precise administration to be effective. Unlike traditional injections, FluMist is delivered intranasally, and improper technique can lead to reduced efficacy or even local adverse effects. In a home setting, the likelihood of administration errors increases without the supervision of trained health care professionals.

Storage, Handling, and Eligibility

FluMist must be stored between 2°C to 8°C (36°F to 46°F) to maintain its efficacy. At-home environments may lack the necessary refrigeration capabilities, increasing the risk of temperature abuse. This could lead to vaccine degradation, rendering the vaccine ineffective.² Not all patients are suitable candidates for FluMist; contraindications include asthma, immunocompromised status, and certain other medical conditions. Pharmacists play a crucial role in screening patients for eligibility prior to vaccination. In an at-home setting, such screening may be less thorough, potentially leading to adverse outcomes.³

Monitoring, Education, and Counseling

Vaccination typically requires monitoring for immediate adverse reactions, such as anaphylaxis, which can occur within minutes. At-home vaccination poses challenges in this regard as patients may not have immediate access to emergency care or trained personnel to manage adverse reactions.⁴ Effective vaccination involves more than just administration; patient education is vital. Patients need to understand what to expect after receiving FluMist, including potential side effects and the importance of follow-up. In a home setting, the opportunity for in-depth counseling is limited, increasing the risk of misinformation and patient anxiety.⁵

Conclusion

While the concept of at-home administration of FluMist may enhance vaccine accessibility, it presents significant challenges that could compromise patient safety and vaccine efficacy. Pharmacists and other health care providers must weigh these concerns carefully and advocate for robust patient education and monitoring protocols if at-home administration becomes a viable option.

REFERENCES

1. Antrim A. FDA Approves First At-Home Nasal Spray Flu Vaccine. Pharmacy Times. September 20, 2024. Accessed September 23, 2024. https://www.pharmacytimes.com/view/fda-approves-first-at-home-nasal-spray-flu-vaccine

2. Centers for Disease Control and Prevention. (2022). Influenza (Flu) Vaccine Information. Retrieved from https://www.cdc.gov/flu/prevent/vaccination.htm

3. Chirkov, A., Williams, R., & Newby, K. (2020). Screening for Influenza Vaccine: A Review of Current Practice. Journal of Public Health Management and Practice, 26(3), 309-315.

4. Liu, R., Moller, M., & Awan, N. (2020). Monitoring for Adverse Reactions After Vaccination: Challenges and Solutions. Vaccine, 38(45), 7204-7211.

5. Patel, M., Zarbock, M., & Wiese, M. (2021). Importance of Patient Education in Vaccination: A Review of Current Literature. American Journal of Health-System Pharmacy, 78(6), 495-502.