Did Nasal Spray Absence Cause Flu Vaccination Rates to Drop?


Without the nasal spray as an immunization option for influenza, vaccination rates in children dropped in the 2016-2017 season, according to new data published in Vaccine.

Without the nasal spray as an immunization option for influenza, vaccination rates in children dropped in the 2016-2017 season, according to new data published in Vaccine.1

Following several studies that found the nasal spray to be less effective than the injectable vaccine, the CDC reversed its initial stance on the vaccine option and recommended against use of the nasal spray for the 2016-2017 influenza season.

In a study led by Penn State College of Medicine researchers, vaccine rates were assessed among 9591 Penn State Pediatrics patients aged 2 to 17 years old in the 2014-2015, 2015-2016, and 2016-2017 flu seasons. Among the study participants, influenza vaccination rates early in the 2016-2017 season were initially higher by nearly 2% than they were in the early 2015-2016 season. However, the vaccination rates in the season dropped, resulting in an overall 1.6% reduction compared to the previous influenza season. The researchers also noted that revaccination rates were lower in children who had received the nasal spray in the previous year.

A 1.6% reduction in vaccination rates could be significant, the researchers noted, adding that it could result in 1.2 million additionally unvaccinated children. The ramifications could potentially lead to 4385 additional influenza-related outpatient visits and 30 additional influenza-related hospitalizations in children.

Overall, the findings indicated that 35% to 50% of individuals changed their mind about getting the influenza vaccine from 1 year to the next. Additionally, the study’s data seem to suggest that immunization preference in this case may be based on convenience.

“Instead, it seems that people may not be either vehemently pro flu vaccine or antiflu vaccine,” study co-author Ben Fogel, assistant professor of pediatrics at Penn State College of Medicine and medical director of Penn State Primary Care, said in a press release.2 “Rather if it’s convenient, they’ll get the vaccine, and if it’s not convenient, they won’t go out of their way to get it.”

The researchers intend to conduct a follow-up intervention to help improve vaccination rates among individuals who might not feel strongly about the influenza vaccine either way.


  • Fogel B, Hicks T. Influenza vaccination rates in children decline when the live attenuated influenza vaccine is not recommended. Vaccine. 2017. Doi: 10.1016/j.vaccine.2017.07.067.
  • Flu vaccine rates for kids may drop when the nasal spray vaccine is unavailable [news release]. Pennsylvania. Penn State’s website. http://news.psu.edu/story/478484/2017/08/24/research/flu-vaccine-rates-kids-may-drop-when-nasal-spray-vaccine. Accessed August 24, 2017.
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