With the flu season nearing, a nasal spray to fight the bug is hitting drugstore shelves next month. But health experts say it’s unlikely to replace the dreaded needle.
Doctors say FluMist, touted as a pain-free alternative to the flu shot, is too costly and is off-limits to those most likely to catch the flu — the very young, the very old, and those with chronic illnesses and weakened immune systems.
What’s more, the nasal spray is made with a live but weakened form of the influenza virus that could be passed on to those in close contact with spray users. The flu shot, by contrast, is made with a killed virus.
“I doubt it will ever replace the flu shot,” said Denise Sokos, assistant professor of pharmacy and therapeutics at the University of Pittsburgh School of Pharmacy.
Because it’s made with a live virus, the spray has the potential to trigger mild flu symptoms, such as a runny nose, nasal congestion and a slight cough, Sokos said.
Dr. David Greenberg, head of the vaccine-research center at Children’s Hospital of Pittsburgh, said the risk of a spray-user passing on the virus to another person is very low. The spray is squirted directly into each nostril by a medical professional. It does not linger in the air but, instead, remains on the opening of the nose.
“That person would have to sneeze or cough in the face of someone else,” Greenberg said. “Or they would have to rub their nose with their hands and shake hands with someone else. It has to be very direct and close contact. It’s not like you can cough and leave the room, and five minutes later someone will walk in and catch the virus.”
Still, a live virus could be harmful to elderly folks and those whose immune systems have been weakened by cancer or chronic illnesses. The Food and Drug Administration, therefore, is restricting the use of FluMist to those who are healthy and between the ages of 5 and 49.
Because of the restrictions on FluMist, the Allegheny County Health Department will use injections. The department buys about 80,000 doses of flu vaccines annually.
“Not many people under 50 get flu shots from us,” said health department spokesman Guillermo Cole.
The health department will begin its annual flu clinic Oct. 20 in Oakland. The department also provides vaccines to the Visiting Nurses Foundation, which provides flu shots at supermarkets and drugstores.
Family doctors say they want to see how effective FluMist will be.
“We have to be very careful with any type of live virus vaccine,” said Dr. Marc Itskowitz, an internist with a practice at Allegheny General Hospital on the North Side. “We need to make sure the patients who are receiving it are not immuno-compromised.”
Jamie P. Lacey, a spokeswoman for MedImmune Inc., the Maryland-based maker of FluMist, said clinical tests have unquestionably proven its effectiveness.
“This certainly isn’t the first live virus vaccine,” Lacey said, citing other effective vaccines, such as those to prevent measles, mumps, rubella (MMR) and polio.
Doctors said FluMist could be a relief to people who fear needles. They also say some studies have suggested that FluMist’s effect can last longer than a flu shot.
“The fact that it’s given through the nose, where the flu virus enters the body, could mean it may last longer in the body,” Itskowitz said.
FluMist, which recently announced a deal with Wal-Mart to sell the vaccine, costs about $50 a dose. A flu shot costs about $15 and is covered by Medicare as well as most health-insurance plans.
Officials at Highmark Blue Cross Blue Shield, which provides health-insurance coverage to more than 3 million people in Western Pennsylvania, said it won’t cover the cost of the new product.
Dr. Judith Black, medical director for Highmark’s senior products, said she is concerned about potential waste because storage requirements for FluMist are specific. The vaccine must be stored in a special freezer.
“If you don’t store it correctly, you have to throw it out,” Black said.
As it has the past three years, Highmark is sending its doctors lists of high-risk patients so that they can be alerted about getting flu shots. The insurer also will launch an ad campaign to tell its customers about the importance of vaccination.
The U.S. Centers for Disease Control and Prevention and other top health agencies this week began a campaign to urge the public to get flu shots. Unlike previous years when there were vaccine shortages, the CDC says it has 85 million doses of the vaccine — plenty for anyone who needs it. The agency recommends a flu shot for babies 6 months to 2 years old; for those older than 50; and for those with chronic illnesses.
FluMist will be available at Wal-Mart stores in early October.
Allegheny County Health Department
The county’s annual flu clinic opens Oct. 20. This year’s cost for a flu shot is $16 although it is covered in full for those enrolled in Medicare Part B. No appointments are necessary at the clinic, located at 3441 Forbes Ave. in Oakland. Hours are Monday, Tuesday, Thursday and Friday, 9 a.m. to 3 p.m. and Thursday, 9 a.m. to 7 p.m.
The supermarket chain will offer flu shots from Oct. 3 through Nov. 9. Cost is $20 per shot. For store locations, go to www.gianteagle.com
Eckerd drug stores
More than 50 Eckerd drug stores in the region are offering flu shots at $20 each. Clinics begin Oct. 5. For more information and store locations, go to www.eckerd.com
Mercy Providence Hospital
The North Side hospital will offer flu shots at a community health fair on Saturday, Oct. 18. The event is from 9 a.m. to 1 p.m. Only 300 shots will be available at a cost of $9 each. Pre-registration is required by calling 412-232-5660
Visiting Nurse Foundation
The group has scheduled flu shot clinics at more than 100 locations. Cost for each vaccine is $21. The program kicks off the week of Oct. 5 at the following locations:
Century III Mall, Oct. 10, noon to 7 p.m.
Monroeville Mall, Oct. 10, noon to 7 p.m.
Pittsburgh International Airport, Landside terminal,
Oct. 11, 12, 13, 14, 15, 9 a.m. to 1 p.m.
Sunset Hills United Presbyterian Church, 900 Country Club Dr.
Oct. 11, 10 a.m. to 12 p.m.
For additional dates and locations, go to www.vnf-pittsburgh.org or call 412-937-8350.