Vaccine Info

FluMist Quadrivalent Influenza Vaccine

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Last reviewed
September 21, 2021

FluMist Quadrivalent Influenza Description

AstraZeneca's FluMist (Fluenz Tetra) Quadrivalent Intranasal vaccine is a live quadrivalent vaccine formulated to contain four vaccine virus strains. Like other live vaccines, FluMist Quadrivalent contains a weakened live virus. The weakened live virus is designed not to cause the flu but to help protect you from the flu.

FluMist Quadrivalent triggers an immune response in the nose, where people usually catch the flu. It works in 3 ways in your nose, cells, and bloodstream to help provide flu protection. Like the flu shot, immunity occurs within 14 days. It then triggers your immune system to build defenses (called antibodies), mainly in the nose, where the virus enters the body.

For the 2021-2022 flu season, the U.S. CDC authorized Quadrivalent (four-component) egg-based vaccines are recommended to contain: A/Victoria/2570/2019 (H1N1)pdm09-like virus, A/Cambodia/e0826360/2020 (H3N2)-like a virus, B/Washington/02/2019 (B/Victoria lineage)-like virus, and B/Phuket/3073/2013 (B/Yamagata lineage)-like virus.

FluMist Quadrivalent is the only U.S. FDA-approved flu vaccine to use a needle-free nasal spray administrative technique, FluMist was approved by the US Food and Drug Administration in 2003. ATC code: J07BB03; CAS Number: 1704512-59-3 

“As the world continues to navigate an unpredictable public health landscape with coinciding flu and COVID-19 viruses, AstraZeneca remains committed to following the science and putting people and their communities first by helping ensure families have access to a needle-free vaccination option,” stated Mina Makar, SVP, US Respiratory & Immunology at AstraZeneca, in a press statement issued on August 31, 2021.

Delaware-based AstraZeneca (AZN) is a global, science-led biopharmaceutical company that focuses on the discovery, development, and commercialization of prescription medicines. Click here to find a FluMist Quadrivalent location in the USA.

FluMist Quadrivalent Influenza Indication

The nasal spray flu vaccine is approved for healthy non-pregnant individuals, 2 years through 49 years old. However, people with certain medical conditions should not receive the nasal spray flu vaccine, says the U.S. CDC.

You should not get FluMist Quadrivalent if you have a severe allergy to eggs or any inactive ingredient in the vaccine; have ever had a life-threatening reaction to influenza vaccinations, or are 2 through 17 years old and take aspirin or medicines containing aspirin—children or adolescents should not be given aspirin for 4 weeks after getting FluMist Quadrivalent unless your healthcare provider tells you otherwise.

LAIV is not recommended for people with some chronic health conditions because this vaccine's safety and effectiveness in people with those conditions have not been established. In addition, children under 2 years old have an increased risk of wheezing (difficulty with breathing) after getting FluMist Quadrivalent.

Pregnant and postpartum women do not need to avoid contact with persons recently vaccinated with the nasal spray flu vaccine. However, the nasal spray flu vaccine should not be given to pregnant women. Postpartum women can receive a flu shot or the nasal spray flu vaccine. In addition, breastfeeding mothers younger than 50 years can get the nasal spray flu vaccine as long as they do not have a contraindication to getting that vaccine.

FluMist Quadrivalent Influenza Vaccine Side effects

FluMist Quadrivalent is contraindicated in persons who have had a severe allergic reaction (e.g., anaphylaxis) to any vaccine component, including egg protein, or after a previous dose of any influenza vaccine, and in children and adolescents receiving concomitant aspirin or aspirin-containing therapy. In clinical trials, the risks of hospitalization and wheezing were increased in children <24 months of age who received trivalent FluMist

FluMist Quadrivalent Influenza Vaccine and COVID-19 Vaccines

The US Centers for Disease Control and Prevention (CDC) previously issued interim clinical considerations stating that 'COVID-19 vaccines and other vaccines, including influenza vaccines, can be administered without regard to timing. And the annual influenza vaccination is recommended for all persons aged 6 months and older who do not have contraindications. 'Providers should be aware of the potential for increased reactogenicity with coadministration and should consult the CDC for updated guidance as more information becomes available. If coadministered, COVID-19 vaccines and vaccines that might be more likely to cause a local reaction (e.g., aIIV4 or HD-IIV4) should be administered in different limbs, if possible.'

'No data are currently available concerning coadministration of currently Authorized COVID-19 vaccines and influenza vaccines,' stated Lisa Grohskopf, M.D., MPH, CDC's ACIP vaccine committee presentation (slide #14) on June 24, 2021.

FluMist Quadrivalent Influenza Dosage

FluMist Quadrivalent is a vaccine sprayed into the nose by a healthcare professional. One spray of FluMist in each nostril can help protect eligible children and adults ages 2-49. People 9 years of age and older need one dose of FluMist Quadrivalent each year. Children 2 through 8 years old may need 2 doses of FluMist Quadrivalent, depending on their history of previous influenza vaccination. Your healthcare provider will decide if your child needs to come back for a second dose.

'You can breathe normally while you get FluMist Quadrivalent. It's okay if you sneeze, blow your nose, feel dripping down your nose or throat, or swallow after receiving FluMist Quadrivalent. You still get enough FluMist Quadrivalent to help protect you against the flu,' says AstraZeneca.

FluMist Quadrivalent Influenza News

September 11, 2021 - The US CDC reported that influenza like illness continues to be below the baseline of 2.6% nationally.

August 31, 2021 - AstraZeneca announced that FLUMIST® QUADRIVALENT vaccine doses are now available in the USA for the 2021-2022 influenza season. FLUMIST QUADRIVALENT, the only U.S. FDA-Approved nasal-spray flu vaccine. The bulk of AstraZeneca’s supply for the 2021-2022 flu season is expected to be available by mid-September.

August 26, 2021 - The U.S. FDA confirmed (3) FluMist Quadrivalent lots from MedImmune, LLC, were released. 

August 13, 2021 - Nationwide, during week 31, 2.0% of patient visits reported through ILINet were due to ILI. Although increasing, the percentage of patient visits for ILI remains below the baseline of 2.6% nationally. One region (Region 7) is at its region-specific baseline while the remaining regions are below their baselines. Influenza virus circulation remains low; therefore, increases in ILI activity are likely due to increased circulation of other respiratory viruses.

June 1, 2021 - Global Nasal Spray Vaccine Market 2020 Development Analysis – AstraZeneca FluMist, Cipla, BCHT

February 11, 2021 - AstraZeneca plc published financial results, which stated Flumist Total Revenue, entirely comprising Product Sales, increased by 161% in the year (153% at CER) to $295m, reflecting the greater use of influenza vaccines as health authorities in northern-hemisphere countries expanded seasonal-vaccination programs beyond typical levels during the ongoing COVID-19 pandemic. In the US, sales increased by 254% in the year to $70m and, in Europe, by 135% (126% at CER) to $219m.

November 25, 2020 -  Israel has ordered AstraZeneca's FluMist vaccines for its citizens.

August 21, 2020 - Prevention and Control of Seasonal Influenza with Vaccines: Recommendations of the Advisory Committee on Immunization Practices — the United States, 2020–21 Influenza Season.

August 13, 2020 - AstraZeneca Ships FLUMIST® QUADRIVALENT Vaccine in the US for 2020-2021 Flu Season.  AstraZeneca has increased production of FluMist QUADRIVALENT doses in the US by over 25% more than previously planned, a majority of which are expected to be available by the end of September.

FluMist Quadrivalent Influenza Clinical Trials

Astra Zeneca's FluMist has been studied in several clinical trials over the years.