Medical Professional Publications

Clearing Up Confusion About the Influenza Vaccine

Columbus, OH - September 2016

In June, the Advisory Committee on Immunization Practices at the Centers for Disease Control and Prevention said health care providers should not use the live attenuated influenza vaccine (LAIV) for the upcoming influenza season. LAIV, given by intranasal spray, was shown to be ineffective over the last three flu seasons.
But in August, a study in Annals of Internal Medicine found that the LAIV vaccine had been effective. Dennis Cunningham, MD, medical director of the Department of Epidemiology and Infection Control at Nationwide Children’s Hospital and an infectious disease specialist, answers some key questions raised in the last few months.
The findings from the CDC and the more recent study seem to be in conflict. What should I do in my practice?
In short, follow the CDC recommendation, which is supported by the American Academy of Pediatrics. Last season’s data shows LAIV effectiveness in ages 2-17 years old was an estimated 3 percent – meaning no protectiveness could be measured in children. The inactivated influenza vaccine injection, however, was found to have an effectiveness of approximately 63 percent in the same age group. Data from 2013-2014 and 2014-2015 also showed lower than expected effectiveness for LAIV.
The CDC continues to recommend an annual influenza vaccination for everyone 6 months of age and older. For children this season, that vaccination should be the inactivated influenza injection, not LAIV. While the CDC does not recommend LAIV this year, the recommendation may very well change for future influenza seasons.
What should I tell parents who saw media reports contradicting the CDC recommendation?
Those media reports were spurred by the August study. The study was based on a relatively small population of Canadian children who used a different version of LAIV from the one available in the United States, and the study does not include results from the most recent influenza season.
For those reasons, that study is not directly applicable to the situation in the United States.
How is Nationwide Children’s handling the flu vaccine?
Nationwide Children’s will offer the inactivated influenza injection. Like other providers, we have notified the manufacturer that we are not ordering LAIV this year.
How can we calm parents and patients nervous about another shot?
It’s true that many families are used to the nasal mist at this point, and may feel trepidation about an injection. Nationwide Children’s has a number of recommended “comfort holds” and distraction techniques that may make the process easier for provider and patient alike.

For more information and patient resources regarding the flu, visit

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Nationwide Children's Hospital
700 Children's Drive Columbus, Ohio 43205 614.722.2000