FluMist (LAIV, AstraZeneca) is currently approved by FDA only for healthy non-pregnant people age 2 through 49 years. Beginning in the 2025–26 season, FluMist is approved for home use, to be administered to oneself (if age 18 or older) or by a caregiver to a child (if age 2 through 17 years). Home use does not require a visit to a healthcare provider. Details about the new home-use program, including self-screening, online ordering, and home administration are available from www.flumist.com.
Last reviewed:
September 3, 2025
No. Giving FluMist (LAIV) is not considered an aerosol-generating procedure.
Last reviewed:
September 3, 2025
The vaccine dose (0.2 mL) comes inside a special sprayer device. A plastic clip on the plunger divides the dose into two equal parts. The recipient is seated in an upright position with head tilted back. Half of the contents of the sprayer (0.1 mL) is sprayed into each nostril.
Immunize.org offers a 1-page clinic resource demonstrating how to administer intramuscular or intranasal influenza vaccines: www.immunize.org/wp-content/uploads/catg.d/p2024.pdf.
Last reviewed:
September 3, 2025
Yes, unless clinical judgment suggests nasal congestion is present that might keep the vaccine from making good contact with the nasopharyngeal mucosa. In that case, consider either deferring its use until the congestion resolves or using an appropriate alternative influenza vaccine, if available.
Last reviewed:
September 3, 2025
Yes. Breastfeeding is not a contraindication for any routine vaccination including FluMist (LAIV).
Last reviewed:
September 3, 2025
With rare exceptions, yes. Like other live vaccines, FluMist (LAIV) should not be administered to immunosuppressed people. ACIP has stated a preference for using injectable influenza vaccine for all close contacts of severely immunosuppressed individuals during those periods in which the immunosuppressed person requires care in a protective environment because of the theoretical risk that the live attenuated vaccine virus could be transmitted to the severely immunosuppressed individual and cause disease. Healthcare personnel or other people who have close contact with people with lesser degrees of immunosuppression (people who do not require a protective environment such as reverse isolation in a hospital setting) who are otherwise eligible for FluMist may receive it. No special precautions need to be taken by the vaccinated person.
Last reviewed:
September 3, 2025
People should avoid contact with any person who is severely immunosuppressed for at least 7 days after receiving FluMist (LAIV). There are no restrictions on being in contact with any other patients.
Last reviewed:
September 3, 2025
Asthma is a precaution, not a contraindication, for FluMist (LAIV) in people 5 years of age and older. FluMist is contraindicated for children 2 through 4 years old who have had a diagnosis of asthma or whose parents or caregivers report that a health care provider has told them during the preceding 12 months that their child had wheezing or asthma or whose medical record indicates a wheezing episode has occurred during the preceding 12 months.
Last reviewed:
September 3, 2025
An antiviral drug active against influenza virus may reduce the effectiveness of FluMist by interfering with the vaccine viruses’ ability to replicate in the upper airway in order to produce protective immunity. To prevent interference, ACIP has recommended different intervals between the last dose of an antiviral medication and FluMist administration, based upon the half-life of the antiviral medication. The recommendations are as follows:
- Oseltamivir or zanamivir: wait at least 48 hours after the last dose before administering FluMist
- Peramivir: wait at least 5 days before administering FluMist
- Baloxavir: wait at least 17 days before administering FluMist
If any influenza antiviral medication must be given within 14 days after FluMist administration, the patient should be revaccinated without delay with any age-appropriate injectable influenza vaccine. Inactivated influenza vaccines (IIVs) and recombinant influenza vaccine (RIV) may be administered at any time relative to antiviral medication.
Last reviewed:
September 3, 2025
A half dose of FluMist (or any other vaccine) is a non-standard dose and generally should not be counted. If you were unable to give the second half of the vaccine on the same day, you will have to provide another full dose of influenza vaccine at another time. If you want to give FluMist again, you should wait four weeks because it is a live vaccine. Alternatively, you can give an injectable influenza vaccine any time after this partial dose.
Last reviewed:
September 3, 2025
