Intranasal Influenza Vaccine

The Australian Technical Advisory Group on Immunisation (ATAGI) has released its clinical advice for influenza vaccination in 2026. Annual vaccination continues to be recommended for all people six months of age and older. A notable change this year is the introduction of a needle-free option.

FluMist® is a live attenuated influenza vaccine (LAIV) that is administered intranasally. It is indicated for use in children and adolescents between 2 and 17 years of age. Each pre-filled nasal applicator delivers two sprays, with one spray administered to each nostril. Children up to 8 years of age who have not previously been vaccinated against seasonal influenza are recommended to receive an additional dose four weeks later.

While this is the first year that an intranasal influenza vaccine has been available in Australia, they have been safely used in other countries since 2003. A recent meta-analysis found intranasal influenza vaccines to be comparable to injectable influenza vaccines for both safety and effectiveness.

On-going surveillance has not identified any cases of intranasal LAIVs causing influenza in vaccine recipients. However, FluMist® is contraindicated in moderate and severe immunodeficiency and children receiving salicylate therapy (due to the association of Reye’s syndrome with salicylates and wild-type influenza infection). The National Centre for Immunisation Research and Surveillance (NCIRS) recommends against administration to children with a runny or blocked nose as absorption may be affected. In these cases, vaccination may be deferred or an age‑appropriate injectable influenza vaccine considered.

FluMist® is available by private prescription and is also state funded for specific age groups in Queensland, New South Wales, South Australia, and Western Australia.