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FDA just greenlighted an at-home flu vaccine. What the approval of a self-administered spray means for you.

You can now vaccinate yourself — or your children — against the flu with a nasal spray. On Sept. 20, the Food and Drug Administration approved the first-ever vaccine that adults can give themselves or caregivers can administer to others. The same nasal spray, FluMist, has been approved since 2003 but previously had to be administered by a pharmacist or other health care provider.

Read on for what you need to know about the new nasal spray flu vaccine.

The nasal spray vaccine has been around for two decades and was initially approved for pharmacists or health care providers to give to people ages 5 to 49. In 2007, the approval was expanded to include children as young as 2 years old. FluMist comes in a single-dose sprayer, and half of the dose is sprayed into each nostril.

Aside from being given as a nasal spray rather than as an injection, FluMist also differs from the flu shot in that it contains what’s known as live-attenuated flu virus. That means it contains a version of the virus that has been weakened but not killed. By contrast, flu shots contain an inactivated or dead form of the virus. However, the nasal spray vaccine won’t cause influenza illness. According to the FluMist package insert, the flu spray is about as effective as the shot: 45%, compared to between 40% and 60% for the injection.

A self-administered version of the flu vaccine has been in the works for a long time. But you’ll have to wait a little longer before you can order yours. The FDA says that it should be broadly available for next flu season (beginning in 2025). However, for those who prefer a nasal spray vaccine for themselves or their children, it’s already available at many pharmacies and doctor’s offices; it just can’t be taken at home. Instead, a pharmacist or health care provider will administer the vaccine.

Yahoo Life reached out to FluMist’s manufacturer, AstraZeneca, to ask when the product might be available for at-home use but had not received a response at the time of publication. But the most likely reason FluMist is not yet available is that data on how effectively people are able to vaccinate themselves and their children needs to be collected, Dr. Davey Smith, chief of infectious diseases and global public health at the University of California, San Diego, tells Yahoo Life.

FluMist is approved for anyone between ages 2 and 49. “I’m really hoping that we can get more people vaccinated [with FluMist approved for home use], including children and people who have needle aversions,” says Smith. “There are all sorts of impediments in our health care system anyway, so hopefully this is one less.”

But you’ll need to meet the eligibility requirements. Neither the FDA, FluMist, nor AstraZeneca has said outright what these criteria are. But Smith says the questionnaire will most likely ask people’s ages to make sure they are not under 2 or over 49, or taking any medications that might not mix well with the vaccine. For example, people between ages 2 and 17 who are taking aspirin shouldn’t take FluMist or other live-attenuated vaccines because the combination has been linked to greater risks of a rare but serious condition called Reye’s syndrome. Pregnant women also should not take the nasal vaccine since it may pose risks to the fetus. However, it’s important to note that the injected flu shot is safe and recommended for pregnant women.

The FDA also says that people with weakened immune systems and certain allergies should not take FluMist and other live-attenuated virus vaccines. It’s not approved for use in people age 50 and older either. Smith explains why: An injected flu vaccine activates an immune response throughout the body, but FluMist is more localized. Because the immune system declines with age, FluMist may not trigger an equally strong response to the shot in older people.

Yes, say experts. The weakened but living virus in the nasal spray is “cold-temperature-adapted, so it reproduces itself in the nose, which is cooler than the core body temperature,” Dr. Paul Offit, director of the Children’s Hospital of Philadelphia’s Vaccine Education Center, tells Yahoo Life. “But it doesn’t reproduce itself in the lungs,” where it would cause infection.

FluMist’s side effects are similar to those associated with the shot: a runny nose and nasal congestion, fever in kids ages 2 to 6 and sore throat for adults, according to the FDA.

The process is not very different from using the allergy nasal spray Flonase, Smith says, and involves inserting the flu nasal spray into the nostril, pushing the plunger to administer the vaccine and then repeating in the other nostril. Smith says he has no concerns about people being able to give the flu nasal spray to themselves or their children. “People use Flonase and have forever … this is going to be pretty easy, that’s the whole point,” he says. In AstraZeneca’s trial, 100% of adults were able to administer a full dose to themselves.

The ease of giving the nasal spray vaccine is good news for both kids and needle-nervous people, as well as for public health, says Offit. The availability of FluMist for use at home “should make it more likely that people will get the flu vaccine,” he says. “There is no reason one shouldn’t be able to administer this vaccine intranasally without help of a health care person, and I think this will only have the effect of increasing vaccine rates.”

However, Offit says he hopes to see more data on how effectively parents and caregivers administer the spray to their children. Still, “I think this will only have the effect of improving vaccination rates,” which have been declining since the COVID-19 pandemic began, dropping to 50% as of last year.

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