Ontario to offer nasal flu vaccine for kids, despite study showing 'no protective benefit'

Parents say skipping the needle helps get their kids vaccinated. The province says it’s just as effective as a flu shot. The U.S. Centers for Disease Control and Prevention says it doesn’t work at all.

Doctors warn against making hasty changes to Canadian vaccine offerings based on U.S. data

Nasal spray vaccinations spare kids the pain of getting a needle, but are they as effective as the traditional flu shot? (Jaela Bernstien/CBC)

Ontario will continue to offer the nasal spray flu vaccine for children, despite a report from the U.S. Centers for Disease Control and Prevention (CDC) arguing that the spray offered "no protective benefit" based on data from the last three flu seasons.

The nasal spray, sometimes called the flu mist, was introduced in Ontario last year for children aged two to 17 as a needle-free alternative to the traditional flu shot.

After finding that the nasal spray's effectiveness clocked in at just three per cent in the 2015-2016 flu season — compared to 63 per cent for the traditional flu shot — the CDC's Advisory Committee on Immunization Practices voted that the spray should not be used this year in the United States.

But Ontario Health Minister Eric Hoskins said the province will continue to offer it, pointing to a study by the Canadian Institutes for Health Research that found flu mist "as effective as the injectable version."

"They have found a different result in the U.S., and we respect that, but we look to the National Advisory Committee on Immunization and the federal government, and their recommendation ... is that flu mist continue to be an option for vaccination for children," said Hoskins.

Explaining the CDC's data 

Dr. Samira Mubareka said she was "surprised" to see the CDC's report, but that Canadian health authorities shouldn't be overly influenced by their data. (CBC)

Ontario's Chief Medical Officer of Health, Dr. David Williams, said it's difficult to rely on data from a specific flu season since the strains of flu that are present change every year.

"Effectiveness in the community is difficult to measure in any one flu season, or even two or three flu seasons," he said.  

Dr. Samira Mubareka, an infectious diseases physician at the Sunnybrook Health Sciences Centre, agrees with Williams, adding that effectiveness levels measured in the U.S. may not hold true for Canada.

"There are significant differences on a number of levels between Canada and the U.S., whether we're talking about systemic differences — how vaccines are delivered and rolled out — or in our population in general and our geographic distribution," she said.

Mubareka warned against making hasty changes to Canada's recommendations based on the CDC's findings.

"We wouldn't want to base those changes on data from a different population from just a single year."

Spray no longer 'preferential'

Though the National Advisory Committee on Immunization (NACI) maintains that the two vaccine options offer comparable protection from the flu, they have taken steps this year to dial down the strength of their recommendation for the nasal spray.

NACI wrote in a report on the coming flu season that "the current evidence does not support a recommendation for the preferential use of [nasal mist] in children and adolescents 2-17 years of age."

In 2011, NACI had said that the mist was preferential to the shot for children.

This year's report also said that more research is needed to "fill knowledge gaps" around the effectiveness of the spray.

Nasal spray a help to parents

Shirley Moore's children found needles "stressful" and she says it's much easier to convince them to sit still for a nasal spray vaccination. (CBC)

The nasal spray vaccination can be a boon to parents whose kids are afraid of needles.

Toronto parent Shirley Moore said her six-year-old twins both received the nasal spray last year.

"Last year they didn't get sick, so that was good for us, and it went so much more smoothly than it would have the year before when they got the needle," she said.

Despite the CDC study, Moore said she's considering signing her children up for the spray vaccination again.

"There have been Canadian studies that say differently than the CDC study, and that makes me feel better, and it makes me think, ok, I'll wait and see."

Williams said his priority is increasing the number of children being vaccinated in Ontario.

"Both[types of vaccination]are safe, both are equally effective in my mind. Getting one or the other is better than getting nothing," he said.