Influenza nasal spray vaccination

For anyone who dreads needles — and for parents of children who turn flu-shot day into a battle — a needle-free flu vaccine sounds almost too good to be true. The influenza nasal spray vaccine is exactly that: protection against the flu delivered as a quick spray up the nose instead of an injection. It’s a newer option in Australia, and where pharmacies offer it, it can make staying protected against influenza far less stressful for the needle-averse.

What is the nasal spray flu vaccine?

It’s a vaccine that protects against influenza but, unlike the standard flu shot, is given as a fine spray into each nostril. The key difference is in how it’s made: the nasal spray is a live attenuated influenza vaccine, meaning it contains weakened flu viruses that can’t cause the flu but prompt your immune system to build protection — including a strong defence at the lining of the nose, which is where flu first takes hold. The familiar injected vaccine, by contrast, is inactivated (it contains no live virus).

Both protect against influenza; the nasal spray simply offers a needle-free route. Like all flu vaccines, it’s updated each year to match the strains expected to circulate, so it’s a yearly vaccination.

Who is it for?

The nasal spray is registered for a specific age range — it’s designed for children and younger people rather than older adults, and there’s a minimum age below which it isn’t used. Its biggest appeal is for needle-phobic children and adults within the eligible age group, for whom the alternative might be no vaccination at all. Because eligibility and the exact age limits are set by the product registration and immunisation rules, your pharmacist will confirm whether it suits you or your child.

Importantly, because it contains live (weakened) virus, the nasal spray is not suitable for everyone. It’s generally avoided in people with a significantly weakened immune system, in pregnancy, in young children with certain wheezing or severe asthma histories, and in some other specific situations. People in these groups — and anyone the nasal spray doesn’t suit — can have the standard inactivated flu shot instead, which the pharmacist can usually provide. There can also be timing considerations around certain antiviral medicines. The pre-vaccination check exists precisely to sort this out.

The pharmacist will ask about age, health conditions, immune status, asthma and wheezing history, pregnancy, allergies, recent illness and medicines before giving it.

How it works at the pharmacy

It’s quick. After a pre-vaccination screening to confirm it’s suitable, the pharmacist administers the vaccine as a spray into each nostril — there’s no need to actively sniff, and it works even if you sneeze or your nose is a little runny. You don’t need to be unwell to have it, though a heavily blocked nose might be a reason to wait. As with any vaccination, you’ll be asked to wait a short time afterwards so the pharmacist can make sure you’re well before you leave, and the dose is recorded on the Australian Immunisation Register.

Side effects are usually mild — a runny or blocked nose, a mild headache, or a sore throat for a day or two. The nasal spray flu vaccine is generally a private (paid) service rather than a free National Immunisation Program vaccine, so the pharmacist will explain the cost, and whether the funded injected vaccine might be an option for you. Because it’s a newer and more specialised offering, phone ahead to check the pharmacy stocks it and can give it to your age group.

Safety and practical notes

• It cannot give you the flu — the virus in it is weakened and can’t cause influenza.
• It’s not for everyone: tell the pharmacist about immune conditions, pregnancy, and any asthma or wheezing, so they can confirm it’s safe or offer the injected vaccine instead.
• It’s a yearly vaccine — last year’s flu shot won’t protect you this season.
• Seek medical advice if you feel unwell after vaccination beyond the expected mild effects, and urgent care for any rare signs of a serious allergic reaction.

How it’s regulated in Australia

All flu vaccines available in Australia are approved by the Therapeutic Goods Administration, and recommendations on their use come from the Australian Immunisation Handbook and ATAGI. Pharmacist immunisers administer vaccines under state and territory rules, which set the ages a pharmacist can vaccinate, and record doses on the Australian Immunisation Register. Pharmacists complete accredited immunisation training and are registered with the Pharmacy Board of Australia. Availability of the nasal spray specifically varies by pharmacy and state.

Official sources

• Healthdirect: flu (influenza)
• Australian Immunisation Handbook: influenza
• Department of Health: influenza (flu)

Phone ahead to confirm the nasal spray is stocked and suitable for your age group. Use the button below to find a pharmacy listing a nasal spray flu vaccination service near you.