FluMist v. COVID-19
October 11, 2020 7:38 PM   Subscribe

Virologist Robert Gallo recommends getting the live, attenuated nasal spray flu vaccine (FluMist) if you have the option, on the theory that the live virus will prep your immune system to mount a more effective response to the coronavirus (or anything else) in the months ahead. This article came a bit late for me, as I already received a flu shot from my GP in early September. YANMD, but should I seek out the nasal spray version as well? It couldn't hurt, right? Or could it?

I’m a 48 year old cis-male with no pre-existing conditions to disqualify me from taking FluMist. But having already been vaccinated against this year’s influenza, would I be likely to see any benefit? If so, the $30 seems like money well spent to buff my saving throw against the ‘rona.

(We’ve discussed the benefits of the BGC tuberculosis vaccine as a Covid prophylactic, but the counter-arguments in that Ask don’t seem to apply here.)
posted by mumkin to Health & Fitness (9 answers total) 2 users marked this as a favorite
If I'm understanding that article correctly, other live vaccines would potentially have a similar effect. Have you had a second MMR vaccine? That seems to be a live vaccine, and there have occasionally been outbreaks of measles with the rise of the antivax movement so it's a useful one.

Current advice is that you need two doses but they didn't start giving a second dose routinely during childhood until some time in the 90s. (I had to get a second one in middle school when rules changed, and I'm 37.)
posted by needs more cowbell at 8:06 PM on October 11, 2020

That article is full of weasel words and it wouldn’t have made it past me when I was editing health content, unless a lot of actual information was omitted. There’s one enthusiastic expert saying “just wait and see! This might work!” and some vaguely related information that:

- live vaccines may confer other benefits, like a heightened immune defence
- scientists are looking into whether a widely used TB vaccine might help with Covid
- this one guy says there’s a hypothesis about a live flu vaccine helping

Like, there’s no there there in this article. It seems like a huge leap to me to draw that line.
posted by warriorqueen at 8:41 PM on October 11, 2020 [8 favorites]

The TWIV people did an episode on the possibility that the oral polio vaccine might provide some protection against SARS-CoV-2. There have been no studies on protection against SARS-CoV-2 so it's just speculation. Also, you can't get the oral polio vaccine in the United States. To be clear I am very much not a scientist and I cannot judge what makes biological sense. The virologists on TWIV treated this like an interesting hypothesis and nothing more.
posted by rdr at 3:53 AM on October 12, 2020

This is a question for a doctor, not the internet. But also, as I remember last year, there were shortages of the flu vaccine in some areas AND I've heard predictions that there will be more shortages this year as more people get vaccinated hoping to get some protection against COVID. Don't be that guy that takes two doses and your neighbor gets none.
posted by peanut_mcgillicuty at 5:47 AM on October 12, 2020 [3 favorites]

Also: one year a friend had to get two flu shots because their employer lost the documentation for the first one, and having one is required for their job. The second one caused much more activation of their immune system; it was not pleasant.
posted by Ms Vegetable at 6:08 AM on October 12, 2020 [1 favorite]

Your insurance may not pay for a 2nd vax. As far as the science, what's your level of risk? If you are at higher risk, talk to your doc about getting the 2nd flu vax.
posted by theora55 at 6:40 AM on October 12, 2020

I don't know if it could hurt or not - that is definitely a question for your doctor or pharmacist. But the three times I've gotten the FluMist vaccine I've had a reaction severe enough that I had to take several days off work. It was like getting a mini-version of the flu. I've never had that reaction to any other flu vaccine.
posted by ilovewinter at 7:26 AM on October 12, 2020

This effect, the induction of trained immunity that leads to temporary cross-protection, is a real one. I would guess that FluMist might indeed trigger it the way that BCG and oral polio do. Whether it protects against Covid-19 is not clear.

I think the quality of the evidence is sufficient that *if* you are getting a flu vaccine and have a choice, you should get FluMist since that is a perfectly good flu vaccine that *may* also have this additional benefit so why not?

I also think that having been vaccinated against this year's strain[s] already and given your risk profile it is probably not worth getting re-vaccinated. You may also wish to consider that there are not infinite doses available for the world's population.
posted by atrazine at 7:29 AM on October 12, 2020

Best answer: Epidemiologist here. The short answer is, unfortunately, no, you shouldn't do this. Since the antigens are essentially the same across all forms of the vaccine in a given flu season, you'd be running the quite small but nevertheless real possibility of encouraging your body to mount too great of an immune response to your second dose of vaccine to be able to effectively mount a response to a new challenge from something like COVID-19 (or anything else you might encounter). And, look, I'm really reaching here for this word of caution. Some nonzero number of people probably do this accidentally every year, and we haven't seen a crises unfold. It's worth having a frank discussion with your doctor if you do go forward with the idea because, specifically, you're at the upper end of the age range for which FluMist is recommended and we out here on the internet don't know the vagaries of your medical record. Your doctor does and could handily let you know if they see any reason to advise you against this (it's not all down to just what contraindications make it into the product's package insert).

Another option to consider, though: are there any other live viral vaccines that you're eligible for? Are you up to date with your MMR? If you've never had chickenpox, have you had a varicella vaccine? May be another question to pose to your doctor. I guarantee you, almost all doctors on earth right now are receptive to discussion of steps they can take to reduce patients' risks during this pandemic. THis is the kind of drug seeking behavior that doctors are probably excited about. I mean, can you imagine a world in which people are asking for EXTRA VACCINATIONS? Up is down, day is night.
posted by late afternoon dreaming hotel at 11:31 AM on October 12, 2020 [11 favorites]

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