Nav: Home

New findings on flu nasal spray

August 15, 2016

1. Flu nasal spray offers similar protection against flu compared to standard flu shot

Findings differ from those that prompted ACIP to recommend that the nasal spray not be used during the upcoming flu season

URL goes live when the embargo lifts

A study conducted in the Hutterite community found that immunizing children with the live attenuated influenza vaccine, the kind found in the flu nasal spray, did not provide better direct or community protection against influenza than the inactivated influenza vaccine, or standard flu shot. The protection, however, was similar in both groups. The findings are published in Annals of Internal Medicine.

Influenza, or flu, is a major cause of morbidity and mortality. Vaccinating children against flu can both protect them individually and also protect the community from becoming infected, which is known as herd immunity. Earlier studies conducted in young children suggested that the nasal spray vaccine provided better direct protection against flu than the standard shot, which would suggest better heard immunity as well. However, most comparative flu vaccine studies assess direct protection only.

Researchers conducted a cluster randomized trial in a Hutterite colony where people live communally and are relatively isolated from cities and towns to determine whether vaccinating children and adolescents with the flu nasal spray provided better direct and community protection than the standard flu shot. The authors randomly assigned 1,186 children in 52 Hutterite colonies in Alberta and Saskatchewan, Canada to receive the nasal spray vaccine and 3,425 children to receive the standard flu shot. They found that the nasal spray vaccine was very similar to the standard flu shot in providing direct protection to children and also in creating herd immunity.

According to the study lead author, Mark Loeb, MD of McMaster University, while these findings did not show superiority of the live vaccine, rather that both vaccines had a similar effect, they differ from recent observational studies showing that the nasal spray vaccine was ineffective, which had prompted the Centers for Disease Control Advisory Committee on Immunization Practices (ACIP) to recommend that the nasal spray not be used during the 2016-2017 flu season.

Note: For an embargoed PDF, please contact Cara Graeff. To reach the lead author, Dr. Mark Loeb, please contact Veronica McGuire at or (905) 525-9140, ext. 22169.

2. Strong evidence lacking to compare management strategies for renal artery stenosis

URL goes live when the embargo lifts

Researchers found a lack of strong evidence to compare the benefits and harms of revascularization using percutaneous transluminal renal angioplasty with stent placement (PTRAS) versus medical therapy alone for atherosclerotic renal artery stenosis (ARAS). The report is published in Annals of Internal Medicine.

ARAS is a narrowing of arteries that carry blood to one or both of the kidneys. It is more prevalent in older people and can lead to hypertension and kidney damage. Treatment options for ARAS include medical therapy - aggressive blood pressure control, statins, and antiplatelets - or renal artery revascularization with continued medical therapy. PTRAS is the current standard for revascularization. A 2007 systematic review of management strategies for ARAS concluded that evidence did not support one treatment approach over another. Since then, two large trials have been conducted. Given the inconclusive prior review and the availability of new evidence, investigators sought to reevaluate the comparative benefits and harms of strategies for management of patients with ARAS and to identify factors that may predict which patients are most likely to benefit from each intervention.

The researchers reviewed 83 published studies to compare the benefits and harms of PTRAS versus medical therapy alone for ARAS. Overall, the evidence did not support a benefit with PTRAS over medical therapy alone in most patients with ARAS. Observational studies did suggest that some high risk patients may have improved outcomes with PTRA and anecdotal evidence suggest that some patients with acute decompensation due to ARAS benefit clinically from revascularization. A reanalysis of available research or more targeted studies may be needed to determine the comparative effectiveness of the two interventions.

Note: For an embargoed PDF, please contact Cara Graeff. The lead author, Dr. Ethan Balk, can be reached through David Orenstein at or 401-863-1862.
Also in this issue:

Getting to Lower Systolic Blood Pressure: Beyond Antihypertensive Therapy

Nadia A. Khan, MD, MSc
Ideas and Opinions

Chlorthalidone Versus Hydrochlorothiazide: A New Kind of Veterans Affairs Cooperative Study
Frank A. Lederle, MD; William C. Cushman, MD; Ryan E. Ferguson, ScD, MPH; Mary T. Brophy, MD, MPH; Lois D. Fiore, MD, MPH
Ideas and Opinions

American College of Physicians

Related Influenza Articles:

Birds become immune to influenza
An influenza infection in birds gives a good protection against other subtypes of the virus, like a natural vaccination, according to a new study.
Researchers shed new light on influenza detection
Notre Dame Researchers have discovered a way to make influenza visible to the naked eye, by engineering dye molecules to target a specific enzyme of the virus.
Maternal vaccination again influenza associated with protection for infants
How long does the protection from a mother's immunization against influenza during pregnancy last for infants after they are born?
Influenza in the tropics shows variable seasonality
Whilst countries in the tropics and subtropics exhibit diverse patterns of seasonal flu activity, they can be grouped into eight geographical zones to optimise vaccine formulation and delivery timing, according to a study published April 27, 2016 in the open-access journal PLOS ONE.
Influenza viruses can hide from the immune system
Influenza is able to mask itself, so that the virus is not initially detected by our immune system.
Using 'big data' to combat influenza
Team of scientists from the Icahn School of Medicine at Mount Sinai and Sanford Burnham Prebys Medical Discovery Institute among those who combined large genomic and proteomic datasets to identify novel host targets to treat flu.
Rapidly assessing the next influenza pandemic
Influenza pandemics are potentially the most serious natural catastrophes that affect the human population.
Early detection of highly pathogenic influenza viruses
Lack of appropriate drugs and vaccines during the influenza A virus pandemic in 2009, the recent Ebola epidemic in West Africa, as well as the ongoing Middle Eastern Respiratory Syndrome-Coronavirus outbreak demonstrates that the world is only insufficiently prepared for global attacks of emerging infectious diseases and that the handling of such threats remains a great challenge.
Study maps travel of H7 influenza genes
In a new bioinformatics analysis of the H7N9 influenza virus that has recently infected humans in China, researchers trace the separate phylogenetic histories of the virus's genes, giving a frightening new picture of viruses where the genes are traveling independently in the environment, across large geographic distances and between species, to form 'a new constellation of genes -- a new disease, based not only on H7, but other strains of influenza.'
Influenza A potentiates pneumococcal co-infection: New details emerge
Influenza infection can enhance the ability of the bacterium Streptococcus pneumoniae to cause ear and throat infections, according to research published ahead of print in the journal Infection and Immunity.

Related Influenza Reading:

Best Science Podcasts 2019

We have hand picked the best science podcasts for 2019. Sit back and enjoy new science podcasts updated daily from your favorite science news services and scientists.
Now Playing: TED Radio Hour

Moving Forward
When the life you've built slips out of your grasp, you're often told it's best to move on. But is that true? Instead of forgetting the past, TED speakers describe how we can move forward with it. Guests include writers Nora McInerny and Suleika Jaouad, and human rights advocate Lindy Lou Isonhood.
Now Playing: Science for the People

#527 Honey I CRISPR'd the Kids
This week we're coming to you from Awesome Con in Washington, D.C. There, host Bethany Brookshire led a panel of three amazing guests to talk about the promise and perils of CRISPR, and what happens now that CRISPR babies have (maybe?) been born. Featuring science writer Tina Saey, molecular biologist Anne Simon, and bioethicist Alan Regenberg. A Nobel Prize winner argues banning CRISPR babies won’t work Geneticists push for a 5-year global ban on gene-edited babies A CRISPR spin-off causes unintended typos in DNA News of the first gene-edited babies ignited a firestorm The researcher who created CRISPR twins defends...