November 19th, 2009
12:33 PM ET

Nasal vaccine for 14-month-old?

As a feature of CNNhealth.com, our team of expert doctors will answer readers' questions. Here's a question for Dr. Gupta.

From Elaine in New Jersey:

I attended a clinic this weekend for the H1N1 shots, and they administered the nasal spray to my 14-month-old! According to the CDC website it should NOT be administered to children under 2 years of age! I contacted the pharmacy where the clinic was held, and they took my contact info and said we will get back to me. Can you tell me is my child at risk?? I also have a call into my pediatrician. I also contact the CDC and was told they are not medical professionals.


Elaine, it is easy to sense dismay and concern from your e-mail, and as a father I can certainly relate.

The reality is – yes – the nasal spray version of the H1N1 vaccine, which contains a weakened live flu virus, should be given only to people ages 2 to 49. We also know that children with conditions such as asthma may not be eligible for the live flu vaccine.

In order to ease your mind a bit, unless he or she has asthma, chances are very good that your 14-month-old will be fine.

The primary reason children younger than 2 do not get the nasal spray H1N1 vaccine is that it has not been tested in, and therefore is not licensed for, that age group. It is that simple. You need solid data to submit to the Food and Drug Administration before a medication can be approved for use in a particular population – that data do not exist for children younger than 24 months.

To ease your mind a bit more, rare complaints among adults and children taking the nasal spray form of the H1N1 vaccine are runny nose, sore throat, and sometimes fever. These symptoms usually go away within a couple of days. If they do crop up for your 14-month-old, you should not be too concerned, but if the symptoms get worse or your instinct tells you to, do see your pediatrician.

On the bright side of your predicament, your son or daughter is now vaccinated against H1N1. There are many parents who are still waiting to have their children vaccinated, so count yourself among the fortunate. Your child should soon have a second H1N1 vaccine dose – this time with the injectable form of the vaccine. And if you have not yet been vaccinated, you should do so – as the caregiver for your baby, you are eligible for these early doses of vaccine.

soundoff (4 Responses)
  1. Dr. Harris Meyer

    As a San Francisco chiropractor, I am always urging my community to play an active role in protecting their health and to take actions that will boost their own immunity. Perhaps the most dangerous thing about all flu vaccines is that people give all responsibility for protecting themselves to the vaccine itself. Dangerous, and irresponsible. But I acknowledge that you haven't been told this before and so I would never "blame' you. It would be worth looking closely at what tets are actually done and how valid their findings are.
    I urge you, become an advocate for yourself and begin researching all the chemicals (medicines, anyway) you consider putting into your body or that of your children.

    March 15, 2010 at 04:53 | Report abuse | Reply
  2. tia

    I guess the important thing we can take away from this is that as parents and even as patients, before we seek a treatment we should try to do some preliminary homework on it. I really hope your baby has been fine through this!

    June 3, 2010 at 16:20 | Report abuse | Reply
  3. Miranda

    Flu vaccines sulauly do contain thimerosal; they are basically the only vaccines that still do. From the CDC website: "Today, all routinely recommended licensed pediatric vaccines that are currently being manufactured for the U.S. market, with the exception of influenza vaccine, contain no thimerosal or only trace amounts."Some flu vaccines are thimerosal-free, and it seems that thimerosal-free (or trace thimerosal) vaccines are becoming more and more common – but I wouldn't assume the new H1N1 vaccines would be thimerosal-free.I think vaccinating in schools for something like this is a good idea: since flu is so seasonal, and most people go to the doctor only once a year, if your checkup happens to be at the wrong time of year you can miss the window for getting the vaccine. I would bet many children miss flu vaccines for this reason – how many parents are going to feel it's worthwhile to do a whole trip to the doctor just for a flu shot?

    March 3, 2012 at 21:35 | Report abuse | Reply
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Get a behind-the-scenes look at the latest stories from CNN Chief Medical Correspondent, Dr. Sanjay Gupta, Senior Medical Correspondent Elizabeth Cohen and the CNN Medical Unit producers. They'll share news and views on health and medical trends - info that will help you take better care of yourself and the people you love.