Pneumococcal Vaccine: What You Need to Know

You Can Soon Give Yourself A Flu Nasal Spray Vaccine At Home

Key Takeaways

The FDA has approved FluMist, a nasal spray flu vaccine, for self-administration.

Healthy individuals aged 2 to 49 can use FluMist, but people with specific medical conditions or health concerns should consult a healthcare provider before use.

The effectiveness of FluMist is similar to the traditional flu shot and protects against severe flu complications.

The Food and Drug Administration (FDA) has approved the first-ever influenza vaccine that can be administered at home. It's a nasal spray vaccine called FluMist, and it's been available in doctor's offices and pharmacies for years.

The approval "provides a new option for receiving a safe and effective seasonal influenza vaccine potentially with greater convenience, flexibility, and accessibility for individuals and families," said Peter Marks, MD, PhD, director of the FDA's Center for Biologics Evaluation and Research.

Here's what you need to know about administering FluMist at home.

What Is FluMist and Who Can Use It?? FluMist is a live attenuated flu vaccine. Meaning, it uses a weakened version of the flu to encourage your body to mount an immune response. The flu shot does not use a live version of the influenza virus. FluMist is approved for use in healthy people between the ages of 2 to 49. Aside from age, people who should not get the FluMist vaccine include: People with a history of severe allergic reactions to any ingredient of the vaccine (except for egg protein) or to a previous dose of any flu vaccine. People who have ever had a severe allergic reaction to influenza vaccinations. Children aged 2 through 17 who are receiving aspirin- or salicylate-containing medications. People in certain categories or parents of children or teens with any of the following conditions should check with their healthcare provider about whether it's safe to get FluMist: Children under age 5 who have asthma or who have had a history of wheezing in the past 12 months. People who are currently wheezing People who have asthma People who have had Guillain-Barré syndrome People who have a weakened immune system or live with someone who has a severely weakened immune system People who have problems with their heart, kidneys, or lungs People who have diabetes People who are pregnant or nursing People who have taking antiviral drugs for the treatment of influenza How Effective Is FluMist Compared to a Flu Shot?  The effectiveness of FluMist has varied over time. Previous research found that the vaccine was not as effective as the flu shot against the 2009 pandemic H1N1 viruses, leading federal health officials to recommend against using FluMist for the 2016–2017 and 2017–2018 seasons. But the nasal spray vaccine has since been updated with new influenza A(H1N1) vaccine virus ingredients, giving it similar protection as the flu shot. "The efficacy is considered to be comparable," said Amesh A. Adalja, MD, an infectious disease expert and senior scholar at the Johns Hopkins Center for Health Security. As a result, it's been recommended for use to prevent the flu and protect against serious complications of influenza since the 2018-2019 flu season. As for how effective FluMist is, it's lumped in with data for the flu shot from the Centers for Disease Control and Prevention (CDC). Based on that data, the flu vaccines were 42% effective at preventing the flu during the 2023-2024 season and 30% effective during the 2022-2023 season. It's important to note that these numbers only reflect how many people actually got the flu who were vaccinated against it, said John Sellick, DO, an infectious disease expert and professor of medicine at the University at Buffalo. The vaccine is still "highly protective" against severe complications of the flu, he added. How Do You Administer FluMist at Home? FluMist is given with a spray in each nostril. "The process is not too complicated," Sellick said. The sprayer comes with a dose divider to let users know how much to give in each nostril. To use it, spray half of the contents in one nostril and then the other half in the other nostril. What Are the Risks of FluMist? The FluMist vaccine comes with several potential side effects. Those include: Runny nose Nasal congestion Fever over 100 degrees Sore throat How Much Does FluMist Cost?  Currently, private health insurance companies are required to cover the cost of FluMist when it's given by a healthcare provider. But it's not clear how much the at-home version of FluMist will cost or if it will be covered by insurance. "I suspected insurance will cover it, but that may vary depending on the plan," Adalja said. Sellick also stresses that cost is uncertain at this point. "The key thing that usually drives all of this is what Medicare says, and the vaccine is not indicated in that group," he said. (Medicare is designed for people aged 65 and up.) Where Can You Get FluMist? The home version of FluMist will not be available until next flu season. However, for the current flu season, FluMist is available from local pharmacies and healthcare providers. FluMist manufacturer AstraZeneca plans to provide the home version of the vaccine through a third-party online pharmacy. To receive it, you'll need to go through a screening and eligibility assessment before the pharmacy will write a prescription and send the vaccine to you. Doctors are uncertain how much this will impact flu vaccination rates in the future. "I suspect that this will have a marginal effect on flu vaccine uptake rates in the near term, but it may become a pular for certain people to get their flu vaccine," Adalja said. What This Means For You Starting next flu season, you'll be able to order a flu vaccine to be delivered directly to your home. For now, though, you'll still need to see a healthcare provider to get vaccinated.

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Verywell Health uses only high-quality sources, including peer-reviewed studies, to support the facts within our articles. Read our editorial process to learn more about how we fact-check and keep our content accurate, reliable, and trustworthy.

By Korin MillerMiller is a health and lifestyle journalist with a master's degree in online journalism. Her work appears in The Washington Post, Prevention, SELF, Women's Health, and more.

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Make Room, MRNA: What To Know About The Novavax COVID Vaccine

We're on the cusp of the fall season, which means respiratory viruses like flu, RSV and COVID are expected to keep spreading as weather cools and more people gather indoors. 

Luckily, we've got vaccines in stock to help prevent respiratory viruses from turning into severe illnesses. In addition to flu vaccines for the general public and RSV vaccines for older adults and pregnant people, new COVID vaccines from Pfizer-BioNTech, Moderna and Novavax are available this season to reduce the risk of hospitalization. 

This means adults have a choice in which COVID vaccine they receive: an mRNA vaccine by Moderna or Pfizer, or Novavax, a protein-based vaccine that targets the virus in a more "traditional" way. All three have been authorized by the US Food and Drug Administration. While Moderna and Pfizer have been widely used over the last few years, the Novavax vaccine is building up a bit of a following. 

Novavax, a protein-based vaccine, is an option for those who don't want or can't take an mRNA vaccine. Novavax may also be appealing to those wanting to experiment with the "mix-and-match" approach to COVID boosters as a way to potentially strengthen the immune response. 

"Even though mRNA vaccines dominate the market for COVID vaccines, it remains important to have multiple different types of technologies against various pathogens because each may have specific use cases," Dr. Amesh Adalja, an infectious disease expert and senior scholar with Johns Hopkins Center for Health Security, said in an email. 

Here's everything we know about Novavax this year. Also, read more about the at-home flu vaccine that will be available next year and how you can order more free COVID tests online. 

How is Novavax different from Pfizer and Moderna? 

Novavax is a protein-based vaccine, which people have associated with a "traditional" approach to vaccination. This is compared with mRNA technology, which does not use dead or weakened virus as an ingredient in the vaccine but instead uses genetic code to instruct the recipient's immune system to respond. 

However, Adalja said that calling Novavax traditional may be a "misnomer" because it brings its own innovation to the table. Novavax uses an insect virus that has been genetically engineered to express spike proteins, Adalja explained, which are then incorporated into the vaccine.

"The vaccine itself is coupled with an immune system booster, called an adjuvant, which increases its immunity," he said, referencing a component existing vaccines have also incorporated. 

This year, there are also slight differences between Novavax and Pfizer and Moderna's updated vaccines. Both mRNA vaccines have been tweaked to target the KP.2 strain of COVID-19, which is a slightly more recent version of the virus than what Novavax targets, which is KP.2's "parent" JN.1. While the FDA ultimately decided KP.2 was preferred in vaccines, all of them are expected to help protect against severe disease and death. 

However, no COVID vaccines this season will be covered free of charge by the US government. While most people's insurance is expected to continue footing the bill, adults without private or public health insurance will be responsible for payment. The Bridge Access Program was expected to provide COVID vaccines for free to people without health insurance through this year, though it ended early in August due to lack of funding. 

According to GoodRx, which has a coupon available for Novavax, the retail price of the protein-based vaccine is about $191. 

Who should get Novavax? Does Novavax have different side effects? 

Novavax was authorized by the FDA for use in adults and children 12 and older, so younger kids can't get this vaccine. But for most adults, which COVID vaccine you should choose depends on your preference and what your neighborhood pharmacy has in stock. 

People may opt for Novavax for different reasons, though. For people who do not want to take an mRNA vaccine, having a protein-based vaccine like Novavax available means they can still be vaccinated for the fall and winter season. 

Other people may be interested in Novavax for its use in the "mix-and-match" approach to boosting, which in the past has been associated with a strong immune response. 

There is some early research that suggests Novavax may have fewer short-term side effects, such as muscle fatigue and nausea, but "we can't say this for sure," Joshua Murdock, a pharmacist and pharmacy editor of GoodRx, said in an email. 

"This isn't proven, and side effects do vary by person," Murdock said. He added the CDC doesn't recommend one vaccine over the other, even in people who are immunocompromised.

In general, mRNA vaccines have been found to be fairly "reactogenic" compared to other vaccines, Adalja said, noting that it also depends on the individual. But if someone had a bad experience with the mRNA vaccine, Adalja said, they "may fare better with the Novavax vaccine."

Some flu-like side effects can be expected post-vaccine, no matter which one you choose. This includes symptoms like headache, tiredness, a sore arm and even chills. Not experiencing symptoms doesn't mean your immune system isn't kicking in, but experiencing some side effects may signal that your immune system is responding to the jolt, so to speak. 

In rare cases, myocarditis or heart inflammation problems have been associated with COVID vaccination, particularly in younger men and adolescents within the two weeks following vaccination. Research so far shows that Novavax, like mRNA vaccines, may also carry this rare side effect though. 

Following high levels of COVID this summer in the US, more information will be needed to see how all vaccines and their freshly targeted formulas fare against the virus that's expected to continue to spread this fall and winter. 

"There's no strong evidence that one vaccine is preferable to another in specific individuals, but that will be an important avenue to study for more precision-guided vaccine recommendations," Adalja said. 

How to find a Novavax vaccine 

Novavax announced on Sept. 13 that doses of its vaccine will be available at the following pharmacies: 

Novavax also has a vaccine finder on its website. To use it, type in your ZIP code in the small search box, and pharmacies nearby with the vaccine in stock will be displayed. 

New Updated COVID-19 Vaccines Are Available. When Should You Get It?

The new updated Comirnaty Pfizer COVID mRNA vaccine is seen here next to the Fluzone H,D. Influenza ... [+] vaccine at a Walgreens pharmacy in Torrance, Caifornia, on September 5, 2024. (Genaro Molina/Los Angeles Times via Getty Images)

Los Angeles Times via Getty Images

The newest, updated Pfizer-BioNTech and Moderna COVID-19 mRNA vaccines are now available at pharmacies and clinics. The Novavax recombinant protein vaccine should be available soon. All three updated vaccines have been approved by the U.S. Food and Drug Administration—that's fully approved by the FDA and not just emergency-use authorized. So, as has been the case each time a new COVID-19 vaccine becomes available, you may have many questions. Here are answers to some of the most common ones.

Should You Get The Updated COVID-19 Vaccine?

If you are less than 6 months of age, congratulations on your ability to read and, no, you do not qualify to get any of the updated vaccines. The Moderna and Pfizer-BioNtech vaccines are FDA-approved for those 6 months and older while the Novavax vaccine is FDA-approved for those 12 years and older.

If on the other hand you are old enough to get the vaccine, the Centers for Disease Control and Prevention is recommending that you go ahead and get the updated vaccine. That's unless you have a clear, medical doctor-verified contraindication to the vaccine such having had a severe allergic reaction or a major adverse event like myocarditis after a pervious COVID vaccination. Getting the update can renew your protection against COVID-19. The immune protection offered by the vaccines tends to start waning about four to six months after vaccination. So, if you got the last updated vaccine last Fall, a lot of that protection may have gone bye-bye by now.

Plus, the vaccines from last year targeted previous severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) variants from 2023 that have since gone the way of skinny jeans and midi skirts. As you have probably figured out by now, new variants have been emerging at the rate of new fashion with a new dominant variant every several months or so.

The latest Pfizer-BioNTech and Moderna vaccines target the KP.2 Omicron variant that was dominant during the past summer months, whereas the Novavax vaccine targets the JN.1 variant that was widespread even earlier this year. None of the vaccines specifically target the KP.3.1.1 variant, which is the current alpha-dog variant. But the targets of these updated vaccines are significantly closer to what's going on now than what was targeted by vaccines from previous years. Therefore, these updated vaccines should offer stronger protection against the currently circulating variants.

It's especially important to get these updated vaccines if you are at higher risk of getting more severe COVID-19. That would be the case if you have a weaker immune system from being over 65 years of age, having a chronic medical condition or getting medical treatment that suppresses your immune system.

The protection offered by the COVID-19 vaccines tends to wane after four to six months. So if you ... [+] last got the COVID vaccine or infected with the SARS-CoV-2 before 2024, your immune protection may not be very high right now. (Photo by Patrick van Katwijk/Getty Images)

Getty Images

For most adults the protective benefits of getting the updated vaccines far, far outweigh the risks. More major side effects such as myocarditis from the vaccines have been quite rare. And by now over 5 billion people, or over 70% of the world's population, have been vaccinated against COVID. Many have gotten vaccinated multiple times.

Now, some have said that the updated COVID vaccine may not be necessary if you are less than 30 years of age and have previously been vaccinated. The argument is that the risk of death, hospitalization and more severe COVID-19 outcomes is no longer high enough for such younger people. It is true that the risk of bad stuff happening from a SARS-CoV-2 infection for anyone is significantly lower now than it was back in 2020 and 2021. That's because our immune systems are no longer so virginal to the SARS-CoV-2, given previous exposure to its spike proteins via vaccination or natural infection.

But it's not as if COVID-19 has become just like a cold. It's not even at the level of the flu yet. The risk of very bad stuff happening is still high enough to merit concern even if you are younger. So it's not as if you should be gesturing "bring it on" toward the virus.

Plus, there is the lingering risk of long COVID after you've supposedly recovered from a SARS-CoV-2 infection. Many political and business leaders may want to make it seem like COVID-19 is no longer a threat and everything is hunky-dory SARS-CoV-2-wise when it's not that way yet. Of course, the best way to avoid long COVID is to not get COVID in the first place, and evidence suggests that the vaccines may reduce your risk of getting long COVID.

When Should You Get The Updated COVID-19 Vaccine?

The answer to this question is a little tricky. Since around mid-June, we have been in the midst of a COVID surge. So, it may help to have more protection right now, especially if you aren't doing anything else, like wearing a N95 face mask to keep the SARS-CoV-2 away from your respiratory tract.

The trouble, though, is the whole "wane world" thing. Again, the protection from the vaccine tends to wane significantly after four to six months. Counting forward by four months will land you in January 2025. By then the world around you will be smack in the middle of the winter months if you are in the Northern Hemisphere. And remember, since 2020, every mid-November has seen the start of a major winter COVID surge. Who's to say this November will be different, as the colder and drier air, the movement of activities indoors and the holiday travel could once again contribute to greater SARS-CoV-2 transmission and spread.

Therefore, if you want to get maximal protection throughout much of the anticipated winter surge, it may make sense to wait until mid-October to get the updated COVID vaccine. This is the typical recommendation for the flu vaccine as well. So next month you could get the flu and COVID vaccines.

Also, if you recently got vaccinated or infected with the virus then the CDC recommendation is to wait at least until three months has passed. This could allow your immune system enough time to fully collect itself again and then deliver a more full response to the updated vaccine.

Which Updated COVID-19 Vaccine Should You Get?

The Novavax COVID vaccines use a more traditional recombinant protein approach that can serve as an ... [+] alternative for people who are hesitant about getting an mRNA vaccine. (Photo by Patrick van Katwijk/Getty Images)

Getty Images

If you are still a bit squeamish about the newer mRNA technology despite all its testing and use over the past four years, you may feel more comfortable with the more traditional approach of the Novavax vaccine. While the mRNA vaccines contain mRNA that then go into your cells and serve as blueprints for you cells to produce the SARS-CoV-2 spike protein, the Novavax vaccine includes a version of the spike protein itself. To manufacture the spike protein, Novavax uses the same process that has been long utilized for vaccines—such as the Hepatitis B vaccine—that have been around for many years.

The Pfizer and Moderna vaccines are pretty darn similar. The main difference is that the Moderna vaccines have higher doses of mRNA in them, which could mean a somewhat higher rate of side effects like fever, fatigue and body aches in the days after vaccination. The Moderna vaccines could offer a slightly higher degree of protection as a result, too. But there really isn't a slam dunk protection difference between the two mRNA vaccines.

How Will You Pay For The Updated COVID-19 Vaccine?

There is also the question of money. The government used to pay for all the vaccines, including boatloads of money to the pharmaceutical companies to develop and manufacture the vaccines. But that's no longer completely the case. Plus, Pfizer and Moderna have—surprise, surprise—since pushed up the prices of their vaccines several-fold, to over $100. So, first check to see if your insurance—if you have it— will cover the cost of your vaccine of interest. If it doesn't or if you are uninsured, you may be able to find a clinic that still offers the vaccine at low to no cost.

One final thing to remember. The vaccine's protection offered against more severe COVID-19 is not 100%, and you can still catch the virus if exposed, although your chances may be lower after vaccination.

Moreover, the chances of the virus being transmitted to you does depend on how many people around you have gotten the latest vaccines, too. Only about 22% of eligible adults got the last set of COVID-19 vaccine updates from fall 2023. That doesn't bode well for many people getting this latest set of updates, which means that the majority of people around you could end up being relatively unprotected against the COVID-19, be readily infected and, as a result, shed the virus in larger amounts.

Therefore, even if you do get the updated vaccine, it is still a good idea to take other precautions simultaneously. Remember a few years the so-called "Swiss cheese" approach of layering different protections on top of each other to cover the holes in each type of protection. Even though the COVID-19 situation has improved significantly since then, 2024 is not necessarily a hole different situation.

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