This article by Professor Christopher Blyth, from The University of Western Australia and The Kids Research Institute Australia, and Professor Allen Cheng, from Monash University, was originally published in The Conversation on 20 March 2026.

Many kids are scared of getting needles, and this can stop them getting vaccinations that protect that against the flu. Less than one in four Australian children were vaccinated against influenza in 2025.

This winter, Australian families have another option. A nasal flu vaccine called FluMist will be available for the first time for children aged 2–17 years.

FluMist is a needle-free alternative to the existing influenza vaccines. Nasal flu vaccines are widely used in the United Kingdom, Europe, Canada and the United States.

Recent studies in which both injectable and nasal flu vaccines are available suggest parents prefer a nasal vaccine, particularly when they’re hesitant about vaccination. As such, the nasal option could increase vaccination coverage in Australia and reduce the spread of flu, not only in children but potentially in the wider community.

FluMist will be free in some states and territories for certain age groups. It will also be available for a fee at selected pharmacies and immunisation providers.

Here’s what you need to know about how FluMist works, how effective it is, and whether your child is eligible.

What’s different about this vaccine?

Current vaccines used in Australia are all injected. They contain specific components of the influenza virus that are not capable of replicating.

FluMist is different. It contains a weakened “live” form of the flu strain. These types of vaccines are known as live attenuated vaccines. Other examples include MMR (measles, mumps, rubella), chickenpox and rotavirus vaccines.

With FluMist, six of the eight genetic segments in influenza virus are altered so they cannot replicate efficiently at normal body temperature. This means the virus only replicates in the nose (which is at a lower temperature), rather than deeper inside the body.

How do nasal sprays work? Are they more effective?

To give FluMist, a health professional sprays one dose of 0.1ml of the vaccine in each nostril. It is simple, painless and very well tolerated by children, even the very young.

Unlike injected vaccines, nasal vaccines trigger protective immune responses where influenza viruses enter the body – on the surface of the upper respiratory tract (the mucosa) including the nose and throat. So in theory, nasal sprays should work better than injections.

Early studies in the late 1990s suggested the vaccine provided very good protection against influenza in children – and might even provide some protection against influenza strains not contained in the vaccine.

However, in practice, data from subsequent studies suggests the live vaccine probably provides similar protection to the current injectable vaccines.

In the US, there was also an issue in the mid-2010s where the live attenuated vaccine (given as a nasal spray) was not as effective as the injected vaccines. This led to the recommendation for its use being withdrawn from 2016 until 2018.

As a result, changes were made to the process of selecting vaccine strains.

Data from more recent seasons shows nasal spray vaccines are now just as effective as injected vaccines. Both reduce influenza infection by 40–60%.

How safe is the nasal flu vaccine?

The vaccine is safe, with mostly similar side effects to the injected influenza vaccine.

The nasal flu vaccine has been used in the US since 2003, Canada since 2010, and Europe since 2011. The UK has had a national childhood program using the nasal vaccine since 2013.

A proportion of people may have side effects, but these are mild and transient. Over half of children will have a blocked or runny nose, and around one in ten have a fever or headache.

Those who are severely immunosuppressed (have a weakened immune system) or regularly take aspirin should not use FluMist.

If your child is mildly immunosuppressed, has severe asthma or another lung disease, speak to your GP or specialist about the vaccine. Adolescents who are pregnant should also seek medical advice.

What are the potential benefits?

The main benefit of a nasal vaccine is improving coverage in an age group where fear of needles stop children getting vaccinated and in settings where needles are a logistical hurdle.

The UK introduced a school-based vaccine program in 2013. This had an immediate impact on vaccine coverage, which had been very low before 2013. Now, around half of children there receive an annual influenza vaccine.

We know vaccinated children are less likely to fall sick and to take time off school. And evidence also suggests vaccinating this age group can reduce transmission of influenza in the community, thereby protecting others.

In the UK, studies suggest the introduction of influenza vaccines for school-aged children reduced GP presentations with influenza in all age groups.

Reducing influenza community transmission is expected to result in fewer influenza cases, lower health-care costs, and reduced pressure on hospital and health providers.

So, who can get the nasal flu vaccine?

In 2026, FluMist will be one of several influenza vaccines available in Australia. But funding arrangements vary across states and territories, affecting who is eligible for a free vaccine. Others will need to pay around $50–70.

From early April, the nasal vaccine will be available in:

• New South Wales and South Australia as state-funded programs (free) for children aged 2–4 (inclusive) and available on the private market (for around $50–70) for 5–17-year-olds

• Queensland as a state-funded program for 2–5-year-olds and privately for those aged 6–17 years

• Western Australia as a state-funded program for 2–11-year-olds (inclusive), and on the private market for those aged 12–17 years

• the Australian Capital Territory, Northern Territory, Tasmania and Victoria on the private market for 2–17 year olds.

The nasal vaccine is currently only registered in Australia for children.