FluMist Quadrivalent

FluMist Quadrivalent is a vaccine that is sprayed into the nose to help protect against influenza ("the flu"). You should not get FluMist Quadrivalent if you have a severe allergy to eggs.

FluMist Quadrivalent Overview

Reviewed: August 3, 2015

FluMist Quadrivalent is a vaccine used for the prevention of "the flu". It can be used in children, adolescents, and adults ages 2 through 49. This vaccine contains weakened live virus. It works by producing antibodies in the nose (where the flu typically starts) and continues into the cells and bloodstream. FluMist Quadrivalent does not cause "the flu". Immunity occurs within 14 days.

Traditionally, flu vaccines protect against 3 flu virus strains. These are called “trivalent” flu vaccines. They protect against 2 A and 1 B strain. Now, some flu vaccines, like FluMist Quadrivalent, protect against 4 strains. A quadrivalent vaccine helps protect against 2 A strains and 2 B strains and may reduce the risk of being unprotected against the flu.

FluMist Quadrivalent is a liquid that is sprayed into each nostril of the nose. This vaccine should be repeated each year before the start of the flu season, as early as vaccines become available.

The most common FluMist Quadrivalent side effects are runny or stuffy nose, sore throat, and fever over 100°F. FluMist Quadrivalent does not contain mercury or thimerosal.

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Uses of FluMist Quadrivalent

FluMist Quadrivalent is a vaccine used to prevent influenza in persons ages 2 through 49. FluMist Quadrivalent helps protect against 4 different strains of the flu: 2 strains of influenza A viruses and 2 strains of influenza B viruses.

This vaccine may be prescribed for other uses. Ask your doctor or pharmacist for more information.


Influenza, Live Attenuated

For more information on this medication choose from the list of selections below.

FluMist Quadrivalent Drug Class

FluMist Quadrivalent is part of the drug class:

Side Effects of FluMist Quadrivalent

Serious side effects have been reporter with FluMist Quadrivalent. See the "FluMist Quadrivalent Precautions" section.

Common side effects of FluMist Quadrivalent include the following:

  • runny or stuffy nose
  • sore throat
  • fever over 100 degrees Fahrenheit
  • decreased appetite
  • irritability
  • tiredness
  • cough
  • headache
  • muscle ache
  • chills

This is not a complete list of FluMist Quadrivalent side effects. Ask your doctor or pharmacist for more information.

Tell your doctor if you have any side effect that bothers you or that does not go away.

Call your doctor for medical advice about side effects. You may report side effects to VAERS at 1-800-822-7967.

FluMist Quadrivalent Interactions

Tell your doctor about all the medicines you take, including prescription and non-prescription medicines, vitamins, and herbal supplements. Especially tell your doctor if you take:

  • Aspirin
  • Antiviral agents against influenza A and/or B
  • Concomitant vaccination with inactivated vaccines
  • Concomitant administration with other live vaccines
  • Intranasal products

This is not a complete list of FluMist Quadrivalent drug interactions. Ask your doctor or pharmacist for more information.

FluMist Quadrivalent Precautions

Serious side effects have been reported with FluMist Quadrivalent including the following:

  • Risks of Hospitalization and Wheezing in Children Younger than 24 Months of Age. In clinical trials, risks of hospitalization and wheezing were increased in children younger than 2 years of age who received FluMist Quadrivalent.
  • Asthma, Recurrent Wheezing, and Active Wheezing. Children younger than 5 years of age with recurrent wheezing and persons of any age with asthma may be at increased risk of wheezing following administration of FluMist Quadrivalent.
  • Guillain-Barre syndrome. Tell your healthcare provider immediately if you have a history of GBS or any neurologic disorder including seizures. If Guillain-Barré syndrome has occurred within 6 weeks of receiving an influenza vaccine in the past, your doctor will determine if you should receive FluMist Quadrivalent.
  • Altered Immunocompetence. FluMist Quadrivalent has not been studied in immunocompromised persons.


Do not get FluMist Quadrivalent if you:

  • have a severe allergy to eggs or to any inactive ingredient in this vaccine
  • have ever had a life-threatening reaction to influenza vaccinations
  • are 2-17 years old and take aspirin or medicines containing aspirin. Children or adolescents should not be given aspirin for 4 weeks after getting FluMist Quadrivalent unless your healthcare provider tells you otherwise.

FluMist Quadrivalent Food Interactions

Medications and vaccines can interact with certain foods. In some cases, this may be harmful and your doctor may advise you to avoid certain foods. In the case of FluMist Quadrivalent, there are no specific foods that you must exclude from your diet when receiving this vaccination.

Inform MD

Before receiving FluMist Quadrivalent, tell your doctor about all of your medical conditions. Especially tell your doctor if you:

  • have a severe allergy to eggs
  • are currently wheezing
  • have a history of wheezing if under 5 years old
  • have had Guillain-Barre syndrome
  • have a weakened immune system or live with someone who has a severely weakened immune system
  • have problems with your heart, kidneys, or lungs
  • have diabetes
  • are pregnant or plan to become pregnant
  • are breastfeeding or plan to breastfeed
  • are taking Tamiflu, Relenza, amantadine, or rimantadine

Tell your doctor about all the medicines you take including prescription and non-prescription medicines, vitamins, and herbal supplements.

FluMist Quadrivalent and Pregnancy

Tell your doctor if you are pregnant or plan to become pregnant. The FDA categorizes medications based on safety for use during pregnancy. Five categories - A, B, C, D, and X, are used to classify the possible risks to an unborn baby when a medication is taken during pregnancy.

FluMist Quadrivalent falls into category B. There are no well-done studies that have been done in humans with FluMist Quadrivalent. In animal studies, pregnant animals were given this vaccine, and the babies did not show any medical issues related to this vaccine. Because animal studies are not always predictive of human response FluMist Quadrivalent should be administered during pregnancy only if clearly needed.

FluMist Quadrivalent and Lactation

Tell your doctor if you are breastfeeding or plan to breastfeed.

It is not known whether FluMist Quadrivalent is excreted in human milk. Because some viruses are excreted in human milk, caution should be exercised when FluMist Quadrivalent is administered to a nursing woman.

FluMist Quadrivalent Usage

FluMist Quadrivalent comes in liquid form and is administered by a healthcare professional.

It is given as one spray in each nostril.You do not have to actively inhale or sniff during vaccine administration. 

Sniffing is not necessary for the vaccine to work effectively. Don’t worry if you sneeze or blow your nose after receiving FluMist Quadrivalent.

You don’t need to get vaccinated again.

For the best protection against getting "the flu", the CDC recommends patients receive an annual seasonal flu vaccine.

FluMist Quadrivalent Dosage

The FluMist Quadrivalent dosage your doctor recommends will be based on your age. 

2 through 8 years of age: 1 or 2 doses of FluMist Quadrivalent. If 2 doses are required, they will be administered at least 1 month apart. (1 or 2 doses depends on vaccination history as per Advisory Committee on Immunization Practices annual recommendations on prevention and control of influenza with vaccines)

9 through 49 years of age: 1 dose of FluMist Quadrivalent is recommended

FluMist Quadrivalent Overdose

FluMist Quadrivalent is administered by a healthcare provider in a medical setting. It is unlikely that an overdose will occur. However, if overdose is suspected, seek emergency medical attention.