Nasal spray influenza vaccination

Question

Dear expert team,
last year, at this site, it was advised against the nasal spray influenza vaccination for CF patients. On the website of the German patient organization Muko.ev it is recommended this year, that it would even have a better effect. Are there any new findings concerning this kind of flu vaccination? I am insecure! Thanks!
[Supplement of ECORN-CF:
On request we got the following additional information from the questioner:
"Hello. It deals in general with CF children between 2 and 17 years, this questions arose on an internet forum with involved parents. Thank you!"

End of the supplement]

Answer

Hello,
it is correct, that the "The German Standing Committee on Vaccination (STIKO)" has stated in a recent recommendation, that patients having a vaccination indication for influnza vaccination should be vaccinated with the nasal vaccine. In its recommendation the STIKO proposes, that patients with the age of 2-6 years should be vaccinated with this vaccine. On the other hand the vaccine is licensed in Germany for children and adolescents between 2 and 17 years of age.
Wyh the STIKO is mentioning the age group of 2-6 years, is not clear. It has to be emphazised that the data on the vaccine is discussed controversely. The STIKO refers to a study, that has been conducted in the USA. This study is reporting a better result concerning the protection rate with the nasal vaccine compared to other intramuscular vaccines. An author of the "drug telegram" points at the fact that the better effect has only been shown against placebo. On the indcation for CF it has to be said, that the STIKO, according to my information, has not particularly mentioned CF, however has only spoken about the group of patients having an indication. Of course CF patients belong to this group, however the statement of the Muko.ev is not a citation (the words are therefore not repeated word for word).
Compared to the last year there is a further change concerning the nasal vaccine. In the meantime, single health insurances cover the costs of the vaccine. In case you should decide to let your child vaccinate with this vaccine, you should get in contact in advance with your insurance due to the question of covering the costs. In this case it would also be important, that there is a written confirmation of your pediatrician that states that your child belongs to the group of indicative patients.
I am sorry that a clarifying, detailed and mandatory statement on the nasal vaccine is at the moment not possible in my opinion.
Probably it does not make any difference with what vaccine your child is vaccinated.
The main point is that it is vaccinated at all. In case it has not been done, it would be time now.

We wish you and your family all the best,
Yours sincerely,
Dr. H.-G. Posselt

18.11.2013