View the video and content in this section about how to administer FLUMIST QUADRIVALENT

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Administer 1 spray in each nostril—No sniff required1

Six steps for administration1

FluMist Quadrivalent Administration Step 1

Check expiration date. Product must be used before the date on sprayer label.

FluMist Quadrivalent Administration Step 2

Remove rubber tip protector. Do not remove dose-divider clip at the other end of the sprayer.

FluMist Quadrivalent Administration Step 3

With the patient in an upright position, place the tip just inside the nostril to ensure FLUMIST QUADRIVALENT is delivered into the nose.

FluMist Quadrivalent Administration Step 4

With a single motion, depress plunger as rapidly as possible until the dose-divider clip prevents you from going further.

FluMist Quadrivalent Administration Step 5

Pinch and remove the dose-divider clip from the plunger.

FluMist Quadrivalent Administration Step 6

Place the tip just inside the other nostril and with a single motion, depress plunger as rapidly as possible to deliver remaining vaccine.

Dispose of sprayer per standard procedures for medical waste (eg, sharps container).

Nasal Spray IconKey clarifications about administration

No need to sniff!1

Patients can breathe normally during administration; active inhalation (eg, sniffing) is not required1

No need to readminister if sneezing, dripping, or swallowing occurs2

  • The vaccine viruses bind to cells in the nasopharynx1
  • FLUMIST QUADRIVALENT is formulated with more attenuated infectious units of each of the 4 component viral strains than needed to develop the immune response1,3
  • Patients will receive a sufficient dose even if they sneeze or swallow, or if dripping occurs2
  • There is no need to repeat the vaccination2
  • Immunity occurs within 2 weeks, just like the flu shot4

Your patients may have misconceptions about receiving FLUMIST QUADRIVALENT—and may need your help to clarify


  • FLUMIST QUADRIVALENT is contraindicated in persons who have had a severe allergic reaction (eg, anaphylaxis) to any vaccine component, including egg protein, or after a previous dose of any influenza vaccine, and in children and adolescents receiving concomitant aspirin or aspirin-containing therapy
  • In clinical trials, the risks of hospitalization and wheezing were increased in children <24 months of age who received trivalent FluMist
  • Children <5 years of age with recurrent wheezing and persons of any age with asthma may be at increased risk of wheezing following FLUMIST QUADRIVALENT administration. FLUMIST QUADRIVALENT has not been studied in persons with severe asthma or active wheezing
  • If Guillain-Barré syndrome has occurred within 6 weeks of any prior influenza vaccination, the decision to give FLUMIST QUADRIVALENT should be based on careful consideration of the potential benefits and risks
  • FLUMIST QUADRIVALENT has not been studied in immunocompromised persons
  • The safety of FLUMIST QUADRIVALENT in individuals with underlying medical conditions predisposing them to wild-type influenza infection complications has not been established
  • Appropriate medical treatment and supervision must be available to manage possible anaphylactic reactions following administration of the vaccine
  • FLUMIST QUADRIVALENT may not protect all individuals receiving the vaccine
  • The most common solicited adverse reactions (occurring ≥10% in vaccine recipients and at least 5% greater than in placebo) reported were runny nose or nasal congestion in persons 2-49 years, fever >100°F in children 2-6 years, and sore throat in adults 18-49 years. Among children 2-17 years who received FLUMIST QUADRIVALENT, 32% reported runny nose or nasal congestion and 7% reported fever >100°F. Among adults 18-49 years who received FLUMIST QUADRIVALENT, 44% reported runny nose or nasal congestion and 19% reported sore throat

FLUMIST QUADRIVALENT is a vaccine indicated for active immunization of persons 2-49 years of age for the prevention of influenza disease caused by influenza A subtype viruses and type B viruses contained in the vaccine. FLUMIST QUADRIVALENT is for intranasal administration only.

Please see full Prescribing Information for FLUMIST QUADRIVALENT, including Patient Information.

You may report side effects related to AstraZeneca products by clicking here.