Nasal Flu Shot Reduces Scarlet Fever and Group A Strep Infections in Children

A new analysis published today suggests an approved nasal spray flu vaccine may also reduce the rate of group A strep and scarlet fever infections in children.

The U.K. Health Security Agency (UKHSA) published a pre-print, not yet been peer-reviewed analysis on December 16, 2022, that indicated the live attenuated influenza vaccine (LAIV) nasal spray could be deployed in England to reduce ongoing scarlet fever or invasive group A strep (iGAS) outbreaks.

On December 15, 2022, the UKHSA confirmed cases of scarlet fever in England were higher than usual for this point in the season, after persisting later into the previous season.

For example, 1,062 scarlet fever notifications were received in England during week #48.

And invasive group A streptococcus (iGAS) disease cases in children are following a similar trend.

So far this season, there have been 652 notifications of iGAS disease reported in England, with a weekly high of 91 notifications in week #47. 

This new study reviewed 2013 to 2017 data comparing group A strep (GAS) infection rates.

The study found that the incidence of GAS was lower in pilot areas where the LAIV vaccine was offered to all primary school children.

• In 2 to 4-year-olds, rates of GAS were 73.5 per 100,000 children in pilot areas, compared to 93 per 100,000 children in non-pilot areas,
• In 5 to 10-year-olds, rates of GAS were 50.3 per 100,000 children in pilot areas, compared to 57.8 per 100,000 in non-pilot areas.
• And there was no difference in scarlet fever or iGAS notifications.

Dr. Jamie Lopez Bernal, Consultant Epidemiologist for Immunisation and Countermeasures at UKHSA, said in a related press release, "Our findings suggest that the nasal spray vaccine program, which offers very good protection against flu, may also help contribute to reductions in the rates of GAS infections among children."

"Children who catch influenza are at greater risk from subsequent infections, including group A strep."

"So these findings provide more reasons for parents of eligible children to bring them forward for the flu vaccine."

"This is particularly important at this time when we are seeing unusually high rates of group A strep infection across the population."

The lLAIV nasal spray, now known as Fluenz® Tetra, was first rolled out in England in 2013. Currently, it is offered each flu season to most children as protection from the influenza virus variants.

In the U.S., the Food and Drug Administration approved, on May 20, 2022, a supplement for AstraZeneca's FluMist® vaccine's existing Biologics License Application to include the 2022- 2023 flu season viruses and labeling.

FluMist Quadrivalent triggers an immune response in people's noses, where they usually catch the flu.

As of December 16, 2022, the FluMist nasal vaccine was offered in many clinics and pharmacies in the U.S.

Other approved influenza vaccine news for the 2022-2023 flu season is listed at PrecisionVaccinations.com/Flu.

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