Hate the flu? Hate the flu shot even more?

Crybabies large and small, this news is for you: Soon there should be a flu vaccine that's sprayed painlessly up the nose, and it seems to work even better than the kind that comes via a needle.The nasal spray vaccine has been in the works for several years, but testing last winter produced some surprising results. The ordinary flu shot was a bust, but the spray variety worked very well.

Doctors who released the findings Sunday said they believe the spray vaccine will have an important place in preventing the flu, especially for children or anyone else who's phobic about shots.

The flu virus is constantly mutating. So each year, government health agencies choose the three strains of the virus that appear most likely to be problems during the upcoming flu season. These are then used to create the flu shot, which is made of killed viruses.

Going into last winter, the agencies chose wrong. They picked strains called A/Shenzhen, A/Wuhan and B/Harbin-like. But the culprit turned out to be a variety of flu called A/Sydney.

Dr. Nancy J. Cox, a flu expert at the National Centers for Disease Control and Prevention in Atlanta, said the flu shot offered only marginal protection against this strain.

However, the nasal spray variety did much better, even though it contained the same three flu strains. Testing on 1,358 children last winter showed that it was 86 percent protective against A/Sydney.

"What happened last year with A/Sydney is very exciting. This was a true test, and the vaccine passed with flying colors. Right now, it looks like the spray has advantages," said Dr. Dominick Iacuzio of the National Institutes of Health.

The NIH co-sponsored the test of the spray vaccine, called FluMist, with its developer, Aviron of Mountain View, Calif. Dr. Robert Belshe of Saint Louis University described the results at an infectious disease meeting sponsored by the American Society for Microbiology.

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In the study, 917 children received the spray vaccine, while 441 got dummy sprays. Two percent of the vaccinated children got the flu, compared with 13 percent in the comparison group.

Doctors believe the spray works better because it is made with a weakened virus rather than a dead one. When sprayed up the nose, the virus causes a harmless infection and produces new copies of itself.

"We believe the live vaccine induces a fuller complement of immune responses," said Belshe. This gives the body an edge even against strains of the flu virus that are not included in the vaccine.

While the vaccine is likely to be aimed initially at children, Belshe said it probably will make sense for healthy adults as well. Researchers suspect that for the elderly, who are especially prone to serious flu infections, vaccination with both the spray and the shot may be better than either alone.

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