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That is not something that has been established, according to this document from the American Society of Health-System Pharmacists (page 3 of 4). http://www.ashp.org/DocLibrary/Policy/Influenza/influenzalive_ahfs.pdf

“Vaccine virus capable of infection and replication is present in nasal secretions of vaccine recipients, and viral shedding occurs in adults and children who have received the intranasal live vaccine. Relationship between vaccine virus replication in vaccine recipients and transmission of vaccine virus to other individuals not established. However, transmission of vaccine virus has occurred rarely between vaccine recipients and their contacts. Duration of vaccine virus replication and shedding in vaccine recipients not established”.

Having said that, keep in mind that FluMist is a WEAKENED virus that will not cause infection in a healthy individual, but is enough to produce an immune response. From what I gather though, it seems that it is not as effective as the “shot”. http://www.flumist.com/Professional/Efficacy/Vaccine-Efficacy-Children.aspx

I have a horse in this race, as I’m a transplant recipient AND a health care professional. My transplant surgeon told me I should not be around those who have received the nasal vaccine, and this seems to be common across the country as far as advice from transplant centers. Having had the transplant, I have noticed that transplant professionals tend to be overly cautious (a desireable trait) in regards to their patients.

I did discuss this with 2 Infectious Disease specialists that I work with, and both said it is not an issue, except for those with severe immune suppression such as patients who have undergone recent bone marrow transplant (aka stem cell transplant). The one ID specialist worked at a top transplant facility (ranked in top 5 in the world), and initially they were advising this, but have since changed their opinion, and do not feel that this is a threat. Having had the transplant, I have noticed that transplant professionals tend to be overly cautious (a desireable trait) in regards to their patients.

I’m a RN at a large medical center; I mostly work in an outpatient clinic, but also work in the hospital several times per month doing direct patient care.

As for myself, I have told my manager that I will not administer the vaccine, but realistically, I cannot totally stay away from others who had the vaccine. I say this because I can’t quarantine myself in my home all flu season. How do I know who in the public has had the vaccine? In addition, Swine Flu is ALL around me when I’m in public, based on what I’m seeing in the clinic. I use common sense precautions at work (I don’t have a lot of patient contact normally, although I do on occasion); I wear a mask around patients with flu symptoms, I wash my hands or use hand sanitizer frequently, and keep a heightened awareness of those around me who are sick.

I did get the vaccine for seasonal flu, as I have for the past 18 years, long before my kidney transplant (one episode of influenza and it’s accompanying symptoms that make you feel like you will die spurred me to get the vaccine early in my career).

As for the Swine Flu vaccine, the transplant center I go to has been non-committal about whether we should get it.

I most likely will get it when it is available. My line of thinking on this is that it’s the same base vaccine as I’ve always received, the only difference being that it contains the Swine Flu strain, whereas the Seasonal vaccine contains the seasonal flu strains. Also, H1N1 at this point is widespread, but what if the virus mutates and becomes more virulent? What if it becomes resistant to Tamiflu? It’s all about risk vs. benefit.

Hope this helps.