With the shortage of standard flu vaccine, there has been increased interest in the Flumist nasal vaccine. But Flumist is restricted to ages 6 to 49. I can understand why children, with immature immune systems, would not be exposed to a relatively new live-virus vaccine, and I can understand why it would be bad for anyone of any age with a weakened immune system. But why is there an arbitrary upper age cutoff of 49? Is there a presumption that everybody is more illness-prone after age 50? Is there any practical reason why healthy people in their '50s and '60s shouldn’t get Flumist? Will doctors refuse to give it to someone they know is older than 49?
My guess is that it’s age-restricted either because those are the age-groups it’s been tested for (so they can’t legally offer it to other groups), or because younger and/or older people are presumed to have less-sufficient immune systems - and might be genuinely sickened by even a weakened flu virus. They also say it’s not OK for people who are high-risk even within the target age group. Presumably this is somewhat up to the discretion of the doctors (e.g., docs can prescribe medications for “off-label” uses, why not vaccines?).
I’ll be interested to see how this all turns out this winter. I’m higher-risk (asthma) so always get the flu shot - but my doctor has no vaccine this year, and the local grocery store chain is reporting hours-long waits for their limited supplies, then running out of the shots. And supposedly I won’t be allowed the FluMist either, because of the asthma. We’re actually planning on getting the kids vaccinated this year, even though they’re not high-risk, because their ped does have the vaccine, and that’ll reduce my risk of exposure.