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The US Food and Drug Administration is reviewing an application for the nasal spray flu vaccine FluMist to be able to be self-administered at home, drugmaker AstraZeneca said Tuesday. The vaccine, the only nasal spray option against flu, has been on the market in the United States since 2003. AstraZeneca has asked the FDA to allow adults ages 18 to 49 to be able to give themselves the vaccine, or to give it to children as young as age 2, citing a “usability study” showing people can do it properly without a health care provider present. If approved, it would be the first flu vaccine cleared for self-administration. (Tirrell, 10/24)

The company said it expects the FDA to decide on the vaccine by the first quarter of 2024, adding that it expects the vaccine to be made available for self-administration in the United States during the 2024-2025 flu season, if approved. (10/24)

In the latest headache for parents hunting for a new shot to protect babies against respiratory syncytial virus, or RSV, this winter, the manufacturer says it has stopped taking orders for some doses because they are unable to keep up with “unprecedented demand.” (Goodman, 10/23)

The Food and Drug Administration approved the antibody drug, called Beyfortus, in July. ... Newborns and infants can get doses of Beyfortus during their first RSV seasons, and children up to age 2 who are at high risk for severe illness from the virus can get second doses during their second RSV seasons. According to the CDC alert, the highest dosage, 100 milligrams, is in limited supply. The agency told doctors to prioritize getting those doses to infants at the highest risk of severe RSV, including infants younger than 6 months and those with underlying conditions. The CDC also advised doctors to preserve 50 mg doses for infants who weigh less than 11 pounds. (Miller and Edwards, 10/23)

Officials at Henry Ford Medical Center Fairlane in Dearborn, Mich., thought they may have had faulty testing swabs for strep throat when rates were so high, but the swabs are accurate, radio station WWJ reported Oct. 23. Strep throat rates are currently the highest Jennifer Stevenson, DO, director of the medical center's emergency department, has seen in her 25 years of practice. (Carbajal, 10/23)

An imbalance of fungi in the gut could contribute to excessive inflammation in people with severe COVID-19 or long COVID. A study found that individuals with severe disease had elevated levels of a fungus that can activate the immune system and induce long-lasting changes. The work, published on 23 October in Nature Immunology1, raises the possibility that antifungal treatment could provide some relief to people who are critically ill with COVID-19. (Prillaman, 10/23)

Molnupiravir, an antiviral drug used to treat COVID-19, induces numerous mutations in the SARS-CoV-2 genome that can increase the rate at which the virus evolves — yielding viral variants that might survive and be passed on. (Pond and Martin, 10/24)

Children who tested positive for COVID-19 in 2022 were contagious for a median of 3 days, regardless of vaccination status, suggesting that 5-day school isolation policies are sufficient amid Omicron variant predominance, University of Southern California (USC) and Stanford University researchers report today in JAMA Pediatrics. The study included 76 children aged 7 to 18 years infected with SARS-CoV-2 in Los Angeles County from April to September 2022. (Van Beusekom, 10/23)

The risks of severe neonatal morbidity, neonatal death, and admission to the neonatal intensive care unit were all significantly lower during the first month of birth in infants whose mothers were vaccinated against Covid-19, and protection against the virus continued for up to six months after birth, according to a new study published Monday in JAMA Pediatrics. (Balthazar, 10/23)