A needle-free option could be a game-changer for children who can't tolerate needles
Each year, the question of how to protect children from influenza collides with a quieter obstacle: the fear of needles. In Victoria, Australia, researchers at Murdoch Children's Research Institute are enrolling 270 young children in a study called SNIFFLES, comparing the traditional flu injection with FluMist, a nasal spray long used in the UK and US but new to Australian shores. Beyond easing childhood distress, the study carries a global purpose — feeding Southern Hemisphere immune response data into the WHO's vaccine strain selection process, correcting a long-standing imbalance in how the world's flu vaccines are designed.
- Australia recorded its highest-ever flu case count in 2024 — over 365,000 confirmed infections — with children under ten bearing the heaviest burden.
- Vaccination rates among children remain alarmingly low, with only 15–32% of Victorian children receiving a flu shot, suggesting that access alone is not closing the gap.
- Seven in ten parents say they would prioritize flu vaccination if a needle-free option were available, pointing to fear and distress — not indifference — as the core barrier.
- The SNIFFLES trial is recruiting 270 children aged 2–9 to compare immune responses between the nasal spray and the injection, giving families a genuine choice in how their child is protected.
- Biological samples from the study will flow to the WHO and the Doherty Institute, filling a critical blind spot in global flu surveillance that has long overlooked Southern Hemisphere children.
Australia is preparing to run an experiment that could change how millions of children receive their annual flu vaccine. Researchers at Murdoch Children's Research Institute are recruiting 270 children aged two to nine in Victoria for a study called SNIFFLES, which will compare the standard flu injection against FluMist — an AstraZeneca nasal spray with a strong safety record in the UK and US, now arriving in Australia for the first time.
The study's significance reaches beyond its shores. Blood samples collected from participating children will contribute to the WHO's global flu vaccine strategy, providing immune response data from the Southern Hemisphere — a population that has long been underrepresented in the datasets used to select which flu strains vaccines should target each year.
The urgency is real. In 2024, Australia recorded more than 365,000 confirmed flu cases — the most ever — with children under ten accounting for a disproportionate share. Yet vaccination rates remain low: only 32% of Victorian children aged six months to five years received a flu shot, and just 15% of those aged five to fifteen. A 2025 national survey offered a telling explanation — 72% of parents said they would be more likely to vaccinate if a needle-free option existed.
Pediatrician and associate professor Shidan Tosif, who leads the project, sees the nasal spray as potentially transformative for needle-phobic children and the families caring for them. One enrolled family — Danica and George, whose eight-year-old son Panos is participating — described needle fear as a genuine barrier, and the spray as a possible 'game-changer' for school-age vaccination rates.
The data gathered will be analyzed by the MOVE Consortium in the UK and the Doherty Institute, with findings feeding directly into how flu vaccines are formulated for children across the Southern Hemisphere. If a simple shift in delivery method can move vaccination rates, the implications will extend well beyond one Australian winter.
Australia is about to run an experiment that could reshape how millions of children get their annual flu shot. Researchers at Murdoch Children's Research Institute are recruiting 270 children between two and nine years old in Victoria to compare two ways of vaccinating against influenza: the traditional needle-and-syringe approach, and FluMist, a nasal spray made by AstraZeneca that has been used safely in the UK and US for years but is arriving in Australia for the first time this season.
The study, called SNIFFLES, will track how children's immune systems respond to each vaccine option, giving parents the choice of which their child receives. What makes this work particularly significant is that blood samples collected from Australian children will feed directly into the World Health Organization's global flu vaccine strategy. Until now, the WHO has relied heavily on immune response data from the Northern Hemisphere when deciding which flu strains to include in vaccines for the rest of the world. This study will fill that gap by providing the Southern Hemisphere's perspective—essentially ensuring that Australian children's biology informs the vaccines designed to protect them.
The timing matters because Australia is facing a genuine vaccination problem. In 2024, the country recorded more than 365,000 confirmed flu cases, the highest number ever reported. The majority of those cases occurred in children under ten. Yet despite having safe, effective vaccines available, uptake remains stubbornly low. In Victoria, only 32 percent of children aged six months to five years received a flu shot in 2024, and just 15 percent of those aged five to fifteen did. The numbers suggest that availability alone is not enough to move the needle.
Parents, however, have signaled what might. A 2025 national survey found that 72 percent of parents said they would be more likely to prioritize flu vaccination if a needle-free option existed. That statistic is the real driver behind this research. Shidan Tosif, the pediatrician and associate professor leading the project at Murdoch Children's Research Institute, frames it plainly: the nasal spray would likely make vaccination less distressing for children and easier for the adults administering it. For families with needle-phobic children—and Tosif notes there are many—the difference could be transformative.
One family already enrolled in the study is Danica and George, whose eight-year-old son Panos is participating. Danica described the needle phobia she sees in young children as a real barrier to vaccination. "Some just can't tolerate a needle," she said, adding that a nasal spray option could be "a game-changer" that would mean more children vaccinated and less illness spreading through schools. The family stays current with flu shots themselves and saw the research as a way to improve the experience for other children.
Tosif emphasizes that the study will yield insights into how children develop immunity to influenza vaccines more broadly, knowledge that could strengthen protection strategies in future years. The nasal spray has already been approved for safe use in children aged two to seventeen by Australia's Therapeutic Goods Administration. The biological samples and data collected will be analyzed by the MOVE Consortium in the UK and the WHO Collaborating Centre for Reference and Research on Influenza at The Doherty Institute.
What unfolds over the coming months will reveal whether a simple change in delivery method—spray instead of injection—can shift parental behavior and vaccination rates. If it does, the implications extend far beyond Australia. The data flowing to the WHO could reshape how flu vaccines are formulated for children across the Southern Hemisphere, making them more precisely matched to the immune responses of the populations they're meant to protect.
Citações Notáveis
The nasal spray would likely make vaccination easier and less distressing for children, and the study will provide valuable insights into how children develop immunity to influenza vaccines.— Shidan Tosif, Associate Professor and Project Lead, Murdoch Children's Research Institute
For children who can't tolerate needles, the nasal spray will be a game-changer, and more vaccinated children means less illness spreading through schools.— Danica, parent of study participant
A Conversa do Hearth Outra perspectiva sobre a história
Why does it matter that this is the first time FluMist is being studied in Australian children specifically?
Because the WHO has been making vaccine decisions based almost entirely on data from the Northern Hemisphere. Australian children's immune systems might respond differently to flu strains circulating here. This study fills that gap.
But FluMist has been used safely in other countries for years. What's new about studying it here?
The safety is established. What's new is understanding how Australian children's bodies respond to it, and more importantly, using that data to inform which flu strains get included in vaccines designed for this region.
The 72 percent figure about needle-free options—that seems like the real story. Are parents actually hesitant about flu vaccines, or just needles?
The data suggests it's the needle itself that's the barrier for many families. Parents aren't rejecting the vaccine; they're avoiding the experience of giving it. A needle-free option removes that friction.
If 72 percent of parents want a needle-free option, why hasn't this happened sooner?
FluMist existed elsewhere but wasn't available in Australia until now. This study is essentially the first real-world test of whether that preference translates into actual behavior change.
What happens if the nasal spray doesn't increase vaccination rates?
Then researchers learn something important about what's actually driving hesitancy. It might not be the needle at all. It could be access, trust, or something else entirely.
And if it does work?
Then Australia has found a tool to significantly increase childhood flu vaccination, and the WHO gets better data for protecting children across the Southern Hemisphere.