On September 19, 2007, MedImmune Vaccines (Gaithersburg, Maryland) received approval from the Food and Drug Administration (FDA) to expand the use of FluMist®, a live, attenuated influenza vaccine (LAIV), to children aged 2--4 years (i.e., 24--49 months). FluMist is an intranasally administered influenza vaccine that was first licensed by the FDA in 2003 for healthy, nonpregnant persons aged 5--49 years (1). Expanding the age indications to include healthy children aged 2--4 years provides another influenza vaccination option for young children. In granting the new approval, FDA emphasized that FluMist is not approved for vaccination of children aged <2 years or adults aged >49 years, and that FluMist safety has not been established in persons with underlying medical conditions predisposing them to influenza-related complications (2). In addition, FluMist should not be administered to persons with asthma or children aged <5 years with recurrent wheezing (1,2).

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