Children in years past who escaped painful flu shots and got their annual flu vaccination by a quick spray in the nose won’t be so lucky this upcoming flu season. A committee of experts that advises the Centers for Disease Control and Prevention voted that the FluMist nasal spray vaccine should not be used this flu season because it has not protected against the flu as well as standard flu shots for the past three years. This underscores the longstanding advice from our medical advisers that the flu shot is the best option for most people, including children.

The sting of flu shots may trigger more tears but the increased protection could save lives. Every year, the flu causes thousands of deaths and more than 200,000 people are hospitalized. The most vulnerable are the very old and the very young.

The bottom line is that everybody over 6 months of age should be getting injectable vaccines against influenza this flu season, says William Schaffner, M.D., who is a liaison representative on the CDC’s Advisory Committee on Immunization Practices that made the recommendation against FluMist.

“This will have a particular impact on pediatric practices because there are a lot of kids who would prefer to get a nasal spray flu vaccine rather than an injection,” adds Schaffner, who is the chairman of the department of preventive medicine at Vanderbilt University School of Medicine in Nashville, Tenn.

The CDC said FluMist accounted for about a third of flu vaccinations given to children in recent years and that it is working with manufacturers of flu shots to make sure they produce enough to make up the shortfall for the upcoming flu season.

The CDC said it’s not sure why FluMist has been less effective in recent years. Initial studies with the nasal spray vaccine when it was first approved in 2003 suggested it might provide better protection against the flu than standard flu shots. The CDC even recommended it as the preferred flu vaccine for young children in 2014. But the CDC’s review of data from the 2013, 2014, and 2015 flu seasons found that FluMist offered no protection against the flu in children two to 17 years old. The standard flu shot by comparison reduced the risk of children getting the flu by 63 percent in 2015.

Some adults who wanted to avoid needles also turned to FluMist in past years. One potential option for them is Fluzone Intradermal, says Schaffner. It still uses a needle but it’s a very tiny needle that injects the vaccine just under the skin, instead of deep into the muscle as standard flu shots do. This avoids the muscle soreness standard flu shots can cause, but Fluzone can trigger temporary redness and swelling at the injection site. And it’s not approved for children, only adults ages 18 to 64.

For more on how to protect yourself this flu season, check out our guide to preventing and treating the flu.

Editor's Note: This article is made possible by a grant from the state Attorney General Consumer and Prescriber Education Grant Program, which is funded by the multistate settlement of consumer-fraud claims regarding the marketing of the prescription drug Neurontin (gabapentin).