Does the nasal flu vaccine work after all? The CDC has recommended against using the live attenuated influenza vaccine (LAIV) this year due to low efficacy rates. Previously, LAIV was considered superior to the inactivated influenza vaccine (IIV). The Canadian Institutes of Health Research studied children in Hutterite colonies in northern Canada, where members live in close-knit, small, rural communities in which influenza virus infection regularly occurs. The goal was to compare LAIV to IIV to assess real-world protection of the two vaccines against flu from October 2012 to May 2015 during the course of three flu seasons. The primary outcome was laboratory-confirmed influenza A or B. The rate of influenza was the same in both groups (5.3% LAIV group vs. 5.2% IIV group) (hazard ratio, 1.03; 95% confidence interval, 0.85-1.24). (Ann Intern Med. Published online Aug. 16, 2016. doi: 10.7326/M16-0513) While this study was designed to establish if LAIV was superior to IIV, it showed that the vaccines were of equal efficacy, at least in preventing influenza.