FLU REMEDY MAY BE JUST A SNIFF AWAY.

Byline: Mary F. Pols Daily News Staff Writer

Everyone knows the traditional faceoff between a quaking child and a needle-wielding physician.

The victim wails, the parent flinches, the doctor stabs.

It's such a painful process that many doctors and school districts opt out of giving children flu shots, choosing instead to save the needle horror for mumps, measles and the like.

But those days may be drawing to an end. Working in collaboration with the National Institutes of Health, researchers at Aviron, a Mountain View-based drug company, are putting the final touches on a new type of flu vaccine that can be delivered with a simple squirt up the nose.

Easier to inflict and possibly more effective, the nasal spray probably will be available commercially by 1999.

Since last fall, about 60 kids from the San Fernando Valley have been part of a study of the new vaccine.

The final results are not in yet - the study is expected to go on for several flu seasons - but Dr. S. Michael Marcy, the Kaiser Permanente pediatrician coordinating the joint study with UCLA, said one benefit is immediately obvious.

``Kids are far more accepting of the internasal spray,'' Marcy said. ``They don't love it, but they certainly tolerate it quite well. It's almost done by the time they realize it is being done.''

Preliminary research released during a meeting of the Pediatric Academic Societies in Washington, D.C., on Tuesday showed that the vaccine was effective against two major flu strains.

The nasal spray has been in development for nearly 20 years. Its origins stem from a team of researchers at the University of Michigan working under contract with the Department of Defense to help keep soldiers healthier.

The incentive behind using a nasal spray to immunize rather than giving a shot is twofold, said Dr. Dominick Iacuzio, an influenza program officer with the NIH. Not only is the spray painless, but because it penetrates the upper respiratory tract - breeding ground for flu - it may create a stronger and longer-lasting immunity to the virus, he said.

``Scientifically there was some data to support the theory that it might be more effective,'' Iacuzio said.

Side effects of the vaccine are minimal, he said, and may include a runny nose or headache.

For immunization specialists, influenza is the plague that persists. It might be common, but they emphasize that its hazards should not be overlooked. For the elderly, those with weakened immune systems and the very young, flu can be fatal.

``Influenza is a terrible disease,'' said Dr. Joel Ward of the UCLA Center for Vaccine Research. ``It is associated with major mortality and major morbidity.''

Researchers have to practically run to keep up with it because the dominant strains shift and mutate constantly. It's impractical to immunize every man, woman and child against the flu because the vaccine must be given at the onset of every flu season.

That's why the advent of a painless, nasal-spray vaccine is so enticing to some local doctors.

``I'm looking forward to it,'' said Dr. Marshall Goldberg, an Encino pediatrician who in his day has faced many howling children with a needle in his hand.

Dr. Michael Tabak, a Woodland Hills-based pediatrician with Kaiser Permanente, said he welcomes the idea for the spray and hopes the technology eventually spreads beyond flu to other sicknesses such as measles and mumps.

``Shots are the bread and butter of what I do,'' Tabak said. ``But having a shot is certainly a noxious stimulus which nobody enjoys.''

Children's inherent dread of needles is actually reinforced by some parents.

``I'll walk in sometimes and a parent will be saying to their child, `Now you be good or I'm going to have the doctor give you a shot,' '' Tabek said. ``So in some small, sick way, that message is being reinforced. I find myself in many of my visits saying, `I'm not the shot doctor!' ''

Maybe someday he'll be known as the spray doctor.