Turn the Vent On in an Airplane Plus Antihistamine Nasal Spray

Is it possible to improve the air you breathe on an airplane? What about that little vent over your seat? Can it do anything to help enhance air quality? If you suffer a runny nose while flying, what can you do to calm an allergic reaction? A reader wants an answer that might prevent unpleasant stares from strangers. The solution might also protect against COVID, colds and flu.

How To Tame An Allergic Reaction to Airplane Air:

Q. On my last few trips, I developed severe nasal allergies and runny nose while on the plane. It was uncomfortable and embarrassing. Other travelers may have thought I had a bad cold or something worse.

I am sensitive to fragrances and air fresheners, but being on a long flight meant there was no escape. I do hope to travel again in the near future. Any suggestion to prevent this unpleasant reaction on the flight would be most welcome.

A. You might want to consider the topical antihistamine azelastine (Astepro). This nasal spray helps combat allergies.

An added bonus might be its antiviral activity. One study showed that it may reduce the risk of catching COVID-19 or a cold (JAMA Internal Medicine, Sept. 2, 2025).

Why Take Azelastine Nasal Spray When Traveling?

First, a disclaimer. We take no money from the pharmaceutical industry. That means we can report objectively on the pros and cons of medication.

The reason we like this antihistamine nasal spray is its antiviral activity. Yes, it can calm an allergic reaction, and that can be helpful if you have to interact with a cat when visiting a friend’s house.

If you are allergic to cat dander you probably know that the cat will make a beeline for your lap. Preparing in advance with a spray like Astepro or a mast cell stabilizer such as NasalCrom (cromolyn) can be helpful. There is more information about this nasal spray for allergies at this link.

Azelastine may also reduce your risk of catching an upper respiratory infection when traveling.

Here is what the researchers who have studies azelastine describe at the anti-viral activity of this antihistamine:

“Azelastine is a second-generation histamine H1-receptor antagonist and widely used as over-the-counter nasal spray for treatment of allergies. Beyond its established antiallergic and anti-inflammatory properties, recent research has revealed antiviral activity against a range of respiratory viruses, including SARS-CoV-2, respiratory syncytial virus (RSV), and influenza A (H1N1). These effects are thought to involve multiple mechanisms such as interactions with angiotensin converting enzyme 2 (ACE2), inhibition of the SARS-CoV-2 protease Mpro, modulation of the σ-1 receptor, and suppression of ICAM-1 upregulation.”

OK, that’s quite technical. But you get the gist, right? This antihistamine does a lot more than just control allergies. It has surprisingly broad antiviral activity.

Conclusions:

“In this single-center trial, azelastine nasal spray was associated with reduced risk of SARS-CoV-2 respiratory infections.

“In addition to SARS-CoV-2, azelastine nasal spray showed efficacy against symptomatic rhinovirus infection, the most frequently identified non–SARS-CoV-2 pathogen in this trial.”

Rhinoviruses are cold viruses.

Protect Yourself When Traveling:

When you are traveling, you are especially vulnerable to viral infections. That’s because you are exposed to a lot of people in the airport, on the jetway and on the plane. If you need a rental car, the bus that you have to take is almost always crammed with people who will be spreading their germs in a tight space.

Most people realize that air travel increases the chance of catching a respiratory infection. But very few people are willing to wear a mask any more. What else can you do, especially when on an airplane?

While in the air, planes have very good ventilation. True, half the air you breathe is recycled within the cabin. The other half, however, is mixed with outside air. A high efficiency particulate air filter (HEPA) pulls dust and germs out of the recirculated air.

Leave Your Vent On!

But you will be exposed to COVID, cold or flu viruses if someone coughs or sneezes in your general vicinity. That is why you want to keep the air vent on over your seat. A lot of people find that air too cold or annoying, but it is helpful in keeping germs out of your personal space.

The turbulence that air flow creates keeps your personal space cleaner and freer of viruses and other particles. A low or medium setting should be sufficient.

There is a lot of disagreement as to whether you should point the vent directly at your face or to either side. Until there is much better research about this, I would suggest that directing the air from the vent to either side of your face will be more comfortable and will create enough turbulence to reduce viral exposure somewhat.

Though travelers are not currently required to wear masks, a high-quality mask such as an N95 can provide you with a fair amount of protection from airborne pathogens.

Should You Take Echinacea?

Q. After I caught a head cold while traveling, my doctor told me to take echinacea the day before getting on a plane, the day on the plane, and for one day afterward. I’ve followed this advice for years and never caught a cold on an airplane since.

A. We understand that the air filtration systems on airplanes is very good. That said, traveling can be stressful. You also come in contact with lots of people who might be shedding viruses.

Echinacea is a popular herbal treatment that has antiviral activity. It may also help stimulate the immune system to help fight off cold or flu infections.

However, this botanical medicine may interact with prescription medications such as amiodarone, carbamazepine, felodipine, methotrexate and sildenafil. Always check with a physician and pharmacist to avoid dangerous combinations.

Final Words:

Traveling can be both stressful and risky, especially over the holidays when a lot of people are flying to visit friends and family. There will be viruses in the air you breathe! That is why we encourage people to use good common sense.

There has been a surprising lack of high-quality research to determine what the best practices might be to avoid infections.

One study of masking on cruise ships (Emerging Infectious Diseases, May, 2024) concluded:

“In conclusion, our ecologic study demonstrated the safe restart of cruise ship sector operations and indicated that mask use added an extra layer of protection…”

Most people are not going to wear an N95 mask, however. Even if such masks worked really well, Americans seemingly hate masking.

That leaves relatively few options. Azelastine nasal spray (2 to 3 times a day) might be helpful, but we need bigger and longer-lasting clinical trials to know for sure. If you do travel on an airplane, why not turn on your air vent? It just might be beneficial.

Please do share this article with friends and family. Your help keeps this newsletter and website moving forward.