Please don’t tune me out on this one. Don’t let this post resemble Gary Larson’s The Far Side cartoon where you only hear, “Blah, blah, blah, Flu shot, blah, blah, blah, Flu shot, blah, blah, blah”
I write about flu every year because it’s one infectious disease that is not only more aggressive and dangerous for babies and young children, it’s vaccine preventable. The flu causes high fever, terrible cough, body aches, and significant discomfort. It can also potentially cause more serious infections like pneumonia. Unlike viruses that cause the common cold (rhinovirus or RSV), we have a vaccine for influenza.
I’ve had multiple patients in only 7 years of pediatric practice refuse the flu shot and subsequently get influenza. A few of my patients have required hospitalization for influenza and several have had serious infections requiring multiple visits to clinic, ER trips, and respiratory distress. Whenever this happens in an unvaccinated patient, I feel I’ve failed.
The great news with flu is that we can improve protection for our children and teens easily. The majority of the 150+ children who died last year from flu in this country were not vaccinated. And although it’s true that the vaccine doesn’t protect 100% of those who get it, it does protect most from life-threatening illness. Getting a flu shot is the #1 best way to prevent a life-threatening infection from the flu.
It’s flu shot season. You thinking, “blah, blah, blah…?”
The American Academy of Pediatrics has a new policy statement out this month. Their big message is to get all children up to date on their flu shots as early as possible.
What is Influenza?
- Influenza is a respiratory virus that causes days of cough, high fever, body aches, and sometimes pneumonia. Influenza severity is unpredictable from year to year so we immunize annually to protect against serious infections for new strains of the influenza virus that circulate. We want all children to get the flu shot but we also really prioritize those at higher risk for serious infection: infants, children under age 5 years, pregnant moms, the elderly & people of all ages with chronic disease (i.e. asthma, diabetes, neurologic conditions).
Flu Shots
- Who? Recommended for ALL infants and children 6 months of age and up. It’s also recommended for all household contacts of infants and young children.
- What? Trivalent (3 viral strain) flu shots this year contain one new influenza A strain, H1N1 influenza A, and 1 influenza B strain. For the 2013-14 season there is a new quadrivalent influenza vaccine (4 strains) that contains the same 3 strains as the trivalent vaccine, plus an additional B strain. There is no recommendation over getting one over another. Of note, injected shots for babies 6mo-3 years of age do not have thimerosal preservative. Nasal flu spray does not have thimerosal. Those shots for children over age 3 that come in a multi-dose vial may have thimerosal. Once your baby is 2 years old they can get the nasal spray (age 2-49 with no history of asthma or underlying medical conditions) — no pokes!
- Where? The 3 (or 4) strains of influenza included in the shot are predicted to cause illness here in the United States and North America. Here’s a quick video/post I did on how influenza strains are selected for inclusion in the flu shot each year.
- When? Get vaccinated early, especially if in high risk populations. Flu season is unpredictable and the earlier you and your children are immunized the more likely you are protected from flu if and when exposed.
- How Many? Children under age 9 will need a second dose (booster) of flu shot this year if they haven’t had 2 flu shots since 2010.
What Parents Need To Know
- Flu shots for all children 6 months of age and up.
- Egg-allergic children should be vaccinated. Most children diagnosed with egg allergy can safely receive influenza vaccine in the pediatrician’s office without an allergy consultation as the vaccine is well-received by nearly all children and adults who have egg allergy. For children with a history of severe egg allergy– an allergy consultation is still recommended. If concerned about your child’s allergy, talk with their doctor first.
- Children under 9 may need second dose if they’ve not had 2 doses since 2010.
- Protect infants and those at higher-risk for severe infections starting now and ensure you return for boosters as needed. Remind teens, siblings, Grandma, Grandpa, nannies, babysitters, and any caregivers to get a flu shot to protect young children at home.
More information about flu, flu symptoms and prevention is available on Seattle Children’s website.
Lauren @ the VEC says
The Vaccine Education Center at The Children’s Hospital of Philadelphia recently updated its Q&A sheet about influenza to include information about the different forms of the influenza vaccine available this influenza season. Check it out here: https://bit.ly/Influenza_english
Isabelle says
Made appointment for my 5 year old son! Thanks for the reminder!
Chris Johnson says
I’m an intensive care pediatrician and every year see severe cases of influenza. It is an unpredictable virus — you can’t tell who will get severe disease and who won’t. So I echo Dr. Swanson’s (and the American Academy of Pediatrics’s) advice. It’s particularly important for healthcare providers of all sorts to get vaccinated.
Wendy Sue Swanson, MD, MBE says
Thanks, Dr Johnson.
Karen says
What do you say to people who say things like: the flu shot is worse than the flu; you can’t eat eggs for 48-72 hours after getting the flu shot so it’s a terrible vaccine; I never get the flu shot and I’ve never gotten the flu; etc etc. (actual comments when I made a comment on a King5.com facebook post about getting vaccinated). My post was that I hoped all the people who were negating the flu shot would not be the first ones on the Provider’s doorstep when they indeed got the flu, or pneumonia or myocarditis as a complication. Just drives me nuts when people say things that aren’t true, yet then are first in line for Tamiflu when their child gets sick. So…how do you deal with comments like that?
Wendy Sue Swanson, MD, MBE says
Karen,
You ask a great question. I just had to answer similar questions on the Children’s Facebook page where a discussion began.
There is a lot of myth about the flu shot, particularly that it gives you the flu. I also think a fair number of people confuse the stomach flu with influenza. Or feel that once they get the flu shot they should have no upper respiratory infections all season.
The reality is the flu shot only protects against influenza….just one of many colds that circulate in the winter.
All I can do is stick to the fact that no research has ever found that the flu shot gives you the flu. THe injected shot is inactivated (the virus is dead). The live virus nasal spray is a weakened form of the virus that is unable to replicate in numbers in the lungs to cause infection. The vaccine can, commonly, cause symptoms after the injection (things like soreness at hte injection site, fever or overall malaise for a day or two). Those can be common. Runny nose can be common after the nasal spray, too.
But one thing I know from my experience working as a doctor: In my experience, no family that has experienced laboratory positive influenza has declined the flu shot going forward!
Gin says
I thought that it’s up to the doctors office which type of vaccine they order, that there are flu shots for 6 months and up that are multi-dose vials. That said, do you still definitely recommend it (for a little one—my girl just turned one) if it’s a multidose vial? I’ve been reading about the problems with thimerosol, and it seems like everything is anecdotal with no proof. Still, you wonder. I’m so afraid of something bad happening to my child, and being the cause of it or being able to somehow prevent it.
Isabelle says
My two kids and I get a shot every year, but my partner does not. Last year, he was severely ill for about 11 days in our tiny little apartment and we must have had some protection because we did not catch it. He said it changed his mind and he is finally getting the shot this year to avoid that misery!
Kaitlin says
I recently moved from Seattle to Monterey. Because my husband is in the military, our insurance is very limited in terms of pediatricians we can see (there’s only one). My daughter just had her nine month checkup yesterday and her new doctor basically said it was ridiculous to give her a flu shot. He said there are studies saying that vitamin D is almost just as effective. Being a former Seattle Children’s Hospital PICU nurse, I am definitely pro vaccines and pro flu shots. I was caught offguard and didn’t know what to say, it was as if they didn’t even offer them. I was so surprised that we ended up leaving without getting one, and now I’m not sure what to do. Do you have any recommendations for how to approach this issue or talk to this doctor? Thank you!
Wendy Sue Swanson, MD, MBE says
Well, I certainly don’t agree. I work in an area north of Seattle near a pediatrician who tells his patients (by report) that he doesn’t “believe” in the flu shots.
I think you have a few options:
Ask him to share with you the data about flu shots that has encouraged him to go against the Centers for Disease Control and American Academy of Pediatrics recommendation. I think it would be good to have a transparent look.
Ask his the to review the risks for flu shot and if he believes they outweigh the benefit (presumably he believes this if he didn’t encourage your infant to ge the shot).
If he doesn’t provide you with data, get it yourself online. Look at the CDC https://www.cdc.gov/flu/protect/children.htm
and also you can use the data I’ve linked to here in the blog.
In my opinion the flu shot is imperfect (as I said) but certainly in the best interest of your child — esp in our high risk populations like infants who have no long-standing circulating built-up immunity against the virus. You can also go and seek a second opinion from another pediatrician or family physician — ensure they are board-certified, too.
Please let us know how it goes and if I can support you in any other ways.
Camille Devaux says
My sister was talking about getting flu shots for her children. She needs some insights into making sure that this is an effective tool for her kids. It might help her to know that she should look into getting it early in the flu season.