The time to get flu shots is now

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

  1. Flu shots for all children 6 months of age and up.
  2. 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.
  3. Children under 9 may need second dose if they’ve not had 2 doses since 2010.
  4. 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.

Wendy Sue Swanson is a pediatrician who blogs at Seattle Mama Doc.

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  • Chiked

    “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”

    Well that’s stating it kindly. I think the numbers are more like 50%….even worse in the elderly. Flu shots are a waste of time. Get sleep, eat well and dress appropriately is your best protection against the flu.

    • John S.

      The author of this piece is a pediatrician. The flu vaccine does do quite a good job of preventing flu-related illness and death in children and babies.

      Making sure that your children get sleep, eat well, dress appropriately, and practice good hygiene is very important. So is having them get their flu shots.

      • Chiked

        It is pretty lousy under two years…..probably no better than placebo. Over two years, well it depends on your definition of “good job”. The article states that children under nine may need a second shot if they have not had two prior. To me that speaks volumes.

        • kjindal

          even if it has poor overall effectiveness, the downside risk to me seems trivial. NY state is now headed to mandated flu vaccination for healthcare workers (or mandated wearing of a mask while in direct patient care). I think this is a good thing, considering how much misinformation is out there, particularly among nursing staff.

          In anticipation of the cries for personal freedoms, don’t we mandate seatbelts in cars? and helmets for motorcycle riders?

          • Chiked

            Risks are actually not trivial: narcolepsy, febrile seizure, guillain-barre syndrome. It may be rare but I do not want to be in that 0.01% or whatever the real number is.

            More importantly to me, the vaccine contains a preservative, thimerosal, which is part mercury and is a known neurotoxin. Will NOT subject myself or my kids to mercury of any amounts.

          • EE Smith

            The risks of developing narcolepsy, febrile seizure, or guillain-barre syndrome from the ‘flu are greater than developing them from the ‘flu vaccine.

            If you are going to look at the side-effects of the ‘flu vaccine, you must also look at the side-effects of the ‘flu. It’s not like there’s no down-side to a young child getting the ‘flu.

          • EE Smith

            Or to put it another way, it’s like looking at all of the remotely possible negative consequences of wearing a seatbelt or riding in a car fitted with airbags, without taking into consideration the possible negative consequences of NOT wearing a seatbelt or having airbags.

  • Mary_Pat_Whaley

    Hi, Seattle Mama Doc! I quoted you this year in my annual flu shot billing update here: Thanks for your contributions. Mary Pat

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