FLU VACCINATION FOR
An annual flu vaccine is recommended for all children 6 months and older. Ideally, children should be vaccinated with any licensed, age-appropriate flu vaccine by the end of October. However, as long as flu viruses are circulating, vaccination should continue throughout flu season.
By getting children their recommended flu vaccine each year, we can help prevent flu-related illness and death in children, and help stop the spread of the virus to their families and communities.
Children have the highest chance of getting sick from flu and often spread flu throughout their communities. During bad flu seasons, approximately 30 percent of school-aged children fall ill with flu, and as a result, children miss approximately 38 million days of school due to flu each year in the U.S.
Joseph and his family received their flu vaccines every year, but in 2009 he had not been vaccinated against H1N1 influenza because at the time the vaccine was not available in his community.
Flu severity varies each season, but each year millions of children get sick, thousands are hospitalized and some die from flu. The majority of them are otherwise healthy, but unvaccinated.
Approximately 20,000 children under the age of five are hospitalized due to flu each year — that’s enough children to fill 870 average American classrooms. Infants and toddlers are hospitalized at rates similar to elderly people and at higher rates than people of all other ages.
On average, approximately 100 children die from the flu and its complications every year in the U.S.. To date, more than 1,700 children have lost their lives to flu since 2004; most of whom were not vaccinated and many of whom were otherwise healthy. The CDC indicates pediatric flu deaths are likely under-reported because not all children whose death was flu-related may have been tested for influenza.
Benefits of Flu Vaccination in Children
A 2017 study has shown that flu vaccination significantly reduces a child’s risk of dying from influenza - there was 65% reduction of risk among healthy children and a 51% reduction of risk among children with underlying high-risk medical conditions.
Getting children vaccinated helps ensure they don’t spread flu to others who are vulnerable to serious flu illness, like infant siblings too young to be vaccinated, immunocompromised classmates, older family members or people with certain chronic health conditions.
FACT: Less than 60% of children under the age of 17 get an annual flu vaccination. However, a recent study suggests that if we could raise flu vaccination rates among children and adolescents to 80%, we would see a 91% reduction of flu across all populations.
- High and prolonged fever (102 degrees or above for more than 72 hours)
- Changes in mental condition, such as not waking up or not interacting; being so moody that the child does not want to be held; or seizures
- Bluish or gray skin color
- Drop in body temperature (hypothermia)
- Difficulty breathing
- Not able to take in the usual amount of fluids
- Flu-like symptoms improve, but then return with fever or worse cough
- Worsening of underlying medical complications (for example, heart or lung disease, diabetes)
There are two different types of vaccines that are recommended for children depending on their age:
Flu shots (also referred to as inactivated influenza vaccine or IIV), are administered as an injection made with inactivated (killed) flu virus and are approved for use in children 6 months and older.
A nasal spray vaccine (also referred to as live attenuated influenza vaccine or LAIV) is approved for use in children age 2 through 17, with the exception of children who have certain underlying medical conditions such as asthmas. Learn more about precautions against the use of nasal spray flu vaccine here.
The best way to protect infants from flu before they are able to receive their own flu vaccine at 6 months of age, is for expectant women to get a flu vaccine in pregnancy.
Additionally, anyone who will come into close contact with infants, such as other family members and caregivers, should get a flu vaccine to reduce the chance that they will spread flu to young children.
In the first year that children aged 6 months through 8 years of age are vaccinated for flu, the CDC recommends that they receive two doses of flu vaccine, at least one month apart. Children who previously received a flu vaccine only need one dose.
Most flu shots and the nasal spray flu vaccine are manufactured using egg-based technology. Because of this, they contain a small amount of egg proteins, such as ovalbumin. While this may sound concerning for children with egg allergies, an abundance of research has been conducted on the safety of flu vaccines in egg-allergic and non-egg-allergic patients. These studies consistently show that severe allergic reactions in people with egg allergies are unlikely and that individuals with a history of egg allergy of any severity can receive any licensed, recommended, and age-appropriate influenza vaccine.
For those individuals who have a history of severe allergic reaction to egg (i.e., any symptom other than hives) the CDC does suggest that the patient be vaccinated in an inpatient or outpatient medical setting (such as a hospital, clinic, health department or physician's office), under the supervision of a health care provider who is able to recognize and manage severe allergic conditions.
For more information about flu vaccination in persons with a history of egg allergy, visit the CDC’s website here.
Children with asthma are at high risk of developing serious flu complications, even if their asthma is mild or their symptoms are well-controlled by medication. This is because people with asthma have swollen and sensitive airways, and flu can further inflame the lungs and airways which can trigger asthma attacks and worsen asthma symptoms. It also can lead to pneumonia and other acute respiratory diseases. In fact, children with asthma are more likely to develop pneumonia after getting sick with flu than those who do not have asthma. Asthma is the most common medical condition among children hospitalized with flu.
Flu shots have been deemed safe for children with asthma; however, parents are cautioned against using the nasal spray flu vaccine (LAIV) in children with certain underlying medical conditions, including asthma.
Frequently Asked Questions About Flu Vaccination in Children:
Flu vaccines are readily available in a wide variety of locations, including doctors’ offices, schools, health departments and community clinics and health centers. Some supermarkets and pharmacies offer flu vaccines, but there are different regulations in each state which govern the minimum age a patient must be in order to receive a vaccine administered by a pharmacist. It's best to call ahead to inquire about insurance coverage, flu vaccine availability, the need for a scheduled appointment, and potential age or health restrictions. You can use the flu clinic locator to help identify a proper location for flu vaccination.
It’s important to acknowledge your child’s fear and let them know that you will do everything you can to reduce their pain and anxiety. At the same time, be firm and explain that vaccines are necessary to keep your child healthy. It can be helpful to discuss your child’s fears with your clinician so that you can discuss ways to support your child ahead of any immunization appointments.
The following suggestions may help to ease the pain and anxiety surrounding an immunization:
- Prepare your child by talking about what to expect ahead of time, but don’t reveal too much to make them overly anxious. Remind them that any pain they may experience will be brief compared to the pain and discomfort of suffering with a vaccine preventable disease.
- Use deep breathing exercises or distraction techniques both before and during the injection to make the experience more comfortable. This may include noisy toys, video games, music, jokes, or singing.
- Consider desensitizing the skin around the injection site with ice or topical anesthetics that are applied 30-60 minutes ahead of time. You may want to ask a pharmacist to help you select a product and talk to your doctor about where to apply the cream.
- Feel free to offer a treat, like a lollipop, sticker or ice cream afterward but make sure you present it as a reward for a job well done, instead of a bribe.
There are also a few things NOT to do:
- Don’t promise extravagant gifts, because they will expect them every time.
- Don’t convince them that it won’t hurt. Tell them it will hurt a little bit, but it will be over quickly.
- Don’t withhold information from the child who will be getting the needle.
- Don’t apologize. Research shows that saying things like “I’m sorry!” actually makes the experience worse. Instead use positive reinforcement by saying something like “We do this to keep us healthy, and you’re really brave”
- Don’t joke about the doctor or nurse giving a shot as punishment as it sets your child up to believe that the doctor may harm her.
- You may help hold your child still, but refrain from pinning them down. Kids can overreact sometimes in order to get a response from their parents, in hopes that the parent will allow them to skip the shot. So if your kid is throwing a tantrum, consider leaving the room briefly so the staff can do their job. Or try standing in the corner of the room and maintaining eye contact to show support without getting in the way.
In most instances, a fear of needles can be overcome. However, if you have tried these techniques and your child is still are struggling with extreme needle phobia, consider discussing the benefit of an anti anxiety medication with your clinician.
The good news is that you probably don't have to pay for a flu vaccine for your child. Flu vaccinations are considered preventive services that most insurers fully cover without charging a co-pay or co-insurance—even if you haven’t met your annual deductible yet. As long as you choose a provider that is in your plan’s network, your flu vaccine should be free. Under Medicare, you also pay nothing. Also, if your family is uninsured or underinsured, you can often access free vaccines from doctors who participate in the Vaccines for Children Program. This federally funded initiative is designed to provide vaccines at no cost to qualified clinics with the aim of distributing them to the children most in need. Use the vaccine finder tool to look up providers near you and call to inquire about your cost with or without insurance ahead of time so there are no surprises.
Access our Keep Flu Out of School resources for teachers, school nurses and school administrators to find out how we are encouraging flu vaccination among school-aged children.
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