The Flu Vaccine for Children and Toddlers

A flu vaccine can prevent your child from getting seriously sick, so why do many parents blow off the flu shot for toddlers and children?

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If you're thinking about skipping flu vaccination for your family this year, then your child has probably never had influenza – which can leave her coughing, feverish, and completely wiped out for a whole week. "Unfortunately, many parents consider the flu to be nothing more than a slightly nastier version of a cold. It's actually a very serious, potentially fatal illness," says Parents advisor Neal Halsey, MD, director of the Institute for Vaccine Safety at Johns Hopkins Bloomberg School of Public Health, in Baltimore. Complications of the flu include pneumonia, antibiotic-resistant staph infections, and ear and sinus infections.

Amazingly, only 18 percent of children ages 6 months to 2 years are vaccinated, despite the fact that an estimated 20,000 children under the age of five with influenza need to be hospitalized each year, according to the Centers for Disease Control and Prevention (CDC). Kids who have a chronic medical condition like asthma or diabetes have a higher risk; they’re five times more likely to be hospitalized than healthier kids. These statistics help explain why the CDC recommends that all children older than six months get a vaccination. Here’s what you need to know about the flu vaccine for children.

Flu Shot for Toddlers and Children

Most people get immunized as soon as the vaccine is available in October or November, but your child can benefit from getting the shot as late as April. "It's not uncommon to still have flu strains circulating throughout the spring," says Kathleen Gutierrez, MD, a pediatric-infectious-disease expert at Lucile Packard Children's Hospital at Stanford, in Palo Alto, California. Keep in mind, though, that your child's immune system needs two to four weeks to build up protective antibodies, so he could still get sick if he's exposed to an influenza virus soon after he's vaccinated. If your child is younger than 9 and getting the flu vaccine for the first time, he'll need a second dose of the shot within four to six weeks. This two-step process gives his immature immune system time to respond.

Are there any flu shot alternatives? The shot isn't your family's only option for protection against influenza. Your child may be able to get misted, too: A FluMist nasal-spray vaccine is approved for use by people two years to 49 years (but not pregnant women). But children of any age who have asthma or recurrent wheezing problems shouldn't use the nasal spray because it may aggravate breathing difficulties. The mist’s effectiveness changes between seasons, much like the flu shot, and some insurance companies may not cover it.

Will my child get sick from the vaccine? Despite common misconception, your child is not going to get sick from the flu vaccine. The nasal-spray vaccine is made with live, but extremely weak, influenza strains that won't cause the illness. Nevertheless, some children develop mild flu-like symptoms within 48 hours of getting either type of vaccine. "These reactions are actually a good sign that your child's body is busy building flu-fighting antibodies," explains Susan Rehm, MD, medical director of the National Foundation for Infectious Diseases. Any side effects should subside within a day or two.

Does the flu vaccine cause autism? The flu shot is the only immunization given to children that still may contain small amounts of thimerosal, a mercury-based preservative that some claim causes autism. But, thankfully, numerous studies have found no association between vaccines containing thimerosal and autism. Even so, most pediatricians now offer preservative-free shots for young patients whose parents request them. If your child is older than 2, you can also opt for the nasal spray, which doesn't contain thimerosal.

Pregnancy and the Flu Shot

Pregnant women need protection against the flu, too. The American College of Obstetricians and Gynecologists and the CDC recommend that all expectant moms get the flu shot (the nasal spray isn't approved for use in pregnancy) because they're at higher risk of suffering complications of the flu such as pneumonia and even miscarriage. Getting vaccinated during pregnancy may also give your baby's immune system a boost: One study found that babies born to mothers who had received flu shots during their last trimester had a lower rate of influenza during their first six months of life. Breastfeeding moms can be vaccinated and may pass along virus-fighting antibodies to their infants, and the CDC suggests that nursing mothers who've had the shot breastfeed their their infants often as a result.

Facts About Antiviral Drugs

Flu shot effectiveness changes every year, but success rates usually range from 20-60%. If your vaccinated or unvaccinated child develops flu symptoms – a fever, chills, muscle aches, headache, extreme fatigue, runny nose, sore throat, and a hacking cough – get him to the doctor quickly. A rapid flu test can determine in about 30 minutes whether it's the flu. If it is, taking an antiviral drug can reduce the severity of the illness and shorten its duration by at least a day or two. To be effective, treatment must begin within 48 hours of the onset of symptoms. Antiviral drugs may be particularly helpful for kids with underlying conditions that might put them at higher risk for severe influenza. Children older than 1 year can take the liquid drug Tamiflu; kids 7 and up can take Relenza, a spray that's inhaled through the mouth. Using an antiviral drug also reduces the odds that other family members will get sick.

The Life of a Flu Virus

To see the importance of the flu shot for toddlers and children, read about the life of a typical flu virus.

Day 1: An unvaccinated 4-year-old gets sneezed on at preschool.

Day 4: He has a fever of 103 F., is too exhausted to play, and complains that his head hurts. Assuming there's not much she can do if he has the flu, his mom makes him comfy on the couch and gives him lots of liquids and chicken soup.

Day 5: The fever is down to 100 F., but he's coughing up greenish-yellow phlegm, his body aches, and he has loose stools.

Day 8: His cough is better, but he's very congested and isn't eating or drinking much.

Day 9: His mom takes him to an urgent-care facility, where he tests positive for influenza and is given IV fluids for dehydration and antibiotics for an ear infection brought on by the flu.

Day 12: He's finally feeling well enough to play with his big sister, but he gets tired easily. Next year he's definitely getting the flu vaccine.

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