Pediatrician Group Urges Early Flu Vaccine for Children

September 3, 2013

News Review From Harvard Medical School --Pediatrician Group Urges Early Flu Vaccine for Children

Children ages 6 months and older should get vaccinated against the seasonal flu as soon as the vaccine is available. This recommendation is from the American Academy of Pediatrics (AAP). There are two vaccines this year. The trivalent vaccine protects against three strains of the virus. A new quadrivalent vaccine protects against the original three plus a fourth strain. The AAP is not recommending one vaccine over the other. It wants everyone to get vaccinated at the earliest chance so they are protected. The journal Pediatrics published the recommendations online. HealthDay News wrote about it September 2.

By Henry H. Bernstein, D.O.
Harvard Medical School
 

What Is the Doctor's Reaction?

Flu is short for influenza. Nobody likes having the flu. It is an infection of the breathing system (nose, throat and lungs). It can bug the whole body. It causes fever, cough, sore throat, body aches and more.

Last year the flu was moderately severe compared to the year before. That's because it had:

• More outpatient visits due to influenza-like illness
• Higher rates of people being hospitalized
• More deaths due to pneumonia and influenza

The American Academy of Pediatrics (AAP) has just released its latest recommendations to prevent the flu. These are published online in the journal Pediatrics. Here are some key messages for this flu season:

Everyone (6 months of age and older) needs a flu vaccine every year. Vaccination is especially important for:

• Children with conditions that increase their risk of complications from the flu
• Adults who provide care for:
  • Children under the age of 5
  • Children with high-risk conditions
• Doctors, nurses and other health care workers
• Women who are pregnant or are thinking about getting pregnant, those who just delivered or are breastfeeding during flu season

The flu vaccine has changed from last season. It has either 3 (trivalent) or 4 (quadrivalent) strains in it. Some of the strains are different from the vaccine last year. The vaccine protects against those virus strains expected to make people sick this year.

Quadrivalent vaccine is a new form of vaccine licensed this year. It protects against the same 3 strains as in the trivalent one. It also protects against a fourth flu virus strain. The AAP does not recommend one vaccine over another this year. Just be sure everyone gets one!

Children can get the flu vaccine in 2 ways – either an inactivated (killed) vaccine given as a shot into the muscle or a "live-attenuated" (weakened) vaccine sprayed into the nose. Both kinds are available without thimerosal. The doctor can help you decide which vaccine is best for your child.  

The number of vaccine doses needed depends on your child's age and  past flu vaccine history.

• Children 9 years and older need only 1 dose.
• Children 6 months through 8 years of age should get 2 doses, if they have not had 2 or more doses of seasonal flu vaccine since July 1, 2010 (only 1 dose if they did).
• Children less than 6 months old cannot receive any flu vaccine.

Children with an egg allergy still should get flu vaccine. Research shows the flu shot is safe for nearly all children with egg allergy.

• Any child who has had a mild reaction to egg (hives) can receive the flu vaccine.
• If your child has had a severe reaction to egg (facial swelling, wheezing, trouble breathing, vomiting), your pediatrician should check with an allergist before giving the flu vaccine.

What Changes Can I Make Now?

The flu is no fun. It causes children to miss their usual activities. Worst of all, the flu can lead to being admitted to the hospital or even dying.

Get vaccinated! It is the best way for your whole family to prepare for this coming flu season. Everyone -- children, their brothers and sisters, parents, caregivers -- should get a flu vaccine. When others are vaccinated, they are less likely to get the flu. As a result, they are less likely to pass it on to children. This is known as "cocooning."

Flu viruses are unpredictable. You never know when the flu will hit your community. It is important to get the vaccine as soon as it is available in your area.

Keep flu germs from spreading. The flu virus spreads easily through the air with coughing and sneezing. It also spreads by touching things like doorknobs or toys and then touching your eyes, nose or mouth.

• Keep children with the flu home from school or childcare until they recover.
• Everyone should wash his or her hands often. Use soap and warm water for at least 20 seconds. That is about as long as singing the "Happy Birthday" song twice. And an alcohol-based hand cleanser or sanitizer works well, too. Put enough on your hands to make them all wet, then rub them together until dry.
• Teach your children to cover their mouth and nose when coughing or sneezing. Show them how to cough into the elbow or upper sleeve (not a hand) or use a tissue.
• Throw all tissues used for runny noses and sneezes in the trash right away.
• Wash dishes and utensils in hot, soapy water or the dishwasher.
• Don't let your children share pacifiers, cups, spoons, forks, washcloths or towels without washing. Never share toothbrushes.
• Teach your children to try not to touch their eyes, nose or mouth.
• Wash door knobs, toilet handles, countertops and even toys. Use a disinfectant wipe or a cloth with soap and hot water. (A disinfectant is a cleaner that kills germs.) 

What Can I Expect Looking to the Future?

Manufacturers think more than 130 million doses of influenza vaccine will be distributed in the United States this season. This should mean enough vaccine will be available for everyone.

Expect doctors to recommend the flu vaccine for you, your child and your whole family. Hopefully, more people than ever will be vaccinated this year. This should mean there will be fewer medical visits, hospitalizations and deaths from the flu this year.

Next year, more quadrivalent vaccines might replace the trivalent vaccines. Plus, researchers keep studying how to make the flu vaccine even more effective.