New guidelines for protecting kids from flu


For the Mirror

Flu season is arriving, and along with it come questions about influenza vaccination, or Ž“the flu shot.Ž” While most of the usual recommendations for immunization remain the same this year, there are some recent changes regarding infants and toddlers that deserve attention.

Influenza (flu) is a severe and contagious respiratory illness marked by fever, headache, muscle aches and cough. It is not, contrary to a common misconception, an illness of vomiting and diarrhea. Influenza is caused by a virus that seems to disappear in the spring and summer but reappear each year in late fall, eventually peaking between December and March.

Most people with influenza miss school or work but eventually recover. However, a substantial number end up hospitalized or develop complications, such as pneumonia or ear infections, and about 20,000 people in the U.S. die each year as a result of flu.

Due to the amazing memory of our immune systems, a previous infection with any particular virus usually protects you against reinfection with the same virus later on. But the crafty flu virus tends to change itself ever-so-slightly each year as it circles the planet, thwarting our natural defenses and leading to yearly epidemics.

This is where the flu shot comes in. Each year, the Food and Drug Administration predicts which strains are most likely to show up in the U.S. that fall, and the vaccine manufacturers pack protection against three such strains into one vaccine. An annual flu shot is typically recommended for all adults over age 65 and all children and adults with certain chronic medical conditions such as asthma or heart disease, given the increased risk of complications in these groups. Anyone with frequent contact with such high-risk individuals should also be immunized.

For all other healthy children and adults, flu shots are typically recommended for those who wish to personally protect themselves against the flu. But priority must be given first to the previously mentioned high-risk groups, as vaccine supplies are sometimes limited.

However, the Advisory Committee on Immunization Practices of the Centers for Disease Control and Prevention (CDC) recently reviewed new evidence which suggests that healthy children 6 months to 23 months of age are at increased risk of hospitalization from influenza. This risk is close to that of adults over 65. Therefore, flu shots for all healthy infants and toddlers in this age range is now strongly encouraged.

Since the flu shot is not given to infants under 6 months (it simply doesnŽ’t work for them), vaccination of family members is also recommended to protect the littlest ones.

There are some things to keep in mind when considering a flu shot:

Ž¥ First, while most adults get just one dose of the vaccine each year, all children under 9 years old receiving the flu shot for the first time need two doses at least four weeks apart in order to get a proper response. This includes, of course, our newly identified high-risk group of 6 to 23-month-olds.

Ž¥ Next, if you have an egg allergy or have had a severe reaction to the vaccine in the past, the flu shot is not for you.

Ž¥ And finally, you should not get the shot if you are currently sick with a fever.

A few myths about the flu shot are worth dispelling. First, the flu shot cannot give you the flu. It is not a live-virus vaccine. Many believe they got the flu from the shot because they mistook the side-effects of the vaccine itself, which usually consists of mild fatigue and perhaps fever for one or two days (and are generally not nearly as severe as the flu itself and are not contagious) for influenza infection.

Or, they happened to get sick with another illness right after getting the flu shot, which is certainly not infrequent since routine vaccination starts right at the beginning of the cold season.

Secondly, even if you get the flu shot, you can still get sick during the winter. There are hundreds of other cold viruses and flu-like viruses you can catch, and no vaccine (including the flu shot) is guaranteed to be 100 percent effective. But even if you still catch the flu despite being vaccinated, the illness tends to be less severe.

Ideal timing for flu shots is October for high-risk individuals and November for all others.

For more information, visit the CDCŽ’s National Immunization ProgramŽ’s Web site on influenza at

Dr. Jonathan Fox is a pediatrician at Virginia Mason Federal Way. He can be reached at 874-1616.

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