Does my child need a flu shot this year?

Answer From James M. Steckelberg, M.D.

In most cases, yes. The Centers for Disease Control and Prevention (CDC) recommends a yearly flu (influenza) vaccine for all children 6 months and older — ideally given as soon as the vaccine is available each year.

This year the CDC recommends the flu shot or the nasal spray flu vaccine. In the past two flu seasons there was concern that the nasal spray vaccine wasn't effective enough against certain types of flu. The nasal spray vaccine is expected to be more effective in the 2018-2019 season. However, the American Academy of Pediatrics continues to recommend flu shots as the first choice for vaccinating children against the flu.

Depending on your child's age and health, you might be able to choose between a flu shot and the nasal spray flu vaccine:

  • Flu shot. Flu shots can be given to children 6 months and older. Side effects might include soreness, redness, and tenderness or swelling where the shot was given. A low-grade fever, headache and muscle aches can also occur.
  • Nasal spray. The nasal spray flu vaccine can be given to healthy children 2 years and older. Side effects of the nasal spray might include a runny nose, cough, fever, wheezing, vomiting and a sore throat. A headache and muscle aches also can occur.

To determine how many doses of flu vaccine your child needs:

  • 2 doses. If your child is younger than age 9 years and is getting the flu vaccine for the first time or has only had one dose of the vaccine in total prior to July 1, 2018, plan for two doses given at least four weeks apart. Begin the process as early as possible.
  • 1 dose. If your child has had two or more flu vaccine doses at any time before July 1, 2018 — the two doses need not have been given during the same season or consecutive seasons — one dose is enough. Likewise, if your child gets the flu vaccine for the first time at age 9 years or older, one flu shot is enough.

Keep in mind that it takes up to two weeks after vaccination for a child to be fully protected from the flu. Also check with your child's doctor if:

  • Your child isn't feeling well. Nasal congestion might affect the delivery of the nasal spray vaccine. Talk to your child's doctor about your child's symptoms before the flu vaccine is given.
  • Your child has any medical conditions. The nasal spray vaccine isn't recommended for children between 2 and 17 years old who are taking aspirin or a salicylate-containing medication. It also isn't recommended for children ages 2 to 4 years old who have asthma or have had wheezing in the past 12 months. The nasal spray vaccine isn't appropriate for children who have weakened immune systems or serious medical conditions.
  • Your child is allergic to eggs. Most types of flu vaccines contain a small amount of egg protein. If your child has an egg allergy, he or she can receive the flu shot without any additional precautions. If your child has a severe egg allergy, he or she should be vaccinated in a medical setting and be supervised by a doctor who is able to recognize and manage severe allergic conditions.
  • Your child had a severe reaction to a previous flu vaccine. The flu vaccine isn't recommended for anyone who had a severe reaction to a previous flu vaccine. Check with your child's doctor first, though. Some reactions might not be related to the vaccine.

Yearly flu vaccines are also recommended for adults — especially those who have close contact with young children.

Sept. 27, 2018 See more Expert Answers