Winter is coming and many parents are starting to ask themselves whether they should give their child the annual flu vaccine. Each year parents ask me whether it is worth giving to their kids as many don’t think of flu as a serious illness or they simply struggle to find the time to take their kids to the GP for a vaccine that is needed each year. So with the flu season fast approaching, it’s a good time to look at the facts.
What is the flu?
Flu is a viral infection that causes:
- Fever, cough, runny nose
- Headaches, muscle aches and pains
- Nausea, vomiting and diarrhoea in some people
- Neurological complications, such as seizures, encephalitis (inflammation of the brain), confusion or disorientation or paralysis can occur in up to 10% of hospitalised children, with half being previously healthy kids and half having underlying medical conditions (See article by Khandaker below).
The flu strains that circulate in the community can be either A or B strains.
Flu can be a very severe illness and young kids are at higher risk.
Of all vaccine preventable diseases, influenza or the ‘flu’ is the leading cause of hospitalisation among Australian children under five years of age. Many parents simply don’t know that. In fact, nearly 1,500 kids are admitted to hospital for confirmed flu each year and healthy kids under five are the most likely age group to be hospitalised for complications related to flu.
Children can die from the neurological and other complications related to flu. A recent study looking at all admissions to paediatric intensive care units in Australia and New Zealand over a 17-year period (1997-2013) for kids up to 16 years old found that half of the children who died with flu-related admissions were previously healthy kids (see the study by Marlena below). This is a very important reminder about how serious flu can be.
Kids are also more likely to catch the flu compared to adults (20-30% of kids compared to 10-30% of adults) and kids contribute greatly to the spreading of the disease in the community.
Who is eligible for the free flu vaccine?
The flu vaccine is recommended for all children six months of age and older.
It is funded on the National Immunisation Program for all children at higher risk of complications (see list below). Aboriginal and Torres Strait Islander children aged between six months and five years and 15 years and over are also funded to receive free seasonal influenza vaccine.
It is critical that children at particular risk of severe complications from influenza are vaccinated, including those with:
- Heart conditions
- Severe asthma or other lung conditions
- Chronic neurological conditions
- Weakened immune systems due to drugs or diseases
- Down syndrome
- Other chronic conditions such as kidney disease, diabetes, obesity
Please speak to your doctor if you are not sure if your child is at higher risk for getting the flu.
The vaccine is also strongly recommended for pregnant women at any time in the pregnancy and for carers of children who are at higher risk of catching the flu, to avoid them passing on the disease.
What flu vaccines are available in 2016?
We recommend that kids receive the flu vaccine with four strains (two A and two B strains or the quadrivalent vaccine (QIV)) rather than the three-strain vaccine (two A and one B strain or trivalent vaccine (TIV)).
All children under nine years of age are recommended to have two doses of the flu vaccine (one month apart) in the first year that they receive the vaccine and then one dose each year after. Children nine years or older need only one dose each year. Kids who have lowered immune systems need two doses each year.
See the MVEC guidelines for more details on recommended brands, the strains in the vaccine and other recommendations.
How well does the vaccine work?
Vaccination is the best way to protect your kids against flu infection. The effectiveness of the vaccine has recently been estimated to be greater than 70% in healthy kids and those who are at higher risk of severe complications from influenza in Western Australia (see the article by Blyth below).
We know that no vaccine is 100% effective, but the flu vaccine is very effective in protecting against the more severe consequences of the disease. Remember that hand washing and trying not to touch your nose and mouth can also help to prevent the spread of flu, but these are harder to get children to do.
How safe are flu vaccines?
The safety of flu vaccines is monitored very closely each year. With the current flu vaccines, recent Australian data shows that fever occurs in approximately 6-7% of kids under 10 and redness and swelling at the injection site in up to one in five kids. Seizures with a fever are rare (see the article by Wood below).
And remember you can’t catch the flu from the flu vaccine!
If you are worried about a reaction to the flu vaccine, please speak with your doctor or report it to SAEFVIC in Victoria or the vaccine safety service in your State (see the details below).
So with the cold weather and flu season looming, remember these key points:
- The flu vaccine should be available from the start of April 2016
- We recommend all kids over six months of age get the flu vaccine, especially those who are at higher risk of infection
- The flu can have serious consequences and be fatal in previously well children
- Give your kids the four strain or Quadrivalent (QIV) flu vaccine this year if available (if not the three strain vaccine is preferable to no vaccine)
- If you suspect your child may have the flu, anti-viral medications may reduce the severity of the illness if they are taken early after the onset of symptoms (within the first TWO days)
We are already starting to see kids coming into the Emergency Department and being admitted to the ward with flu, so please carefully consider giving the flu vaccine to your kids this year.
- Khandaker G, et al. Neurologic complications of influenza A(H1N1)pdm09: Surveillance in six pediatric hospitals. Neurology. 2012 Oct 2;79(14):1474-81
- Marlena et al. Epidemiology of Australian Influenza-Related Paediatric Intensive Care Unit Admissions, 1997-2013. PLOS one 2016. http://journals.plos.org/plosone/article?id=10.1371/journal.pone.0152305
- Blyth et al. Influenza Vaccine Effectiveness and Uptake in Children at Risk of Severe Disease. PIDJ 2016. http://journals.lww.com/pidj/Citation/2016/03000/Influenza_Vaccine_Effectiveness_and_Uptake_in.18.aspx
- Wood et al. The safety of seasonal influenza vaccines in Australian children in MJA 2014. https://www.mja.com.au/journal/2014/201/10/safety-seasonal-influenza-vaccines-australian-children-2013
- MVEC: http://www.mvec.vic.edu.au/immunisation-references/influenza-vaccine-recommendations-2016/
- Victorian Vaccine Safety Service (SAEFVIC): 1300 882 924 or email@example.com org.au