Should I give my kids the flu vaccine this year?

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.

References:

  1. Khandaker G, et al. Neurologic complications of influenza A(H1N1)pdm09: Surveillance in six pediatric hospitals. Neurology. 2012 Oct 2;79(14):1474-81
  2. 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
  3. 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
  4. 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
  5. MVEC: http://www.mvec.vic.edu.au/immunisation-references/influenza-vaccine-recommendations-2016/
  6. Victorian Vaccine Safety Service (SAEFVIC): 1300 882 924 or saefvic@mcri.edu.au org.au

 

 

15 comments for “Should I give my kids the flu vaccine this year?”

  1. Gopalan

    My daughter will turn one in mid April that’s when she will have her regular 12 month vaccines. Is it safe to give her flu vaccine at the same time or do we need to give her after a month? Is there a separate dosage as per their age? Hope you can clarify. Thanks for the detailed post. Much appreciated!

    Reply
    • walshh

      Hi Gopalan, your daughter can get the vaccine anytime after 6 months of age and it can be given with the 12 month vaccines. The dose is half the normal dose, 0.25ml. Please discuss with your GP or health nurse. – Dr Margie

      Reply
  2. Jodie

    Is flu vaccine now safe for children with egg anaphylaxis??

    Thanks for your help.

    Reply
    • walshh

      Hi Jodie, for children who have had anaphylaxis to egg, we recommend referral to an allergist at RCH or to MMC Immunisation to receive the flu vaccine under supervision by an allergist with a 30 minute observation period. – Dr Margie

      Reply
      • Emily

        What if my 10 month old has recently been diagnosed through a skin prick test to an egg allergy, but has never had an anaphylaxis reaction (as yet). Would you still recommend the flu vax done by his allergist, or GP?

        Reply
  3. Tania

    My daughter had Gbs a few years ago and i have had conflicting reports of if safe to ever have the flu vaccine, what is your opinion
    Thanks

    Reply
    • Dr Margie

      Hi Tania, please get a referral to see an Immunisation paediatrician at RCH or MMC to discuss this further so that you have all the information. – Dr Margie

      Reply
  4. Yvonne

    Hi Dr Margie. Both my children (2.5 & 6 yrs) will definitely be getting flu vax, however my question relates to the Bexsero vax and the conflicting advice I’m receiving. Every health practitioner is telling me something different!! Also, should my 2.5 yr old be getting a whooping cough booster (since the new 18month booster recommendation) to carry her through until her next scheduled vaccinations? Thanking you in advance.

    Reply
    • walshh

      Thanks Yvonne, please look at the information on the MVEC or Melbourne vaccine education centre for advice regarding the Men B vaccine – there is a comprehensive fact sheet there. – Dr Margie

      Reply
  5. Catherine

    Hi Dr Margie,
    My daughter (almost 3) had the flu vaccine on Monday, it was recommended as she has asthma. Today she has been sneezing quite a lot and is grumpy and irritable. Basically how she is when she would normally get a cold. She’s just finished a cold so I’m not sure if it’s a new cold or if it’s just some side effects from the vaccine. I know that they can get a fever, but would they sneeze and be irritable? Thanks so much. Catherine.

    Reply
    • Dr Margie

      Hi Catherine
      I hope your daughter is feeling better – her symptoms are most likely due to another upper respiratory tract infection or “cold” rather than side effects from the vaccine. The flu vaccine is an inactivated vaccine and it does not cause the the flu so should not cause sneezing. It may give your daughter a sore arm or make her feel a bit irritable but it should not give her flu symptoms.- Dr Margie

      Reply
  6. Edwina

    Hi Dr. Margie,
    I have a 7 month old. I’m very pro vaccine. Out of the 1500 flu related hospital admissions you talk about on your video how many had the strains of influenza that were in the vaccine for that season? I ask this as obviously not all strains can be covered each year.
    I guess I’m worried giving such a young baby another vaccine when in the first few years they are receiving so many. Also a number of other GP’s are telling myself and others not to give to children under 5. Obviously you and RCH are experts in children and best practice but it’s a tough decision to make as a parent.
    Thanks.

    Reply
  7. Leah

    Can you get the flu vax at same time as the 2nd shot of the bexsero vax or would that not be recommended as when we got the first bexsero My two year old got a fever (thou four year old was fine). If not at the same time, should we wait til we have finished both bexsero shots before starting course of 2 flu shots, or would it be ok to intersperse the two courses as long as there is, say, at least a week between shots? If a child refuses the second shot, do you still get some immunity from the first shot? Thanks

    Reply
  8. Leah

    Is there a nasal spray form for children who are anxious about needles? If so, is it as effective? Thanks

    Reply
  9. Eliza

    Hi dr margie, I’m an Australian mum living in Singapore. I am considering giving my 2.5 yo the flu vaccine but would I need to consider a different strain of the vaccine in Singapore? Ie would the European flu strain be different to the Australian flu strain? Thanks

    Reply

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