Latest pediatric recommendations for the Flu shot

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Did you know that children often have the highest attack rates of influenza  during influenza epidemics?

The flu virus is unpredictable, spreads very easily, and can cause serious complications.

How can you protect your children against the flu? 

Since we can’t keep our children in a bubble, the best way to protect them against the flu virus is by allowing them to get the flu vaccine.

The flu vaccine significantly decreases a child’s risk of severe influenza illness and death. Children younger than 5 years (especially those younger than 2), and those with underlying medical conditions are at increased risk of hospitalization and complications from the influenza virus. 

Every year, the flu illness causes significant morbidity and mortality among children. We have no way of predicting how severe or how long a flu season will be, therefore pediatric hospitalizations and deaths caused by the flu vary from one season to the next.

The CDC reported 129 pediatric deaths occurring during the 2018-2019 flu season, and 186 pediatric deaths during the 2017-2018 flu season. Historically, 70-80% of the children who die from flu-related complications had not received the flu vaccine. 

What should I know about the 2019-2020 flu vaccine? 

This year, there are two options for the vaccine, the inactivated influenza vaccine (the shot), and the live attenuated influenza vaccine (the nasal spray). The contents of the influenza vaccine have been updated for this season. The A(H1N1) and A(H3N2) strains in the vaccine are new, while the B strains are unchanged from the previous season. All licensed vaccines for this season will contain the same influenza viruses. 

Which vaccination is better? 

Currently, there is no preference for one product over the other, as long as there is no contraindication for its use. Any licensed influenza vaccine appropriate for age and health status can be used. Pediatricians should administer whichever vaccine they have available in their community in order to maximize protection. 

Can anyone get the live attenuated flu vaccine (nasal spray)?

No, not everyone can get this type of vaccination. 

Who can not get the nasal spray?

  • Kids younger than 2 years old
  • Kids age 2-4 years who have history of wheezing in the last 12 months
  • Kids with known or suspected immune deficiencies, or who are getting immunosuppressive therapies
  • Kids taking aspirin
  • Close contacts of those who are immunocompromised
  • Kids who have received other live-virus vaccines (like MMR or varicella) within the previous 4 weeks
  • Pregnant women

What if my child is allergic to eggs? 

Research supports that egg-allergic children can safely get the flu vaccination. Children with egg allergy are not at increased risk of an anaphylactic reaction after receiving the flu vaccine, therefore they can have either the shot or the nasal mist.

Children who have had a previous allergic reaction to the flu vaccine should be evaluated by an allergist to decide whether future administration of the vaccine is appropriate.

Can I get the flu vaccine if I’m pregnant or breastfeeding?

Absolutely yes!

The influenza vaccine is recommended for pregnant ladies for their protection and the protection of their infant. It can be administered at any time during the pregnancy.  Immunization during pregnancy provides the infant with protection for the first 6months of life through transplacental antibodies . 

If the influenza immunization was not provided to the mother during pregnancy, it is strongly recommended to receive it during the postpartum period. The vaccine is safe during breastfeeding for both the mom and the baby. 

What’s the best time to get the flu shot?

According to the CDC and the American Academy of Pediatrics, it is recommended  to receive the immunization by the end of October. Consequently, children who require two doses should receive the first dose as soon as it becomes available. Early immunization, in July and August, is not recommended. 

2019-2020 Flu vaccine recommendations: 

❌All children ages 6 months and older, should be vaccinated for influenza, preferably before the end of October. 

❌Influenza vaccines are not approved for infants younger than six months, so to protect them it is imperative to vaccinate the people living in the same household. 

❌Children 6 months-8 years who are receiving the flu vaccine for the very first time, or who have received only 1 dose before July 1, 2019, should get 2 doses of the vaccine. The second dose should be administered one month after the first dose. 

❌Children 9 years and older only need 1 dose, regardless of previous vaccination history.

❌Pregnant women may receive the flu shot at any time during pregnancy. 

❌For postpartum moms, the influenza vaccination is recommended if not received during pregnancy. Vaccination during breastfeeding and is safe for both the mother and the infant.

❌Children with egg allergy can receive influenza vaccine without any additional precautions.


AAP: Recommendations for Prevention of Influenza in Children, 2019–2020