October 8, 2013

Ask: Do I need to get my child vaccinated for the flu?

It's fall, time for the leaves to turn colors and flu to start going around. Now is the time to get your child (and yourself) vaccinated, says Duke pediatrician Brian Eichner.

Q: I recently received an email from our pediatrician’s office recommending that we bring our children in for flu vaccines? Is this necessary?

A: While thought of by many as a “nuisance illness," influenza is actually responsible for much more severe illness as well. Each year, more than one hundred childhood deaths directly caused by the flu are reported to the Centers for Disease Control and Prevention. The flu is responsible for many hospitalizations and intensive care unit admissions, can lead to pneumonia, and worrisome enough, causes children to feel generally crummy. 

There are populations of children that are at higher risk for bad outcomes from influenza – these include premature infants, young infants, children with asthma, those with impaired immune systems and those with a history of other chronic diseases. While the children mentioned above are at the greatest risk of severe illness, many of the severe cases occur in children who are otherwise healthy – it is not possible to predict for certain who will become severely ill. 

The flu vaccine is recommended for all children six months of age and older. The vaccine is recommended for adults, also. This recommendation is especially strong for any adults who have contact with any high-risk children or who live with children under the age of five years old. Pregnant women and their household contacts should get the flu vaccine as well, as flu can cause devastating illness to the mom-to-be and harm the fetus. It is recommended to get the flu vaccine in early autumn – it does not “wear off” by the end of flu season.

Flu vaccines are available at your pediatrician’s office, health departments, and hospitals in addition to pharmacy-based clinics (such as CVS's Minute Clinic). If your child receives a flu vaccine someplace besides his or her pediatrician’s office, keep documentation of it so that it can be entered into the NC Immunization Registry and become part of your child’s medical record. Please note that while children six months of age and older should receive the flu vaccine, many retail clinics will not administer vaccines to children younger than 18 months, so if you have a young child it might be necessary to go to the pediatrician’s office for the vaccine. 

Many children will be happy to know that the “FluMist” (nasal spray) vaccine is at least as effective as the injectable flu vaccine. However, children under 2-years-old cannot receive FluMist, and there are other restrictions on who may receive it. So, unless you know for a fact that your child qualifies, it’s best not to make any promises about a needle-free doctor’s visit!

Even though some people do feel achy/slightly ill after receiving the flu vaccine, they have not caught the flu from getting the vaccine. These side effects are well worth it, given that the vaccine can prevent an illness as severe as influenza, which, as noted above, can be fatal, and if nothing else, will likely lead to a week of missed school/daycare (and thus parental work!). Finally, similar to the stock market, past success is not an indicator of future performance – not having caught the flu last year (or ever) is not at all predictive of whether somebody will catch it this year.

Here’s to a flu-free winter!

If you have a question about your child's health or happiness, ask Dr. Eichner or any of our experts by sending email to


Brian Eichner is a general pediatrician and assistant professor of pediatrics at Duke Children's Primary Care-Roxboro Street in Durham. He enjoys providing care for children who are healthy as well as those with complex medical conditions. Dr. Eichner also serves as the medical director of the Duke Pediatric Diagnostic Clinic. He and his wife have lived in the Triangle since 2006.

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