Children, the Flu, and the Flu Vaccine

• CDC recommends that everyone 6 months of age and older get a seasonal flu vaccine.
  Keep in mind that vaccination is especially important for certain people who are high risk or who are in close contact with high risk persons. This includes children at high risk for developing complications from influenza illness, and adults who are close contacts of those children.

For the complete list of those at high risk, visit People at High Risk of Developing Flu–Related Complications.

There are special vaccination instructions for children aged 6 months through 8 years of age

Some children 6 months through 8 years of age require two doses of influenza vaccine. Children 6 months through 8 years getting vaccinated for the first time, and those who have only previously gotten one dose of vaccine, should get two doses of vaccine this season. All children who have previously gotten two doses of vaccine (at any time) only need one dose of vaccine this season. The first dose should be given as soon as vaccine becomes available.

The second dose should be given at least 28 days after the first dose. The first dose “primes” the immune system; the second dose provides immune protection. Children who only get one dose but need two doses can have reduced or no protection from a single dose of flu vaccine.

If your child needs the two doses, begin the process early. This will ensure that your child is protected before influenza starts circulating in your community.

Be sure to get your child a second dose if he or she needs one. It usually takes about two weeks after the second dose for protection to begin.

Recommendations on the control and prevention of influenza are published annually, in late summer or early fall. Existing recommendations are available at Seasonal Influenza Vaccination Resources for Health Professionals.

Some children are at especially high risk

Children at greatest risk of serious flu-related complications include the following:

1. Children younger than 6 months old
   These children are too young to be vaccinated. The best way to protect them is to make sure people around them are vaccinated.
2. Children aged 6 months up to their 5th birthday
   Since 2010, CDC estimates that flu-related hospitalizations among children younger than 5 years ranged from 7,000 to 26,000 in the United States. Even children in this age group who are otherwise healthy are at risk simply because of their age. Additionally, children 2 years of age up to their 5^th birthday are more likely than healthy older children to be taken to a doctor, an urgent care center, or the emergency room because of flu^1,2,3. To protect their health, all children 6 months and older should be vaccinated against the flu each year. Vaccinating young children, their families, and other caregivers can also help protect them from getting sick.
   ¹CDC Influenza Vaccine Program Impact Report 2015-2016
   ²Bourgeois F, Valim C, Wei J, et al. Influenza and Other Respiratory Virus–Related Emergency Department Visits Among Young Children. Pediatrics 2006; Volume 118 /Issue 1
   ³Poehling K, Edwards K, Weinberg G, et al. The Underrecognized Burden of Influenza in Young Children. The New England Journal of Medicine 2006; 355:31-4
3. American Indian and Alaskan Native children
   These children are more likely to have severe flu illness that results in hospitalization or death.^{4,5
   4}CDC. Deaths Related to 2009 Pandemic Influenza A (H1N1) Among American Indian/Alaskan Natives — 12 States, 2009. MMWR. 2009;58(48);1341-1344.
   ⁵CDC. Prevention and Control of Influenza with Vaccines: Recommendations of the Advisory Committee on Immunization Practices (ACIP), 2010. MMWR. 2010; 59(No.RR-8).
4. Children aged 6 months through 18 years with chronic health problems, including:
   • Asthma
   • Neurological and neurodevelopmental conditions [including disorders of the brain, spinal cord, peripheral nerve, and muscle such as cerebral palsy, epilepsy (seizure disorders), stroke, intellectual disability (mental retardation), moderate to severe developmental delay, muscular dystrophy, or spinal cord injury].
   • Chronic lung disease (such as chronic obstructive pulmonary disease [COPD] and cystic fibrosis)
   • Heart disease (such as congenital heart disease, congestive heart failure and coronary artery disease)
   • Blood disorders (such as sickle cell disease)
   • Endocrine disorders (such as diabetes mellitus)
   • Kidney disorders
   • Liver disorders
   • Metabolic disorders (such as inherited metabolic disorders and mitochondrial disorders)
   • Weakened immune system due to disease or medication (such as people with HIV or AIDS, or cancer, or those on chronic steroids); and
   • Children who are receiving long-term aspirin therapy

Children should be vaccinated every flu season

Children should be vaccinated every flu season for the best protection against flu. For children who will need two doses of flu vaccine, the first dose should be given as early in the season as possible. For other children, it is good practice to get them vaccinated by the end of October, if possible. However, getting vaccinated later can still be protective, as long as flu viruses are circulating. While seasonal influenza outbreaks can happen as early as October, most of the time influenza activity peaks between December and February. Since it takes about two weeks after vaccination for antibodies to develop in the body that protect against influenza virus infection, it is best that people get vaccinated so they are protected before influenza begins spreading in their community.

Additional Information:

• CDC Reports About 90 Percent of Children Who Died From Flu This Season Not Vaccinated March 22, 2013
• Children with Neurologic Disorders at High Risk of Death from Flu August 29, 2012
• CDC Report Details Influenza Prevention and Treatment for Children and Teens September 15, 2011Frequently Asked Flu Questions 2017-2018 Influenza Season