​​By: Kris Bryant, MD, FAAP

Many people don’t realize how serious influenza (flu) illness can be, even for previously healthy kids and teens. (See “Why Flu Vaccines Top Our Back-to-School List Each Year,” below.) Children also play a role in spreading the flu in their homes and communities.

Influenza viruses change yearly. All children age 6 months and older need a flu shot every year. Children should get their influenza vaccine when the shots become available, especially if they need two shots this season. That way they will be protected before flu starts circulating in your community. It takes about two weeks after the shot to build immunity.

Which flu vaccines are available?

There are two types of influenza vaccines available. The first is what many people call the “flu shot.” The second comes as a nasal spray.

All the vaccines available for children this year protect against four different influenza viruses (two A and two B viruses). During flu season, multiple different flu viruses may circulate. Sometimes the viruses change during the flu season.

Should I get the shot or nasal spray for my child this year?

The American Academy of Pediatrics (AAP) and the Centers for Disease Control and Prevention (CDC) want as many children as possible to get a flu vaccine every year. Both types of flu vaccine (flu shot or nasal spray) can be given according to their indications for this flu season. Any licensed influenza vaccine available this year and appropriate for a child’s age and health status should be given, with no preference.

Can kids get a flu vaccine and other vaccinations at the same time?

Yes. Each year, it is possible that flu, COVID-19, and other common viruses will spread at the same time. Last influenza season was longer than most. Sometimes, the vaccine is not an exact match with the strains in the community. But the vaccine still can protect against serious illness. Talk with your pediatrician about your child getting the flu vaccine along with other recommended immunizations. This includes getting a COVID-19 vaccine or booster, if they are eligible.

If my child tested positive for COVID-19, when should they get a flu vaccine?

Children with COVID-19 should get a flu vaccine after they have recovered from their COVID-19 illness. Keep in mind that symptoms such as a stuffy and runny nose can make it hard to give the nasal spray vaccine.

What about allergies to flu vaccines?

A child who had an allergic reaction after a flu vaccine in the past should be seen by an allergist. The allergist can help parents decide if their child should receive their annual flu vaccination. A child with a known history of egg allergy can receive the flu vaccine.

Where should I go for my child’s flu shot?

Many pediatricians offer flu shot clinics, including curbside and drive-through clinics. The pediatrician’s office has your child’s health information. That makes it easy to keep track of the flu shot in your child’s health record.

If they get a flu shot somewhere else, remember to share this information with the pediatrician so the vaccination is included in your child’s health record.

Don’t let the flu stop you and your family!

Most people who get the flu are sick for at least a week. But some people get much sicker. Getting vaccinated is the best way to prevent influenza and the serious complications that can result from it—especially for those with high-risk conditions like asthma. For example, flu can lead to pneumonia. Kids with flu also can develop brain inflammation as well as febrile and non-febrile seizures. The flu vaccine keeps people out of the hospital—it stops serious illness and deaths from influenza.

Influenza causes thousands of deaths in the United States every year. About 33 to 199 children and teens die each year of flu—80% of those children were not fully vaccinated. Even children who are otherwise healthy and have no other medical conditions can be hospitalized with flu and develop life-threatening complications.

There’s no need to wait, even if your child received the previous year’s flu vaccine in March or April. Children 6 months to 8 years of age should receive two doses if this is the first time they are being vaccinated against influenza, or if they have only received one dose of flu vaccine ever before July 1. The doses are given four weeks apart.

We have a vaccine for flu, unlike many other respiratory viruses that make kids sick. Let’s protect our children from flu when we can.

More information

• The Flu: What Parents Need to Know
• Flu: A Guide for Parents of Children and Adolescents with Chronic Health Conditions
• AAP Releases 2022-23 Flu Vaccine Recommendations for Families
• Flu.gov (Centers for Disease Control and Prevention)

About Dr. Bryant

Kristina A. Bryant, MD, FAAP, a pediatric infectious diseases specialist at the University of Louisville and Norton Children’s Hospital, is a member of the American Academy of Pediatrics (AAP) Committee on Infectious Diseases, lead author of the annual AAP influenza policy statement and technical report, and lead for Red Book Online. She also is the immediate-past president of the Pediatric Infectious Diseases Society.

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