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An ounce of prevention is worth a pound of cure

October 24, 2011

As a pediatrician, one of the most common questions I am asked this time of year is what I think about the seasonal flu vaccine.

I usually tell my patients and their parents that I am more scared of influenza infection than of the seasonal flu vaccine. I hate it when my kids don’t feel well when they have a runny nose, so I can only imagine how much worse it would be if they had the flu! The flu is more dangerous than the common cold for children, and the most severe flu complications typically occur in children under the age of 2 years old. Children under 5 years old who get the flu commonly require medical care in order to get better. This medical care could possibly include hospitalization for dehydration and IV fluids, or if they are having difficulty breathing, they may even need intensive care and respiratory assistance with a ventilator. Each year, approximately 20,000 children under the age of 5 years old are hospitalized with the flu, and unfortunately, some children die of the flu every year. My intention is not to scare my patients and families into vaccinating their children against the seasonal flu, but I want to make sure that parents have correct information so that they can make the best decision for their family.

The Centers for Disease Control and Prevention (CDC) recommends that the single best way to protect against the flu is to get vaccinated every year. The best time to get the flu vaccine is when it is available in your community and typically before December so that your body has produced enough protective antibodies when flu infections are the most common. The CDC recommends that everyone 6 months of age and older get a seasonal flu vaccine every year to protect their health. If this is the first year that your child will receive the seasonal flu vaccine, please talk to your doctor, because your child will probably need two doses of the vaccine given one month apart for optimal protection. Vaccination is very important for children under the age of 5 years old and for children who have any other medical problems such as asthma, diabetes and heart disease.

Another common question that I get asked is whether the flu vaccine actually causes the flu. There are different side effects of the flu shot and the nasal spray flu vaccine. The viruses in the flu shot are killed, so you cannot get the flu from the flu shot. Common side effects with the flu shot include soreness or swelling where the injection was given, a low-grade fever and body aches. The nasal spray flu vaccine can be used in people ages 2 to 49 years of age who are not pregnant and are healthy, meaning they do not have other existing medical conditions that place them at higher risk for developing complications from the flu (examples include but are not limited to asthma, diabetes and heart disease). The nasal spray flu vaccine (also known as Live Attenuated Influenza vaccine) contains flu viruses that are weakened. Side effects associated with the nasal spray flu vaccine are runny nose, headache, low-grade fever, muscle aches and cough. Even though all of these side effects sound very similar to flu symptoms, these potential side effects from the vaccine are typically not as severe as those associated with influenza infection.

In some rare cases, the flu vaccine can cause a severe allergic reaction. People who have had a severe allergic reaction to the flu shot should not receive the flu vaccine before talking to their doctor. Other people who should not receive the flu vaccine before speaking with their physician include children under the age of 6 months old (the flu vaccine is not approved for this age group), people who have a severe allergy to chicken eggs, people who have a moderate-to-severe illness with fever (they should wait until they have recovered from their illness to consider getting the flu vaccine), and anybody who has a history of Guillain-Barre syndrome that occurred after receiving the flu vaccine.

Tell your doctor if your child has ever experienced a seizure. There are some young children who are at increased risk of developing seizures from fever if they receive the flu shot and pneumococcal vaccine at the same time. Since there are risks of contracting disease from delaying these vaccines, the Advisory Committee on Immunization Practices (ACIP) does not recommend giving these two vaccines at separate visits or deviating from the current schedule. I think this is an important risk for parents to be informed and educated about, and I encourage you to speak with your pediatrician or family doctor if your child is scheduled to receive both vaccines at the same visit.

Again, please talk to your pediatrician or family doctor if you have any questions or concerns regarding the flu vaccine. Like everything else in medicine, there are risks and benefits with the flu vaccine. I strongly encourage parents to educate themselves about the risks and benefits of the flu vaccine, and the risks of actually catching the flu. By empowering yourself with information and with the guidance of your doctor, you can make the best decision for your family. Your physician can help you decide if the flu vaccine is a good decision for you and your family. Your doctor will also guide you in selecting which type of flu vaccine (shot vs. nasal spray) would be the best choice if you are eligible, and have no medical contraindications against vaccination.

I am anxiously waiting for the shipment of the flu vaccine to arrive at my pediatrician’s office so that I will be able to vaccinate my kids against the flu. My pediatrician’s secretary is probably tired of hearing my voice asking, “Have you gotten the flu vaccine yet?”  For my family, I believe that the benefits of the flu vaccine outweigh the potential risks. My husband and I are both healthcare workers, and we don’t want to risk passing on influenza to our patients. Our children are both under the age of 5 years old, which is the age group that is at higher risk of requiring medical care to help them recover from the flu.

As a mother, my life is devoted to protecting my children, and as a pediatrician, I know that vaccinating my children is the best way to protect them against influenza infection.

From the CDC website:

Key Facts About Seasonal Flu Vaccine - http://www.cdc.gov/flu/protect/keyfacts.htm

Children, the Flu, and the Flu Vaccine - http://www.cdc.gov/flu/protect/children.htm

From Immunize.org:

Vaccine Information Statement (inactivated, shot) - http://www.immunize.org/vis/vis_flu_inactive.asp

Vaccine Information Statement (activated, nasal spray) - http://www.immunize.org/vis/vis_flu_live.asp

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