Influenza: Protecting children from the flu

By David Rosenberg, MD, FAAP

Issue of Nov. 14, 2008 / 17 Cheshvan 5769

This time of year, a question I get asked very often is, “Should my child get the flu vaccine?” As my patients know very well, I am not one to give a simple “yes” or “no” answer to such a question. Rather, here is what I tell them.

Influenza, commonly called “the flu,” is a serious and potentially deadly disease caused by a virus that spreads very easily. It infects the respiratory tract (nose, throat, and lungs). The symptoms usually include high fever, body aches, chills, headache, cough, sore throat and a stuffed nose. Children, especially infants and toddlers, may have additional symptoms that adults usually don’t experience, including ear aches, nausea and vomiting.

Unlike many other viral infections, such as the common cold, influenza causes severe illness and life-threatening complications in many people. Young children, particularly those with long-term medical conditions such as asthma, are at high risk for severe illness, hospitalization, and even death, if they get influenza.

Anyone can get influenza, but rates of infection are highest among children. Each year influenza causes nearly 100 deaths in American children younger than five years of age. Influenza comes on very suddenly.

The influenza virus spreads from person to person via respiratory droplets when an infected person coughs or sneezes. Unfortunately, people can spread influenza before they realize that they are ill. In general, adults are infectious for about two days before symptoms start until about five days after the start of the illness. Children spread more influenza viruses for even longer periods. They are also usually in closer quarters with others in settings such as school and day care.

Influenza season usually runs from late fall through early spring. The exact timing of flu season varies by state. In our area, influenza activity usually peaks between December and early March (though in recent years it has stretched into April and even May). The best time to get the influenza vaccine is September through November. However, considering the timing of recent flu seasons, getting the influenza vaccine in December, or even later, can still be beneficial.

The CDC, the American Academy of Pediatrics, and other organizations recommend annual influenza vaccination of all children six months through 18 years of age. Vaccination is particularly important for children with certain underlying medical conditions (e.g., asthma, diabetes, cardiovascular disease, immune deficiency) as they are at increased risk for complications from influenza.

Women who are pregnant and their household contacts should be vaccinated to protect themselves from influenza and to help ensure a healthy pregnancy and baby. Infants younger than six months of age cannot be vaccinated against influenza. Vaccinating pregnant women offers these infants passive immunity.

Despite CDC recommendations, influenza vaccination rates in children remain alarmingly low. For instance, only 21.3 percent of children six to 23 months of age were fully immunized during the 2006-2007 season.

Unfortunately, many children do not get vaccinated against influenza due to the many myths concerning the vaccine.

The injectable influenza vaccine is made from inactivated (or killed) viruses. This means that people cannot get influenza from the vaccine.

Serious problems from the influenza vaccine are very rare. The most common side effect that a person is likely to experience is soreness where the injection was given. This usually goes away after a day or two.

Strains of the influenza virus change every year, and a new influenza vaccine is developed to match these specific strains and stop their ability to cause infection. In addition, after you get vaccinated your immunity declines over time. So the vaccination you had last year will not provide protection against this year’s influenza virus.

Lastly, but perhaps most importantly, parents are concerned about flu vaccine containing the preservative thimerosal. While I don’t have nearly enough space to discuss this “non-controversy” at this time, why should we allow children to be susceptible to serious deadly diseases because of internet theories based on no sound scientific studies rather supported by many “celebrities?”

Further proof of this can be seen by looking at the state of California, who several years ago banned thimerosal from all childhood vaccines (much like New York State beginning July 1, 2008). The result was an actual increase in the number of cases of autism diagnosed in subsequent years.

Of course, this is all a moot point when it comes to the flu vaccine. There are plenty of “preservative-free” injectable flu vaccine doses available, as well as the newer nasal flu vaccine which is also preservative-free. Now getting insurance companies to adequately pay for these –– that’s another story!

Dr. David Rosenberg is a board-certified pediatrician whose practice, VIPediatrics, is located at 945 Broadway in Woodmere. Please call (516) 569-2323 or visit www.VIPediatrics.com for more information. Dr. Rosenberg can also be reached by e-mail at DrDave@VIPediatrics.com.