Does My Child Need a Flu Shot This Year?

Many adults choose to make a flu shot part of their annual health routine, since influenza can sometimes lead to serious complications like heart problems, pneumonia, or in rare cases, death.

But the flu can infect people at any age. Doctors often recommend flu shots for children to help protect them from illness. And in many cases, vaccination may also reduce the chances of spreading flu within families and schools.

“Pediatricians often recommend flu shots for children six months and older, says pediatrician Kimberly Giuliano, MD. "Flu vaccines have been used for decades, and research shows they lower the risk of severe illness and hospitalization.”

Why a flu shot is important

Much like it does for adults, a flu shot for kids offers protection against serious illness. Kids who get the flu vaccine are less likely to get sick and less likely to need to be hospitalized if they do get the flu.

After all, the flu doesn’t care how old you are. Anybody can get very sick, including children. For example, kids under age 2 are one of the groups at an increased risk for bad influenza if they get infected.

Dr. Giuliano notes that kids who live with underlying medical conditions are especially at risk of developing more serious disease.

“In children living with immunocompromising conditions, the virus can spread more quickly throughout their bodies and give them a more severe case of the flu,” she says. “Children living with heart disease, asthma or other kinds of lung conditions can also have more breathing difficulties and challenges with the illness, as compared to children without.”

Some parents worry about side effects, but the most common ones are usually mild — like arm soreness or muscle aches — and tend to go away quickly.

Flu complications, however, can be much more serious. And there’s often no way of knowing if you’ll have a serious reaction to the flu.

“Although complications and more severe cases of the flu are more common in children with underlying medical conditions, we do see kids who are very sick with the flu every year,” says Dr. Giuliano. “That includes children who were otherwise healthy who are admitted to the hospital with severe pneumonia. They often need oxygen, and sometimes even ventilator support.”

Flu rates were lower during the height of COVID-19, likely due in part to changes in behavior, like people staying home when sick and reduced travel. Those shifts also slowed the spread of other viruses.

Plus, Dr. Giuliano says we can look to trends elsewhere in the world for a clue as to what the U.S. flu season might look like. “What we’re seeing in other parts of the world, most specifically Australia, is that they are having an earlier onset of their flu season, as well as higher rates,” she notes. “If that trend continues, we will likely be seeing that here in the U.S. as well.”

When should my child get the flu shot?

Experts recommend adults and kids get a flu shot in September or October. The Centers for Disease Control and Prevention (CDC) also recommends that kids under age 9 who are getting the flu vaccine for the first time should get a second dose about a month after their first dose.

"Getting vaccinated before flu season begins helps ensure children have protection when flu cases start to rise,” advises Dr. Giuliano. The children’s flu vaccine is typically effective for kids for about six to nine months after it’s been given. “Getting vaccinated in September or October will prepare you for the upcoming season,” Dr. Giuliano notes.

Is the nasal spray vaccine effective?

When it comes to getting a flu shot for your child, you might have heard about the nasal spray vaccine. This option hasn’t been as common in recent years due to production and distribution challenges, although Dr. Giuliano says it should be available “in some limited supplies” this year.

Given that your kids might worry about getting a shot, you may wonder if it’s an acceptable alternative. Dr. Giuliano says the nasal spray could be a viable option for kids who are nervous about needles or injections. “Perhaps a child afraid of needles could think of this as a potential option.”

However, she stresses the nasal spray vaccine isn’t appropriate for everybody. Kids living with certain medical conditions, such as immunocompromising conditions or severe asthma, shouldn’t get the nasal vaccine. “That’s because it’s a live virus,” Dr. Giuliano explains. “For children with certain medical conditions, doctors typically recommend the injection instead, since it avoids possible complications from the live-virus nasal spray.”

Plus, there are some questions about how effective the nasal spray vaccine is. “Some studies show that the nasal spray is bit more effective,” says Dr. Giuliano. “Some show that it’s a little bit less effective.”

The bottom line, she notes, is that it’s important to get some form of the flu vaccine for protection. “The one that’s going to be the most effective for your child is the one that gets into their body,” Dr. Giuliano says. “I wouldn’t worry over which one to pick if you have difficulty getting access to the nasal one. The injectable one is a completely fine option that provides just similar levels of protection for children.”

How to prevent yourself from getting sick

Some doctors also recommend COVID-19 vaccination for children, since both flu and COVID can cause respiratory illness. “We don’t have a vaccine out there for every single virus, but these two we know can be especially problematic,” says Dr. Giuliano. “And so it’s great that we have the vaccination option. Protecting your child with a vaccine for flu and a vaccine for COVID reduces the risk of them having serious respiratory illnesses this year.”

As flu season approaches, kids and families should also make sure they’re following good health hygiene. “Make sure you’re washing your hands really well,” stresses Dr. Giuliano. “Teach kids to cough into their arms instead of into their hands or into the air, where they’re more likely to spread the viruses to other folks.”

Above all, stay home if you’re not feeling well. “It doesn’t have to be COVID,” Dr. Giuliano says. “If you have a cough, respiratory symptoms or a fever, give yourself the time that you need to rest and recover. You’ll also reduce the spread of any respiratory viruses to other people.”

Many families have questions about vaccines, including the flu shot. Dr. Giuliano recommends reaching out to your child’s doctor and discussing any questions with them to get answers. Your child's healthcare provider welcomes these questions and wants you to feel confident in your decision.

“Vaccines have been shown to lower the risk of serious illness and death from flu," says Dr. Giuliano. "While rare side effects can occur, the risks from infection are typically much greater.”