Pediatricians Urge Flu Vaccine for All Kids 6 Months and Older

Nasal spray vaccine can be considered for many kids 2 to 8, doctors say

Monday, September 22, 2014

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MONDAY, Sept. 22, 2014 (HealthDay News) -- Pediatricians are urging that all children aged 6 months and older be vaccinated for the upcoming flu season.

The American Academy of Pediatrics updated their influenza vaccine recommendations to advise that the youngest kids should have two initial doses of vaccine to build immunity. The AAP also wants parents of children aged 2 to 8 to consider getting their kids the nasal spray vaccine instead of the flu shot if it's readily available.

"It's important to get the vaccine as soon as it's available," said lead author Dr. Henry Bernstein, a specialist in pediatrics at North Shore-LIJ Health System in New Hyde Park, N.Y.

The recommendations were published online Sept. 22 in the journal Pediatrics.

Last year, slightly more than 100 children died from flu, according to the U.S. Centers for Disease Control and Prevention. Of these, almost half had no underlying medical conditions, according to the AAP. More than 90 percent of children treated for influenza in intensive care units weren't vaccinated for flu last year, the AAP reported.

Getting the flu is much worse than getting vaccinated, Bernstein said.

"This is a vaccine-preventable disease, and there is no question that the more people who get vaccinated, the better off we all are," Bernstein said.

Although this year's flu vaccine protects against the same type of flu as last year's vaccine, children still need to get vaccinated, even if they were vaccinated last year, he said.

"People still need to get the vaccine, because people's immunity wanes over time," Bernstein said. In fact, antibodies to flu drop 50 percent in the six to 12 months after vaccination, according to the AAP. "Getting the vaccine each year insures better protection," Bernstein said.

There are two vaccines available. The quadrivalent vaccine protects against four types of flu, one more than the trivalent vaccine, Bernstein said. However, neither vaccine is preferred over the other, he added. "People should get whatever vaccine is available in their area," he said.

The youngest kids, those aged 6 months through 8 years old, may need two doses of the vaccine to be fully protected, Bernstein said.

New to the recommendation this year is a stronger recommendation for the nasal spray form of the vaccine. That vaccine, called the live attenuated influenza vaccine (LAIV), should be considered for healthy children aged 2 to 8, the AAP said.

The CDC has also recommended the nasal spray vaccine for young children. While the flu shot and the nasal spray both protect against the flu, there is evidence that the nasal spray may work better in younger children than the flu shot, according to the agency.

Kids who shouldn't get the nasal vaccine are those who have had a severe allergic reaction to it. In addition, the vaccine is not for kids who have medical conditions such as asthma, diabetes, heart or kidney disease or who have taken antiviral medications within two days of getting a vaccination, the CDC cautioned.

Parents shouldn't wait if the nasal spray isn't immediately available, but rather go ahead and get their children flu shots, Bernstein said.

Bernstein said that parents who are afraid to get their children vaccinated because they fear the vaccine isn't safe shouldn't worry. "The vaccine is remarkably safe," he said.

Plenty of vaccine should be available, Bernstein said. "Manufacturers are expecting somewhere around 160 million doses," he said.

Dr. Jefry Biehler, chairman of pediatrics at Miami Children's Hospital, said, "It's very important to get vaccinated this year, as your immunity has a tendency to wane. And just because the vaccine hasn't changed doesn't mean that you should not get your shot this year."

Biehler also said that pregnant women should get vaccinated to protect themselves as well as their newborns. During the first six months of life, it's the mother's immunity that protects the baby, he said.

In addition, anyone who has contact with newborns should also be vaccinated. "Everyone should be vaccinated against flu unless there is a medical reason not to be vaccinated," Biehler said.

SOURCES: Henry Bernstein, D.O., specialist in pediatrics, North Shore-LIJ Health System, New Hyde Park, N.Y.; Jefry Biehler, M.D., chairman, pediatrics, Miami Children's Hospital, Fla.; November 2014, Pediatrics

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