Pediatric Influenza and Vaccination

As school starts up again, it is inevitable that kids will pass around lots of viruses, including influenza. Influenza (often called “the flu”) is a very contagious respiratory virus which causes fever up to 103-105 degrees, muscle aches, runny nose, and sore throat. A dry cough which can become severe is common, and fatigue is often extreme.  Nausea, vomiting, and diarrhea may also occur.

Influenza is passed from one person to another by sneezing, coughing, touching objects that are contaminated like countertops, and sharing cups or silverware.  The time between being exposed and getting sick with influenza is 1-4 days, so it moves quickly through a community. Influenza symptoms usually last 7-10 days in kids, though the cough and tiredness can take longer to resolve. Influenza activity peaks between December and February but may start earlier in the fall.

Though influenza may feel just like a severe cold, for many it can be very dangerous, especially older adults and young children. Over 40,000 adults died last year from influenza and its complications. There were 266 reported deaths due to influenza in children this past flu season, a new record high.

Children under age 5 are most at risk of complications, including severe pneumonia caused by bacteria. Kids can also develop bronchiolitis (swelling and inflammation of the small airways) and croup due to influenza. 

Decreased appetite and fluid intake along with vomiting and diarrhea can cause dehydration, signs of which include decreased urination, dry mouth, and sunken appearing eyes. Neurologic complications may include brain inflammation and seizures. A rare complication called Guillain-Barre Syndrome causes progressive and severe weakness, resulting in respiratory distress that can be life-threatening.

Annual influenza vaccination (of you, other family members, and your child) is your best bet to protect your kiddo. All children over age 6 months (with rare exceptions) should get vaccinated ideally before Halloween. The vaccine effect lasts about 6 months and protects up to 60% of those vaccinated from becoming infected. Although not totally protective against getting influenza, the vaccine is very effective at decreasing the severity of infection, with lower rates of hospitalization and complications including pneumonia. Flu vaccine can be given with other childhood vaccinations.

You cannot get influenza from flu vaccine, but mild side effects like a runny nose and low-grade fever can occur; these are due to the appropriate response of your immune system to the vaccine. Influenza vaccines have been well studied and are extremely safe.  In the past some have been concerned about thimerosal, a vaccine preservative, because it contains ethyl mercury. Ethyl mercury is entirely different from methylmercury, which can be harmful in high levels. Ethyl mercury poses no risk, but to minimize concern, thimerosal was removed from most childhood vaccines in 2001. It is present now only in multi-dose flu vaccine vials, which are not commonly used.

Along with influenza vaccination, don’t forget other simple ways to avoid illness during flu season such as good handwashing and avoiding sharing water bottles, drinks, or food. Influenza home care includes encouraging adequate fluids and fluid-containing foods like soup, Jello, or popsicles. Acetaminophen (Tylenol) and ibuprofen (Advil, Motrin) can help with fever and discomfort; be sure to follow age and weight guidelines.

Call your provider if your child has influenza symptoms and has difficulty breathing, appears dehydrated, or has fever for more than 3 days. You should also reach out to your provider if your child has extreme fatigue or irritability, or is under 3 months old with a fever of 100.4 or higher.