Flu shots recommended for most kids

Ask The Expert Timothy Doran Greater Baltimore Medical Center

October 13, 2008|By Holly Selby

Flu season, with its aches, fever and cough, is around the corner, says Dr. Timothy Doran, chairman of pediatrics at Greater Baltimore Medical Center. This year, for the first time, the Centers for Disease Control and Prevention is recommending that all children 6 months to 18 years old receive flu vaccinations.

Flu shots are available now and will be given until the flu season begins (which may be any time between December and March), Doran says.

Why did the CDC recommend flu shots for children this year?

The shots are safe and effective, and if we universally vaccinate children, we will be protecting the high-risk children who have not been previously vaccinated. It also protects the elderly.

FOR THE RECORD - A statistic reported in yesterday's Ask the Expert column in the You & Your Health section was incorrect. About 100 children die each year of the flu.
THE BALTIMORE SUN REGRETS THE ERROR

There is an average of more than 30,000 deaths a year in the United States from influenza. Most of those deaths are in people over 65. There are about 1,200 deaths in children a year from the flu. By decreasing the number of children with the flu, we also decrease the number who will give the flu to their grandparents.

What is influenza?

Influenza is a virus. There are two or three types of flu viruses in circulation every year.

What are the symptoms of flu?

Usually the most common symptoms are respiratory symptoms, which include a runny nose, malaise, feeling terrible, cough, fever, muscle aches and pains.

Anyone can get a case of the flu, but who is at particular risk?

The elderly are at greatest risk - that is where the deaths occur. The other high-risk group is infants and high-risk children. Their hospitalization rates [from flu] are nearly as high as the elderly, but they don't die from it, generally.

What causes the deaths from flu among the elderly?

Their immune systems are not as robust. Their other systems are not as healthy, so they may already have decreased pulmonary function, for example, and the flu is kind of the last straw.

Does the vaccine have side effects?

Serious side effects occur at a rate of less than 1 percent. They might include an allergy, but it is very rare. Some side effects have been runny nose, headaches, but [in studies] these side effects did not differ at a statistically significant rate among people who received the vaccine and those who received a placebo.

How is the vaccine given?

There are two types of vaccines: live, attenuated vaccine and the inactivated vaccine. The live, attenuated vaccine is given to healthy, nonpregnant people ages 2 to 49. The inactivated vaccine can be given to people ages 6 months to 105 years.

The live, attenuated virus (given as a nasal spray known as FluMist) has the potential to cause mild flu symptoms, but that isn't common.

Children over 2 years old can be given either the FluMist or the injection. I should add, children who are 8 years or younger who have not been vaccinated before need two vaccines about a month apart. They may receive either the nasal mist or the shot, but studies show you need to get two vaccines; one is not effective. And then, in subsequent years, you need only one.

Last year's flu vaccine was not considered particularly effective. Why was that?

The CDC has to make a prediction about what flu will hit [in a particular year] about nine months out. They base the prediction on what is circulating in the world, particularly in Asia, where outbreaks often begin. They make an estimate of what types of flu will circulate in the winter. So last February, they were deciding which flu to vaccinate against.

Two years ago, they were dead on, and last year, they missed. So the overall effectiveness was only about 45 percent.

What do you want to tell parents about flu vaccines?

I encourage them to get a flu vaccine, and most parents also understand the need to protect the grandparents by vaccinating the children.

It is the same reason that health care workers should be vaccinated, not solely to protect them but, really, to protect the patients. Every year there are people in retirement homes who die from getting the flu from physicians or nurses.

Holly Selby is a former reporter for The Baltimore Sun.

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