The Flu Shot: What a pediatrician mom chooses for her own kids

Flu season is right around the corner, and it’s normal for parents to feel anxious about how to keep their kids safe. If all the social media chatter has left you worried or confused, you’re in the right place.

The bottom line: one of the most effective steps you can take to protect your child is getting the flu vaccine. Pediatrician parents (myself included) choose it for our own kids because we’ve seen the data: the flu shot is safe, effective, and helps prevent many of the serious complications from influenza.

In today’s post, I’ll walk you through the top parent questions about the flu shot: When should kids get it? Which type is best? What side effects should you expect? Consider this your clear, evidence-based guide to protecting your family this flu season.

Predictions for this upcoming Winter

The recent season in many parts of the southern hemisphere, like Australia, was severe. Their flu season started early, with high community transmission and a tripledemic vibe due to RSV and Covid-19 infections as well. Based on this, along with the fact that I’m already seeing influenza cases in Northern VA much earlier than normal, I am concerned that the US will see a severe respiratory season this year.

Why does the flu shot change every year?

Unlike most vaccines, the flu vaccine is reformulated annually. Experts analyze which strains are circulating globally and predict which strains are most likely to cause illness in the U.S. for the upcoming season.

Even when the match isn’t perfect, studies show the flu vaccine still reduces the risk of serious illness, hospitalization, and ICU stays in children. Vaccination has been shown to cut the risk of critical illness in kids by up to 75% (PMID: 35024795) and to decrease the risk of hospitalization and ER visits in children by 40-60% (PMID: 33020249), even when the strain is mismatched to the shot.

For those who are interested in reliable information about flu vaccine components, check out this page and this page.

Who should get the flu vaccine?

All children 6 months and older should get a yearly flu shot (unless there’s a medical reason not to).

Why do some kids need 2 doses of the flu shot?

For influenza, a single exposure to influenza vaccine is usually NOT ENOUGH to generate a robust enough immune response to effectively fight the virus if your body encounters it.

In young kids the data shows that a 2nd shot doubles (PMID: 26658375, 16991077). That effect is blunted in older children and adults, except in certain specific situations, such as organ transplant recipients.

Flu shot vs. nasal spray: which is better?

Two types of flu vaccines are available for children:

• Flu shot (injection): Safe for kids 6 months and older, no live virus.

• Nasal spray (mist): A weakened but live virus vaccine, approved for healthy children 2 years and up.

Both work well. The “best” one often depends on your child’s age, health, and comfort level. Many families choose the shot, but the nasal spray can be a good option for kids who fear needles.

What side effects should I expect?

Some children may develop temporary symptoms like mild fever, achiness, or chills (which can seem very flu-like!)

Treat flu vaccine side effect with fluids, rest and acetaminophen or ibuprofen as needed. More serious allergic reactions can occur, but these are very rare. Check out the CDC website for more info on these.

When should kids get the flu shot?

In most years, the ideal time is to be protected by Halloween at the latest. Protection takes about 2 weeks to develop, so vaccinate early enough to cover the start of flu season.

• This year, I’m giving my kids (and patients) the vaccine a little early because of the Australian data and the flu rates in our community. We are aiming for protection by mid-October instead.

• Kids who need 2 doses: Start NOW so they’re fully protected by late fall.

What if my child has an egg allergy?

Good news! Children with egg allergies can still get the flu vaccine. If you’re worried, talk with your pediatrician or allergist for reassurance.

Can my child get the flu shot with other shots (like Covid, Beyfortus, or routine vaccines) ?

YES. The flu vaccine can be given at the same visit as other routine shots, including COVID-19 vaccines.

Can the flu shot give me the flu?

No. The flu vaccine cannot give you the flu.

Although some of the side effects can seem very flu-like, these are signs of the immune system responding, and not a sign of flu infection. Flu shot side effects usually get better within 1-2 days (unlike flu infection, which can last up to 1-2 weeks).

What if my child already had the flu this season? Do they still need the shot?

YES. Remember: the flu shot protects against three strains of the virus. Even if your child had one, they’re still vulnerable to the others. There is no technical strict “waiting period” after illness, but you do want to make sure your child is feeling better

My baby is too young to get the flu shot. How do I protect them?

For babies under 6 months, create a “cocoon” of protection around them. Flu antibodies are also transferred across the placenta during pregnancy, and in breastmilk.

Make sure people around your little one are vaccinated against influenza, are not actively sick, and wash their hands well. As the holidays approach, think seriously about exposures (and you can always discuss with your pediatrician as we know more about what the season looks like).

This time of year, my child is always sniffly. Does my child need to be totally healthy to get their flu shot?

Your child can still get their flu shot if they are mildly ill (eg: cold symptoms or low-grade fever) . But if your child is more sick / has underlying health issues, you should speak with your pediatrician to decide when they should get their flu shot.

Do kids need immune-boosting supplements with (or instead of) the flu shot?

No. Most supplements marketed for “immunity” aren’t backed by strong evidence. I have a FREE immunity download you can read here that reviews the most common supplements that are advertised for respiratory support. If you’re curious about Elderberry, my full post on it is here.

Ultimately, a healthy diet, good sleep, handwashing, and the flu vaccine itself remain your child’s best defense.

The flu vaccine is the safest, most effective way to reduce your child’s risk of serious flu illness.

Haven’t booked your child’s flu shot yet? Now’s the time!