Q. I know that flu season is coming. Do my kids needs a flu shot?

A. If they have a chronic medical condition, such as asthma or diabetes, or if they are between 6 and 59 months old, then yes, they definitely should get a flu shot, since they are in a high risk group for getting severe complications from the flu.

It would also be a good idea to get your child a flu shot if you have another child at home who is less than 6 months old, who is too young to get a flu shot, or if your child might expose someone else who is high risk.

They should also get a flu shot if you simply want to help them avoid getting the flu, especially sine the latest flu shot recommendations state that all persons 6 months and older should get a yearly flu shot, even if they aren't in a high risk group.

Flu Shots

Although the flu season in the United States usually extends from November to April, flu cases usually peak in late December to mid March. Getting a flu shot too early might not protect you later in the season, but this year, they are recommending that people get a flu shot as soon as they can, which may mean getting one in September. Protection begins about two weeks after you get your flu shot.

Also remember that if your children are under 9 years of age and are getting the flu shot for the first time, they will need two shots one month apart, and it would be best to get started in September. This year, kids under age 9 years may also need two doses of a flu shot if they didn't get at least one dose of the 2009 H1N1 swine flu vaccine.

There is an alternative to the flu shot too. FluMist, a nasal spray flu vaccine (no shots), can be given to healthy children and adults from age 2 to 49 years.

Who Needs a Flu Shot

All children between the ages of 6 months and 18 years should now get a yearly flu shot, but it is especially important for those in high risk groups, including:

• children aged 6 to 59 months
• pregnant women
• persons aged 50 years and older,
• children and adults with most chronic health conditions, including asthma, diabetes, neurological and neuromuscular disorders (cerebral palsy, seizures, muscular dystrophy, etc.), and immune system problems
• children and teens who are taking aspirin because of the risk of Reye syndrome
• residents of long-term care facilities
• household contacts and out-of-home caregivers of children aged <6 months or in other high risk groups above
• health-care personnel who provide direct patient care

Keep in mind that the 'household contacts' part places a lot of extra kids into a high risk group who should get a flu vaccine. For example, if you have a 3 year old and a 10 year old, they should both get a flu vaccine, because the 10 year old is a household contact of the 3 year old. Or if one child in your family has asthma, then everyone should get a flu vaccine. The child with asthma is in a high risk group and everyone else is a household contact of someone in a high risk group.

Remember that even if your child is not in a high risk group, he can still get a flu vaccine if you want to simply reduce his risk of getting the flu this year.

And with the latest flu shot recommendations, experts now advise flu vaccines for everyone, including healthy adults between the ages of 18 and 49, so basically everyone over the age of 6 months should get a flu vaccine each year.

Other Vaccination Recommendations

• Healthy persons who are 2-49 years of age and not pregnant, including health-care workers (except those who care for severely immunocompromised patients in special care units) and persons caring for children aged less than 6 months can be vaccinated with intranasally administered live, attenuated influenza vaccine (Flumist).
• People should not get a flu vaccine if they have a severe allergy to chicken eggs, have had a severe reaction to an influenza vaccination in the past, have developed Guillain-Barre syndrome within 6 weeks of getting an influenza vaccine previously, if they are less than 6 months old, or if they have a moderate or severe illness with a fever.

One thing to keep in mind is that although thimerosal has been removed from all routinely recommended childhood vaccines, multi-dose vials of the flu vaccine does still contain thimerosal. This is not necessarily a reason to not get your child immunized though, especially if he is in a high risk group. And a limited amount of influenza vaccine that are thimerosal free or have a reduced thimerosal content will be available for the 2010-2011 influenza season. According to the CDC, 'the benefit of influenza vaccine with reduced or standard thimerosal content outweighs the theoretical risk, if any, from thimerosal.'

Updated for the 2010-2011 Flu Season.

For more information, please visit our guide to Kids and the Flu.

_Sources:

_{MMWR. Prevention and Control of Influenza with Vaccines. Recommendations of the Advisory Committee on Immunization Practices (ACIP), 2010. Early Release. July 29, 2010 / 59(Early Release);1-62}