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Flu and Children: What You Need to Know

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Flu can be more dangerous than the common cold for children. Children younger than 5 years old—especially those younger than 2—and children of any age with certain chronic health conditions, are at higher risk of developing potentially serious flu-related complications. Parents can help children fight flu by getting themselves and their children vaccinated against flu each year. Image for illustration purposes
Flu can be more dangerous than the common cold for children. Children younger than 5 years old—especially those younger than 2—and children of any age with certain chronic health conditions, are at higher risk of developing potentially serious flu-related complications. Parents can help children fight flu by getting themselves and their children vaccinated against flu each year. Image for illustration purposes
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Parents help children fight flu

Each year, flu places a large burden on the health and well-being of children and their families. Annual flu vaccination offers the best protection against flu and its potentially serious complications in children. 

Children younger than 5 years old—especially those younger than 2—and children of any age with certain chronic health conditions, like asthma and diabetes, are at higher risk of developing potentially serious flu complications. Because these groups of children are at higher risk, it is especially important that they get a seasonal flu vaccine to help prevent flu, and to reduce their risk of being hospitalized or dying from flu if they do get sick.

Healthy children 5 years and older can also get very sick from flu, in addition to spreading flu to vulnerable family members like infants younger than 6 months and adults who are 65 years and older or people of any age who have certain chronic health conditions. It’s important to vaccinate everyone 6 months and older against flu each year to help protect those most at risk.

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Caregivers of young children

Children 6 months and older and their caregivers should get vaccinated against flu each year and there are other preventive actions that everyone can take to help stop the spread of flu.

Who’s at risk

Flu can be dangerous for children

Flu illness is more dangerous than the common cold for children. Each year, millions of children get sick with seasonal flu; thousands of children are hospitalized, and some children die from flu. Children commonly need medical care because of flu, especially children younger than 5 years old.

  • Complications from flu among children in this age group can include:
    • Pneumonia: an illness where the lungs get infected and inflamed
    • Dehydration: when a child’s body loses too much water and salts, often because fluid losses are greater than from fluid intake)
    • Worsening of long-term medical problems like heart disease or asthma
    • Brain dysfunction such as encephalopathy
    • Sinus problems and ear infections
    • In rare cases, flu complications can lead to death.

Flu seasons vary in severity; however, every year children are at risk. CDC estimates that from the 2010-2011 season to the 2022-2023 season (excluding 2020-2021), flu-related hospitalizations among children younger than 5 years old each flu season have ranged from 6,000 to 25,000 annually in the United States.

During the 2023-2024 flu season, 70 percent of children 0 to 17 years old hospitalized with flu had at least one underlying health condition, such as asthmaneurologic disease, obesity, or cardiovascular disease. 

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While relatively rare, some children die from flu each year. From the 2004-2005 season to the 2022-2023 season (excluding 2020-2021), flu-related deaths in children reported to CDC during regular flu seasons have ranged from 37 to 199 deaths. Importantly, among reported flu-related deaths in children, about 80% occurred in children who were not fully vaccinated. Also of note, even though each flu death in a child is supposed to be reported to CDC, it is likely that not all flu-related deaths in children are captured and that the actual number of deaths is higher. CDC has developed statistical models that account for the underreporting of flu-related deaths in children to estimate the actual number of deaths. During 2019-2020, for example, 199 flu-related deaths in children were reported to CDC, but statistical modeling suggests approximately 434 deaths may have occurred.

Prevention

In children, annual flu vaccination has been shown to:

  • Reduce flu illnesses, doctor’s visits for flu, and missed school days.
  • Reduce the risk of flu-related hospitalization and death.

Types of flu vaccines for children

CDC recommends annual flu vaccination for everyone 6 months and older with any licensed, age-appropriate flu vaccine.

There are many vaccine options:

  • Flu shots are given as an injection (with a needle) and are approved for use in people 6 months and older. (Indications vary by vaccine.)
  • Nasal spray vaccine (also known as the live attenuated influenza vaccine or LAIV) is approved for people 2 through 49 years old. However, LAIV is not recommended for people who are pregnant or who have certain underlying medical conditions.

When children should get a flu vaccine

Children should be vaccinated every flu season for the best protection against flu. For most people who need only one dose of flu vaccine for the season, September and October are generally good times to be vaccinated. Ideally, everyone 6 months and older should be vaccinated by the end of October. 

Some children need two doses of flu vaccine. For those children, it is recommended to get the first dose as soon as vaccine is available—even if this is in July or August—because the second dose needs to be given at least four weeks after the first. Vaccination during July and August also can be considered for children who need only one dose. If your child is visiting a health care provider in July or August (for example, in the back-to-school context) and vaccine is available, they can be vaccinated early. Early vaccination can be considered for any person who is unable to return at a later time to be vaccinated. 

However, getting vaccinated later can still be protective, as long as influenza viruses are spreading—even into January or later. Since it takes about two weeks after vaccination for the body to develop antibodies against influenza virus infection, it is best to get vaccinated so they are protected before flu begins spreading in their community.

Special vaccination instructions for children aged 6 months through 8 years old

Some children 6 months to 8 years old need two doses of flu vaccine this season:

  • Children in this age group getting vaccinated for the first time,
  • Children who have only previously received one dose of flu vaccine, and
  • Children whose flu vaccination history is unknown.

For these children it is recommended they get the first dose as soon as vaccine is available, because the second dose needs to be given at least 4 weeks after the first. Your child’s health care provider can tell you if your child needs two doses.

Other preventive actions

In addition to getting a flu vaccine, children and caregivers should take the same actions CDC recommends for everyone, including avoiding people who are sick, washing hands often, and covering coughs. This also can include taking steps for cleaner air and hygiene practices like cleaning frequently touched surfaces.

Information source: CDC

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