Why should my child get the flu shot every year?

DEAR DOCTOR K:

I know my child is supposed to get a flu shot each year. But how much good does it really do, and is it safe?

DEAR READER:

Every fall and winter, parents face the question: Should my child get an influenza (flu) shot?

Many parents ask the same question that you do. There are several important reasons why children older than 6 months should get a flu shot every year:

INFLUENZA CAN BE DANGEROUS, EVEN FOR HEALTHY CHILDREN. The flu is not the same as the common cold. Flu can be dangerous for children, particularly those with asthma, diabetes or other chronic health problems. But even healthy children can get very sick — and possibly die — from influenza. The H1N1 “swine flu” virus that has been circulating since the epidemic of 2009–2010 is particularly dangerous for kids.

YOU CAN’T CATCH THE FLU FROM A FLU SHOT. The flu shot, given by needle, contains virus that has been killed. Despite the misconceptions that some parents have, the flu shot cannot infect your child and cause the flu.

There now is a nasal spray flu vaccine made with weakened (but still alive) flu virus, for kids who just hate shots. While nasal congestion and a low-grade fever can occur (in about one in 20 kids), the illness is milder and briefer than the flu. If your child is between 6 months and 2 years or has a weakened immune system, however, he or she should get the flu shot, not the nasal spray vaccine.

Some kids (and adults) who get the flu shot also get a mild fever, an aching muscle where the flu shot was given, and feel tired for a day or so. That’s not because the shot gave them the flu; it’s a sign that their immune system is responding vigorously to the shot. That’s good news, because that’s what we want the immune system to do.

THE FLU SHOT IS SAFE. Years of experience have shown that the influenza vaccine is very safe. There is no evidence that thimerosal, a common vaccine preservative, is dangerous for children. But preservative-free preparations are available.

A particular flu vaccine used in 1976 did seem to cause a few cases of the neurological condition called Guillain-Barre syndrome. But this same condition can follow getting the flu itself. Indeed, it happens more often after the flu than after getting a flu shot. Since the flu shot protects against the flu, your child is less likely to get this rare condition if they get the flu vaccine.

THE FLU SHOT PROTECTS MORE THAN YOUR CHILD. Kids are germ-producing machines. Your child may weather the flu fine — but what about others who could catch the flu from your child?

Although there are a few unusual circumstances in which your pediatrician may recommend against a flu shot, the flu shot is almost always a safe treatment. It is not too late to get the shot: Flu season will continue for another three months. And the shot can make all the difference in your child’s health.

(This column is an update for one that ran originally in October 2012.)