2009 -2010 Flu Season
Frequently Asked Questions - Children
Should my child get the seasonal flu vaccine this flu season?
Anyone who wants to reduce their chances of getting the flu can get vaccinated. However, because we are experiencing a moderate delay in seasonal flu vaccine shipments from vaccine manufacturers, CDC recommends that certain groups of the population receive the seasonal vaccine when it first becomes available. In accordance with those recommendations, Harvard Vanguard will be targeting the following groups to receive seasonal flu vaccine first:
- Pregnant women
- Children aged 6 months up to their 19th birthday
- People 50 years of age and older
- People of any age with certain chronic medical conditions
- People who live in nursing homes and other long-term care facilities
- People who live with or care for those at high risk for complications from flu, including:
- Health care workers
- Household contacts of persons at high risk for complications from the flu
- Household contacts and out of home caregivers of children less than 6 months of age (these children are too young to be vaccinated)
Should my child get the H1N1 vaccine this flu season?
As with seasonal flu, anyone who wants to reduce their chances of getting the flu can get vaccinated. However, because the CDC is initially releasing a limited supply of the H1N1 vaccine, they have recommended that certain groups of the population receive the H1N1 vaccine when it first becomes available. Per their recommendations, Harvard Vanguard will be targeting the following groups to receive the H1N1 flu vaccine first:
- Children under the age of 2
- Siblings of infants below 6 months of age to safeguard the under 6 month old who can't get vaccinated themselves
- Children 18 years of age and under with clinical criteria that places them at high risk of complications.
- Pregnant women
- Healthcare and emergency medical services personnel
- People who live with or care for children younger than 6 months of age
- People ages of 25 through 64 years of age who are at higher risk for H1N1 because of chronic health disorders or compromised immune systems
Can the seasonal flu shot and the H1N1 flu shot be given at the same time?
Seasonal flu and H1N1 flu vaccines may be administered on the same day when given as injections, but given at different sites (e.g. one shot in the left arm and the other shot in the right arm). The vaccines may be available in a nasal spray formulation; the two different vaccines may not both be given as a nasal spray at the same time or within a month of each other. One may be given as a nasal spray at the same time as the other is given as an injection.
Will two doses of H1N1 vaccine be required?
The U.S. Food and Drug Administration (FDA) has approved the use of one dose of H1N1 flu vaccine for persons 10 years of age and older. This is slightly different from CDC’s recommendations for seasonal influenza vaccination which states that children younger than 9 who are being vaccinated against influenza for the first time need to receive two doses. Infants younger than 6 months of age are too young to get the H1N1 and seasonal flu vaccines.
What will be the recommended interval between the first and second dose for children 9 years of age and under?
CDC recommends that the two doses of H1N1 vaccine be separated by 4 weeks. However, if the second dose is separated from the first dose by at least 21 days, the second dose can be considered valid.
If there is H1N1 flu in my community, is it safe for my child to go to school?
At this time, state and local public health officials recommend that students can – and should – continue to go to school, as long as they are not sick and do not have flu symptoms. Flu-like symptoms include: fever (over 100 degrees F), with cough and/or sore throat. Additional symptoms of H1N1 flu include: runny nose, stuffy nose, headache, body aches, feeling very tired, and sometimes vomiting or diarrhea.
What should I do if my child is sick?
Flu spreads easily from person to person. If you think your child is getting the flu:
- Keep your child home. It is very important that your child does not go to school or other places where they could spread the flu virus to other people, such as group childcare, after school programs, the mall, or sporting events.
- Call your doctor’s office and let them know your child’s symptoms and history. Your doctor will advise you whether you should come to the office. It is best to call ahead so that you help prevent spreading illness to others.
- Call your child’s school to notify them that they are sick, and tell the school nurse if your child has flu-like symptoms.
- Keep your school nurse updated on your child’s medical condition.
- Do not give your child or teenager (18 years of age or younger) aspirin or aspirin-containing products due to the rare but serious illness called Reye syndrome.
- All individuals with flu-like symptoms should stay home for at least 24 hours after they no longer have a fever, without using fever-reducing medicines. These medicines include Motrin or Advil (ibuprofen), Tylenol (acetaminophen) or a store brand. Keeping children with a fever at home will keep them from getting other people sick.
Please note: The Boston Public Health Commission is advising parents of children who attend school within the Boston city limits and are diagnosed with influenza that their children need to refrain from all public activities including school and extracurricular activities for four days after the onset of symptoms OR for 24 hours after resolution of fever - whichever is longer.
What can I do to keep my child from getting sick?
It is important to teach your children how to reduce their risk of getting the flu and how to protect others from becoming infected.
- Get your child both the H1N1 and seasonal flu shots. Vaccination is the best way to keep your child from getting the flu.
- Teach your children to wash their hands often. Washing with soap and hot water for at least 20 seconds is ideal (about as long as it takes to sing the “Happy Birthday” song twice).
- Teach your children to use hand sanitizer. Gels, rubs, and hand wipes all work well, as long as they contain at least 60% alcohol. Watch small children using gels so they don’t swallow it.
- Teach your children to cough or sneeze into their elbow – not their hands! Cover coughs and sneezes with tissues or by coughing into the inside of their elbow. They should wash their hands after blowing their nose or coughing into a tissue.
- Teach your children to avoid touching their nose, mouth or eyes. They should keep their hands away from their face.
Is it safe for children to receive an influenza vaccine that contains thimerosal?
Yes. There is no convincing evidence of harm caused by the small amount of thimerosal in vaccines, except for minor effects like swelling and redness at the injection site due to sensitivity to thimerosal. Most importantly, since 1999, newly formulated thimerosal preservative-free childhood vaccines (Hepatitis B, Hib, and DTaP) have been licensed. With the newly formulated childhood vaccines, the maximum total exposure during the first six months of life will now be less than three micrograms of mercury. Based on guidelines established by the FDA, the Environmental Protection Agency (EPA) and the Agency for Toxic Substances and Disease Registry (ATSDR), no child will receive excessive mercury from childhood vaccines regardless of whether or not their flu shot contains thimerosal as a preservative.
Research suggests that healthy children under the age of 2 are more likely than older children and as likely as people over the age of 65 to be hospitalized with flu complications. In addition, children between 24-59 months of age have higher rates of influenza-related doctor and Emergency Department visits than older children. Therefore, vaccination with either reduced or standard thimerosal-content flu vaccine is recommended for children between the ages of 6 and 59 months by CDC’s Advisory Committee on Immunization Practices.
Can children take antiviral drugs?
Yes. The two drugs recommended for use against influenza (including H1N1) this season can be used in children:
- Oseltamivir (Tamiflu®) is approved by the Food and Drug Administration (FDA) for use in children 1 year of age or older.
- Zanamivir (Relenza®) is approved for treatment in children 7 years and older, but is licensed only for use in people without underlying respiratory or heart disease, including people with asthma.
What are the side effects of antiviral drugs in children?
Reported side effects of oseltamivir are nausea and vomiting. Among children treated with oseltamivir in clinical studies, 14% had vomiting, compared with 8.5% of children getting a “placebo.” Nausea and vomiting might be less severe if oseltamivir is taken with food.
Side effects from zanamivir have been reported in fewer than 5% of people participating in clinical trials and have been reported at the same rate in people receiving zanamivir as those being given a “placebo.” Reported side effects have included diarrhea, nausea, sinusitis, nasal signs and symptoms, bronchitis, cough, headache, dizziness, and ear, nose and throat infections. Also, zanamivir should not be used in people with underlying respiratory disease, including asthma.
What do other experts say about antiviral drugs and children?
The American Academy of Pediatrics (AAP) recommends antiviral drugs to treat influenza in children who are at higher risk of serious flu-related complications and who have moderate-to-severe influenza. These children in particular may benefit from a decrease in the duration of their symptoms.
Source: The Centers for Disease Control & Prevention (CDC) and Department of Public Health (DPH)
Page last updated: 11/4/09