Thoughts on Influenza and the Flu Vaccine from a Pediatrician-Father

I’ve been seeing A LOT of children with influenza the past month, and, although I don’t currently see adult patients, I’ve heard the same from colleagues in the adult realm and friends- it seems almost everyone I’ve spoken with lately has either had the flu or had a family member or friend get ill with the flu.

As we continue to see widespread influenza activity across much of the United States, with very high rates in my home state of Louisiana, in particular, I wanted to share some information on influenza and the flu vaccine from a pediatrician-father’s standpoint.

While influenza is typically a self-limited disease, certain groups are at increased risk of severe disease and complications.? Kids at the highest risk are those less than 5 years of age- especially those under 2- and kids under 6 months of age have the highest rates of hospitalization and mortality.? Chronic medical conditions (in kids of all ages) can also place children at higher risk of severe illness- asthma, diabetes, cardiac disease, chronic lung disease to name just a few. Older adults and those with underlying health conditions are also at increased risk of severe disease and complications.

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Annual vaccination is the most important component of preventing infection and is also important from a public health standpoint.? Everyone 6 months of age and older should seriously consider getting their annual flu vaccine. If you are still on the fence, consider the information below and reach out to your healthcare provider to discuss risks/benefits.

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A brief summary of common myths about influenza and the flu vaccine.???

Myth#1 “The flu vaccine gives me the flu.”? To be brief…no.? The flu shot is made of inactivated virus; it simply cannot give you the flu.? Nasal spray flu vaccines are made with live virus which has been weakened (so-called attenuated virus), but even so, it will not “give” you the flu.? This myth persists due to a few reasons.? First, flu vaccines are administered during cold and flu season; getting sick after receiving the vaccine typically means you got sick with another respiratory virus. Second, the flu vaccine takes about 2 weeks to be fully effective; you might have the bad luck of still getting the flu during that window.? Also, the vaccine (any vaccine) can make you feel feverish and achy for a day or two- these symptoms signify your body’s immune system doing what it does best and are not indicative of an infection. ?????????

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Myth#2 “You don’t need a flu vaccine every year.”? Because the different strains of flu virus are constantly changing (called antigenic drift/shift), a new influenza vaccine is needed every year to best protect you.? Scientists work hard to predict what the coming season will bring and target those strains in the upcoming vaccine. ?

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Myth#3 “The flu vaccine causes serious side effects.”? Truth- the flu vaccine is very safe.? Common side effects are similar in frequency and severity to those with other vaccinations- redness or soreness at injection site, feeling tired, achy and/or having a low-grade fever for a day or so.? Serious complications are rare- Guillain-Barré Syndrome (GBS) occurs at a rate of about 1 in 1 million.? ????

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Mthy#4 “The flu isn’t serious.”? It’s true that most people recover from influenza within a week or so; however, some people can get very ill.? For the 2022-2023 season, the CDC estimates that 21,000 people died due to influenza (this number is almost assuredly an underestimate due to the intricacies involved with reporting).? 183 influenza-associated pediatric deaths occurred last year in the U.S.? So far this season, there have been 40 pediatric deaths. ?

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Here is another point to consider: No vaccine is perfect, and the nature of flu viruses to change from season to season means that vaccines may be more effective in some years than others. So, while getting vaccinated does not prevent 100% of infections, is HAS been shown in several studies* to reduce severity of illness in people who get vaccinated but still get sick. Likewise, it can prevent hospitalization and deadly complications (especially in those with certain chronic health conditions).

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Last thing, some notes on pregnancy and breastfeeding.? Breastfeeding in the first 6 months of life decreases incidence of flu in infants of vaccinated mothers.? Receiving the flu shot during pregnancy is safe and is recommended. Continuation of breast feeding IS encouraged if the mother has the flu.? If the mother requires antiviral medications, Tamiflu is preferred, and the AAP does NOT recommend baloxovir for pregnant or breast-feeding women (this seems to be due to a lack of evidence in this population).

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It's not too late to get yourself or your child vaccinated against the flu.? Talk to your healthcare provider and seek out good information.? Feel free to reach out to me if you have questions.? Don’t forget basic measures like good hand hygiene and staying home when you are sick are also important aspects of reducing the spread of infection.

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*2021 study demonstrating decreased likelihood of ICU admission and death in vaccinated adults

*Flu vaccination reduced children’s risk of flu-related pediatric intensive care unit (PICU) admission by 74% during flu seasons from 2010-2012