It's time to call your pediatrician. All children should get a flu shot as soon as it becomes available this season, preferably before the end of October, the American Academy of Pediatrics recommends in a policy statement published Monday. It also emphasizes that the shot is preferred over the nasal mist.
"Everyone over 6 months of age should get their flu vaccine before Halloween," said Atlanta pediatrician Dr. Jennifer Shu, who is a member of the academy but was not involved in the new recommendations. "Don't go trick-or-treating unless you've had your flu shot."
Many pediatricians will be offering their patients both the standard flu shot and FluMist nasal spray. The flu shot contains dead influenza virus strains, while the nasal spray contains weakened viruses.
The flu shot is the academy's first choice for children 6 months and older because it has provided the most consistent protection against all strains of the virus in recent years. FluMist may also be used for the 2018-19 season.
The nasal spray has not been recommended for the previous two flu seasons because it was less powerful against some strains of influenza, the pediatrics group said.
Shu explained that the US Centers for Disease Control and Prevention recommendation differs from that of the academy; the CDC says that either the flu shot or FluMist is fine. Parents who are uncertain about which is best for their children should talk it over with their doctors, she added.
What a flu vaccine can do for your child
In the last flu season, 179 children died, while thousands more were hospitalized with flu-related illness. Eighty percent of the children who died had not received a flu vaccination, according to the CDC.
The flu vaccine reduces a child's risk of developing severe symptoms as well as complications including pneumonia and death, according to the committee of specialists who authored the American Academy of Pediatrics statement.
The 2017-18 flu season ranked among the most severe on record, excluding pandemics.
Dr. Anthony Fauci, director of the National Institute of Allergy and Infectious Diseases, recalled that Australia had a "terrible season last year, and in fact, we had a very bad season last year," as well.
"Even though flu seasons are unpredictable, not always but often, we can get a hint of what we're going to face from what people in Australia and the southern hemispheres have faced in their winter, which is essentially our summer," Fauci said. Looking at Australia today, the flu season there is "generally lighter than usual."
"That doesn't mean we are going to definitely parallel Australia. But there's more of a chance than not that we will see something similar to Australia." Still, he cautioned, "their season is not completely over yet."
"One of the most important things about flu that we all have learned through experience is that it is generally unpredictable," Fauci said. "That's the nature of flu."
Because of this random nature, Fauci recommends most everyone get vaccinated against the virus.
"Particularly the people who fall into the high-risk categories: the elderly, young children, pregnant women, those who have chronic illnesses," he said. The CDC website spells out who falls into the high-risk group, he added.
Age, allergies and antivirals
Kids 6 months through 8 years need two doses when it is their first time receiving a flu vaccine, but children 9 and older require only one dose, no matter their health history, according to the pediatrics group.
Because the flu shot is made using chicken eggs, "it used to be that egg allergy was a concern, but it's not a concern anymore," Shu said, referring to the academy recommendation that everyone, even children with egg allergies, can get the vaccine.
That said, parents who have concerns about allergies or possible reactions to the shot should talk with their doctors, she said.
Even though antiviral medications are important in the treatment of flu, they are not a substitute for vaccination, the pediatrics group also advised.
Fauci said that there's "a lot of effort and interest now in doing better" with both the seasonal flu vaccine and a universal flu vaccine.
A universal flu shot "is not going to come overnight. It's not going to come in a couple of years. It's likely to be an iterative process where we do better each season by getting broader coverage and more potent coverage of influenza."
"Influenza is really a unique virus," Fauci said. "So different from diseases like measles and polio that stay essentially stable, and you just got to vaccinate once or get infected, and essentially, you're good for life. That's not the case with flu. It's very complicated with flu."
So, as scientists labor in their labs trying to perfect a one-time vaccine, Shu recommends using the usual precautions against sickness.
"Get your vaccine. Wash your hands well. Don't go to school or work while sick. Cover your cough or your sneeze," she said. "Try not to touch your face. Every time you touch your face, you have a chance of introducing germs."