Saturday, November 01, 2003
By Darcy Lewis
Should your child get a flu shot? People usually think of influenza as just a seasonal inconvenience, but the flu is actually a major cause of ear infections, can lead to children being hospitalized and can be deadly, say researchers.
"The data are fairly compelling that all children between 6 and 23 months should receive the vaccine," says Dr. Todd Davis, a pediatrics professor at Northwestern University Medical School. "And the data are absolutely unequivocal that children with chronic illnesses should be vaccinated."
According to the Centers for Disease Control and Prevention, the flu killed an average of 36,000 people and led to 114,000 hospitalizations during each year of the 1990s. Nearly all of these deaths were adults 65 and older, but three studies published since 2000 show an alarming trend: Children are often hospitalized due to flu complications such as seizures, dehydration and breathing difficulties. In response, the American Academy of Pediatrics issued what they call a "policy statement" in 2002 encouraging parents of children between 6 and 23 months to get flu shots for their kids and explaining why.
It is just as common for children younger than 24 months who get the flu to be hospitalized as it is for adults over age 50. Routine immunization has been recommended for those adults since 2000.
Previously, the AAP recommended that immunizations be given only to children with certain chronic illnesses, such as asthma, diabetes, cystic fibrosis and sickle-cell anemia. The new policy encourages all family members and caregivers of high-risk children to get a flu shot.
Fewer ear infections Apart from avoiding the hospital, immunized children might receive another benefit: fewer ear infections. Influenza causes ear infections in up to 5 percent of all children each year, according to the academy.
"If your child gets many ear infections between October and March, getting him vaccinated will significantly reduce his chances of developing ear infections during flu season," says Dr. William Rutenberg, a Buffalo Grove pediatrician.
Still, the flu vaccine is not a guarantee. According to Rutenberg, who serves on the AAP's immunizations committee, anyone who gets the shot still has up to a 40 percent chance of getting the flu. But "if [a child] does get influenza later, it will be much less severe," says Rutenberg.
And the flu vaccine is really the public health community's best guess about which three strains-out of a constantly growing number-will hit that year. So, it is possible to have the shot but still get a different strain of the flu. That is often what happens when people catch the flu after getting the shot. The vaccine contains killed virus, which means you cannot get influenza from the shot. "I don't think the CDC has ever been wrong about more than one out of the three, which means vaccinated people are still well-protected," Rutenberg says.
Up to a third of those getting the vaccine will get a sore arm and possibly a fever. "People get a fever and say they're sick-no, they're just having a reaction," Rutenberg says. "I ask parents whether they'd rather their child have a mild fever for 24 hours or miss seven to 10 days of school with influenza."
There are parents who are opposed to additional immunizations on the grounds of convenience, added pain or an anti-vaccine philosophy. Evanston pediatrician Dr. Edward Traisman says, "Some parents don't feel comfortable adding another vaccine, and I respect that."
Convenience is a legitimate concern, too. Children under age 9 must receive two doses one month apart their first year of getting vaccinated to develop full immunity.
Nasal spray & prevention It sounds too good to be true, but the Food & Drug Administration recently approved a nasal spray influenza vaccine. It's clearly not for everyone: It costs about five times as much as the injection and is approved for use by people only age 5 and up. Furthermore, it is made with a weakened but live strain of the virus, which means that, unlike the flu shot, there is a small chance of contracting influenza from the spray.
"Because of the small chance of spreading flu from the nasal spray, we recommend that all family members of high-risk children continue to receive the vaccine via injection," Rutenberg says.
Still, when it comes to flu prevention, it's important to remember the basics.
"Whether or not your child gets a flu shot, the best thing you can do is to have your family wash hands and faces with soap and water throughout the day," Traisman says. "Parents, wash yourself as often as you wash your children, and remember to wash when you go from one child to another."
So here's the bottom line: Discuss the AAP's new policy with your pediatrician, but whatever he or she recommends, remember to be a stickler for old-fashioned good hygiene.
Darcy Lewis is a writer who lives in Riverside with her husband and two boys, ages 9 and 4.