ASK THE DOCTOR: Do my kids need a flu shot?
By Dr. JIM MITTERANDO
The Patriot LedgerQ. How does the flu shot affect children? Does the shot affect their other vaccines?
A. Children ages six months to 23 months should receive the flu vaccine yearly, recommends the Centers for Disease Control. The flu tends to infect children more than adults because they are exposed at school or day care.
This year flu vaccine supplies are limited and have to be reserved for younger children, older adults and people with medical problems.
One company that produced the vaccine - Fluvirin - was recently shut down because of quality concerns. This has reduced the supply by almost one-half, which will certainly create a shortage of vaccine and may lead to delays in flu clinics and will require rationing to those in most need.
In our office, we are advising lower risk, older children and adults that are interested in vaccinations to call back in early December after higher-risk people are vaccinated. Additionally, lower-risk people are encouraged to attend community vaccination programs at town halls, pharmacies, malls or employers. Doctor's offices have limited supplies of shots.
Younger children - ages 6 months to 23 months - have a somewhat increased risk of flu-related complications. A toddler has the same risk of hospitalization from flu complications as his grandparent does - one in 1,000 risk. Older children are not at higher risk of flu-related complications and do not require the vaccine. They certainly can get the vaccine if it is available. You may consider vaccinating older children if there is a newborn in the house to reduce the chance of transmission to the baby.
Unlike the mandatory measles or polio vaccines, the flu shot is optional. Your child does not have to receive it. But, the vaccine is safe and can be given with the child's other shots. It occasionally causes a fever or localized swelling at the site of the shot. Even if a child has a low-grade fever or illness, such as a cold or ear infection, they can still get the shot.
Fluzone is the only FDA-approved vaccine for the toddler age group. It can be given after the age of 6 months and requires a repeat booster vaccine one month later to ensure adequate immunity. Unfortunately, this vaccine is not approved for children under 6 months, which is the age group that may be at highest risk. Fluzone is almost free of thimerosal (mercury) preservative that caused public concern in the past.
The newer nasal spray FluMist can cause more flu-like symptoms. FluMist is only approved for ages 5 to 49 and cannot be given to toddlers.
October through December is the best time to get vaccinated but you can still vaccinate your child in January or February. Flu season in New England usually does not begin until December, peaks in January or February, and can last into April or even May.
For most kids, the flu is one of many viral infections that clears up without complication. If he or she has rapid breathing, a fever that won't break or appears very ill, see a doctor. If you're an adult who is around a lot children, you should be vaccinated, too.
Information: www.state.ma.us/dph/ and www.cdc.gov.
Dr. Jim Mitterando is a family doctor at Cohasset Family Practice and a staff member at South Shore Hospital in Weymouth.
Readers should send questions to: Ask the Doctor, The Patriot Ledger, P.O. Box 699159, Quincy, MA 02269-9159, or by E-mail to his attention at features@ledger.com.
Questions of general interest will be answered in this column. The information in this column is not intended to diagnose individual conditions, and individual replies are not possible. Readers should see their own doctors about specific problems.
Copyright 2004 The Patriot Ledger
Transmitted Tuesday, October 12, 2004