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Flu Shots for Children

What is the flu?

The flu (influenza) is a disease caused by viruses. Each winter many people get the flu. Influenza causes a fever, muscle aches, sore throat, cough, and tiredness that may last for several days. Most children are sick for only a few days, but some children get much sicker and may need to be hospitalized. The disease can usually be prevented by getting a vaccine, commonly called a flu shot. The influenza virus changes from year to year. Because of these changes, protection from the influenza virus usually lasts only for 1 year.

Who should get a flu shot?

Healthy children age 6 months to 18 years should routinely get a flu shot. Those less than 5 years old are at a greater risk of needing to be put in the hospital because of the flu.

A flu shot is also recommended each year for children ages 6 months and older if they have certain medical risk factors. These risk factors include:

  • asthma or other lung disease
  • congenital heart disease with defects that require medications or surgery or other heart disease
  • glomerulonephritis, kidney failure, or other kidney disease
  • liver disease
  • diabetes or other metabolic disease
  • sickle cell disease or other anemia
  • immune system problems caused by a disease or medicine
  • juvenile rheumatoid arthritis or any other disease needing aspirin therapy.
  • certain muscle or nerve disorders, such as seizure disorders or cerebral palsy, that can lead to breathing or swallowing problems

Other people who should have a flu shot include:

  • people who will be with infants or children
  • people over 50 years of age or older
  • women who will be pregnant during the influenza season
  • residents of nursing homes or long-term care facilities

Are there other ways to get the vaccine?

For some children, an alternative to flu shots is FluMist. It is a nasal spray form of the vaccine for children over 2 years of age. It costs more than the shot. As with flu shots, your child will need a new dose of FluMist every year. Unlike the shot, FluMist is a live virus vaccine. For this reason pregnant women and children with weakened immune systems, asthma, or certain other medical conditions cannot take the nasal spray.

When are flu shots given?

A flu shot can be given at the same time as any routine vaccine. Your child should get the shot as soon as it is available in your area. This is usually between September and mid-November.

Some children should receive 2 doses of the influenza vaccine in one year. Children younger than 9 years of age who get the influenza vaccine for the first time or who were vaccinated for the first time during the previous flu season but only received 1 dose should receive 2 doses. These doses should be separated by at least 4 weeks.

Are there any other considerations?

Mild symptoms after a flu shot include soreness at the site of the shot, fever, and body aches. If your child has the nasal spray flu vaccine, symptoms may include runny nose, nasal congestion or cough, fever, headache, and muscle aches. These problems usually last for one or two days. Serious complications are very rare. Ask your healthcare provider for a Vaccine Information Statement from the Centers for Disease Control for more information.

Some flu shots contain a very small amount of a preservative called thimerosal. This is an ethyl mercury-based compound. Research has shown that the amount of mercury in an influenza shot is not harmful. If you are concerned about the safety of thimerosal, ask your provider about getting a thimerosal-free flu vaccine

Are there children who should not get a flu shot?

Children with moderate or severe illnesses should come back when they are healthier to get a flu shot. Children with an allergic reaction to eggs or any other constituent of influenza vaccine that involved breathing should not get a flu shot. Persons who have had Guillain-Barré syndrome (a condition of ascending paralysis) should decide whether to get the vaccine with their healthcare provider.

Children with long-term health problems such as heart or lung disease should have the shot, but not the nasal spray form of the vaccine.

For more information about the vaccine, ask your healthcare provider for an Influenza Vaccine Information Statement.


Written by Robert Brayden, MD, Professor of Pediatrics, University of Colorado School of Medicine.
Pediatric Advisor 2012.1 published by RelayHealth.
Last modified: 2011-06-23
Last reviewed: 2011-06-23
This content is reviewed periodically and is subject to change as new health information becomes available. The information is intended to inform and educate and is not a replacement for medical evaluation, advice, diagnosis or treatment by a healthcare professional.
© 2012 RelayHealth and/or its affiliates. All rights reserved.
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