Parenting

By Dimpy Bakshi, Pharm.D.

If you are a parent like me, I am sure that you are strategizing about ways to dodge the flu bullet this season. As you may know, the term “flu” refers to influenza viruses, which infect the nose, throat and lungs. According to the American Academy of Pediatrics, young, healthy children have a high risk of hospitalization for influenza infections.

Since children touch their noses, eyes and mouths often without washing their hands regularly, flu viruses spread easily. Influenza may be spread by droplets that come from the nose and mouth when coughing or sneezing and then travel through the air and reach others. Additionally, the virus can be spread by a person who blows his or her nose, coughs or sneezes on his or her hands and then touches a common object, such as a door knob. Influenza viruses can live for several hours (two to eight) outside of the human body, so the virus can be picked up easily by another set of hands that touches that doorknob.

When Does the Flu Season Start?
While the flu season starts during the fall, it peaks between December and March. The best way to protect against the flu is to get vaccinated every year. Those who were vaccinated last year are not protected from getting the flu this year, because flu viruses are mutating constantly. This is why flu vaccines are updated every year to include the most current strains of the virus.

Although you can get a flu vaccine well into flu season, it’s best to try to get it earlier—ideally in October or November. You can even get it as late as January, since there are still a few months left in the flu season. Once you have been vaccinated, it takes two weeks for your body to develop the antibodies that will help fight the virus.

How Does the Flu Vaccine Work and How Effective is it?
The flu vaccine works by stimulating your body to produce antibodies that will provide protection against the influenza virus. The vaccine can prevent 66 percent or more influenza infections in young children when the vaccine strains match or are similar to the particular flu virus causing the illness. Vaccinating individuals who are regularly in close contact with children can also help decrease children’s risks of getting the flu.

Who Should Receive the Flu Vaccine?
As always, the Centers for Disease Control has specific recommendations regarding administration of the flu vaccine. It recommends that all children between the ages of six months and five years should receive the flu vaccine, as should people who care for or live with children under the age of five. Infants under six months of age should not receive the flu vaccine but are still at high risk for flu-related complications. The best way to protect this age group is to vaccinate everyone around them.

Sirisha Durbhakula, M.D., a pediatrician in Gaithersburg, Maryland strongly advocates flu vaccinations for all children that meet the criteria for receiving it. Dr. Durbhakula notes, “Having had one of my sons develop the flu the year I opted not to give him the flu shot, I will never make that mistake again.”

The Flu Shot or the Nasal-spray?
The flu shot is an inactivated vaccine containing “killed” viruses and is given through a needle in the arm. Because the flu shot is not an activated virus, it does not cause symptoms associated with the flu, such as coughing or congestion. Children who are receiving the flu shot for the first time (and those who were vaccinated for the first time during the previous influenza season, but only received one dose in that season) should receive a second dose one month after the first dose this season.

There is a new type of flu shot available this season that does not contain thimerosol, the preservative that has been used since the 1930s to prevent the contamination of multi-dose vials of the flu vaccine. Some parents are concerned about the presence of thimerosol in childhood vaccines because various vaccine critics and autism advocacy groups have suggested that it has caused children to develop autism or other neurodevelopmental disorders. This form of the vaccine may cost a little more, but is certainly an option for parents who don’t want to expose their children to thimerosol. However, there is no scientific evidence to prove that the low levels of thimerosol in influenza vaccines has had harmful effects.

Side effects from the flu shot are rare but include soreness, redness or swelling at the injection site. A low-grade fever or muscle aches may also occur but usually don’t last past one or two days after receiving the vaccination. If a fever or muscle aches occur, these side effects should not be confused with the flu. As mentioned earlier, the flu shot is an inactive virus, so it does not cause the flu.

The second option for the flu vaccine is the nasal-spray (FluMist®), which is made with live attenuated influenza viruses or a “weakened” virus. These viruses do not cause the flu either. FluMist® is approved for use in healthy people ages 2 to 49. The FDA only recently approved FluMist® for use in healthy two to four year olds; however, it is still not recommended for pregnant women. Additionally, for children aged two to eight years, the same rules about receiving two doses of the flu shot the first time apply to FluMist® as well.

Side effects of the nasal-spray include runny nose, headache, vomiting, muscle aches and fever (greater than 100°F in children two to six years of age). Fever is not a common side effect in adults, but they may experience cough and sore throat in addition to the aforementioned side effects. FluMist® does not contain any thimerosol or other preservatives.

Severe, life-threatening allergic reactions are very rare. Signs of serious allergic reactions include trouble breathing, hives, wheezing or increased heart rate. These kinds of reactions would more likely occur in someone who has had a severe reaction to the flu vaccine in the past or someone allergic to eggs, because the flu vaccine is grown inside eggs. Make sure to tell your physician/pediatrician if you or your child is allergic to eggs or egg products, or has had a serious reaction to the flu vaccine in the past.

What should be done if your child has the flu (after you have called the pediatrician)?
- Give your child lots of fluids to drink.
- Have your child get lots of rest.
- If necessary, give your child Acetaminophen or Ibuprofen to help reduce his or her fever or relieve body aches or pains. Recently, the FDA withdrew infant over-the-counter cough and cold medicines that combine decongestants, anti-histamines or cough suppressants with Acetaminophen or Ibuprofen from the market . So for children under six, be sure to check your medicine cabinet and get rid of any over-the-counter cough and cold preparations that fit this criteria. When in doubt, ask your pediatrician.
- Dress your child in layers because he or she may feel warm one minute and cold the next.
- Use a cool-mist humidifier. Be sure to clean the humidifier based on the manufacturer’s guidelines to avoid mold growth.
- Use a suctioning bulb to remove excess mucus that can make it hard for your child to breathe.
- Use over-the-counter saline nose drops to help break up some of the dry mucus causing nasal congestion. Use a suctioning bulb afterwards to help remove the loosened mucus.
- Above all, make sure to give your child LOTS of love and TLC!

ABCDlady does not provide medical advice, diagnosis or treatment. See additional information.

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