Yesterday, the American Academy of Pediatrics released its recommendations for this year’s seasonal flu vaccine. They recommend that all children and adolescents over 6 months of age be vaccinated as well as anyone falling in one of the following high-risk groups (which appear to be consistent with the H1N1 high risk groups from last year):
- Children younger than 5 (and according to the CDC especially children younger than 2)
- Children with high-risk conditions such as asthma, diabetes, or neurologic disorders
- People who live with or care for those at high risk – family members, health care workers, and day care providers
- Pregnant women
The seasonal flu vaccine protects against the three flu viruses that scientists expect will be the most common during the upcoming season. This year, the seasonal flu vaccine will protect against the 2009 H1N1 virus, the H3N2 virus, and an influenza B virus and will be available in three forms:
- Nasal spray flu vaccine, also referred to as FluMist or “live attenuated influenza vaccine”
- Inactivated flu vaccine
- Preservative-free inactivated flu vaccine (thimerosal-free)
Thimerosal is a mercury-containing organic compound used as a preservative to prevent bacterial contamination in vaccine vials that contain multiple doses. Some parents have concerns about the use of thimerosal in vaccines, so many pediatric offices offer the thimerosal-free single dose injections for children under 3. Anyone over the age of 3 interested in the preservative-free vaccine should consider the FluMist vaccine assuming they don’t meet any of the criteria below.
According to the CDC, the following people should not receive the FluMist vaccine:
- People less than 2 years of age
- People 50 years of age and over
- People with a medical condition that places them at high risk for complications from influenza, including those with chronic heart or lung disease, such as asthma or reactive airways disease; people with medical conditions such as diabetes or kidney failure; or people with illnesses that weaken the immune system, or who take medications that can weaken the immune system.
- Children <5 years old with a history of recurrent wheezing
- Children or adolescents receiving aspirin
- People with a history of Guillain–Barré Syndrome that occurred after receiving influenza vaccine
- Pregnant women
- People who have a severe allergy to chicken eggs or who are allergic to any of the nasal spray vaccine components.
Now, here’s where it gets tricky. The number of doses depends on the child’s age at the time of the first dose and their vaccine history for both seasonal and H1N1 vaccines:
- Children younger than 6 months are too young to receive influenza vaccine.
- Children 9 years of age and older need only 1 dose.
- Children younger than 9 years need a minimum of 2 doses of 2009 pandemic H1N1 vaccine. If they did not receive the H1N1 vaccine during last year’s flu season, they will need two doses of seasonal influenza vaccine this year.
- Children younger than 9 years who have never received the seasonal flu vaccine before will need 2 doses.
- Children younger than 9 years who received seasonal flu vaccine before the 2009-2010 flu season need only one dose this year if they received at least 1 dose of the H1N1 vaccine last year. They need 2 doses this year if they did not receive at least 1 dose of the H1N1 vaccine last year.
- Children younger than 9 years who received seasonal flu vaccine last year for the first time, but only received 1 dose, should receive 2 doses this year.
- Children younger than 9 years who received a flu vaccine last year, but for whom it is unclear whether it was a seasonal flu vaccine or the H1N1 flu vaccine, should receive 2 doses this year.
- All children who need 2 doses should receive the second dose at least 4 weeks after the first dose.
Did you catch that?? Sheesh. To attempt to put it in easier terms, children between the ages of 6 months and 9 years will need 2 doses, 4 weeks apart, unless they have received:
- at least 1 dose of 2009 H1N1 vaccine last flu season, and
- at least 1 dose of seasonal flu vaccine before the 2009-2010 flu season or 2 doses of seasonal flu vaccine last flu season.
So it appears my two year old will need only one dose since she received two doses of the H1N1 vaccine last season and at least 1 dose of seasonal flu vaccine before last season. She only received 1, not 2 doses, of seasonal flu vaccine last year.
Fortunately, the AAP recognizes that this is confusing and says that it has created a concise flow chart to help you determine the required number of doses. The flow chart should be published in the October 2010 issue of Pediatrics with its policy statement on flu vaccination. We’ll plan to post it once we can get our hands on it. In the meantime, it’s probably best to review your child’s vaccination history and consult your pediatrician.
Please leave us a Comment and let us know your thoughts!
If you enjoy reading PureBebe, please click on “Sign me up!” under “Email Subscription” on the right rail of the screen. By subscribing to our emails, you are telling us that you digg our site and want to read more of our baby news and topics!
You Might Also Like: