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Q&A with Dr. Rachel Shnider: Flu vaccine options for your baby

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Dr. Rachel Shnider
Bundoo Pediatrician

Rachel Shnider, MD, FAAP, is a board-certified pediatrician practicing outpatient general pediatrics in Washington, D.C.

Every year, as many as 20,000 children under age 5 are hospitalized with the flu, according to the Centers for Disease Control and Prevention. While the vast majority make a full recovery, there’s no question that the flu makes for miserable families and babies every year. To help prevent the severity and incidence of flu infections, public health authorities recommend that the all children over the age of 6 months receive an annual flu vaccine during the flu season. Bundoo Pediatrician Rachel Shnider, MD, talks about the flu vaccine and why it’s important.

Bundoo: It seems like the campaign against vaccines has been losing steam recently. Do you find much resistance to the flu vaccine among parents? What’s the biggest obstacle when it comes to making sure babies and toddlers are getting their flu vaccines?

In my practice, there is no longer much parental resistance to the flu vaccine. I find that most parents want to be able to take all the available precautions to keep their children from getting sick. I find that the biggest obstacles tend to be temporary shortages in supply of the vaccine. Sometimes parents will not remember to bring their child back to the office to get the flu vaccine if it’s not in stock at the time of the initial visit. Make a reminder for yourself to call your pediatrician’s office and schedule the vaccine once it’s back in stock! Also, if your child is under age 9 and getting the flu vaccine for the first time, remember that they will need a booster dose in a month, so try to schedule this before your leave the office so that you don’t forget.

Is there a best time to get the vaccine?

The best time to get the flu vaccine is actually before flu season hits. Many pediatric practices will have the flu vaccine available as early as August or September, although the flu vaccine tends to hit months later. Of course, availability at your pediatrician’s office depends on availability from the manufacturer, which can vary greatly year to year.

Some children are recommended to receive two doses of vaccine, while others only get one. What determines if a baby should get one or two doses?

As a rule, all children under 9 years of age need two doses of the same seasonal flu vaccine, separated by at least a month in the first year that they get this vaccine. This allows their bodies to mount enough of an immune response to be effective. In following years, they should only need one dose per flu season. Children 9 and older only need one dose of seasonal flu vaccine per year. If a child under 9 years of age only ends up getting one dose of the seasonal flu vaccine the first year they are getting vaccinated, the next year, they will likely need to obtain two doses. Because this can be confusing and because the exact guidelines for flu vaccination change from year to year, it is always a good idea to review this with your medical provider.

What should parents of babies under 6 months of age do if their babies are too young to get vaccinated?

The best thing to do in order to protect infants too young to receive the flu vaccine is to be sure that all people in contact with babies have received the seasonal flu vaccine. This means that parents, siblings 6 months of age and older, grandparents, babysitters, daycare providers, etc. should all receive a dose of the seasonal flu vaccine on an annual basis. It is also important that pregnant and breastfeeding women receive the flu vaccine when available, because maternal antibodies cross the placenta and also get into breast milk, and they may offer the young baby some added protection.

Are there any chronic health conditions or other health conditions that would make it a bad idea to give a flu vaccine to a baby or infant?

There are really very, very few true contraindications to the flu vaccine.  If your child has a severe egg allergy, your provider may elect to have your child receive the flu vaccine under the surveillance of his or her allergist, but it is still recommended that your child be vaccinated.

Reviewed by Dr. Kristie Rivers, November 2018

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