Why the flu shot is important for kids and how to vaccinate your child safely

• Most kids over six months of age should get a flu vaccine.
• Kids under the age of 8 may need to get two vaccines to build up their antibody levels.
• The flu vaccine nasal spray is a useful option for children, but children under 2 years old should not get the nasal spray, as it can cause wheezing.
• This article was medically reviewed by Jason R. McKnight, MD, MS, a family medicine physician and clinical assistant professor at Texas A&M College of Medicine.

Getting a flu shot is an important way to protect yourself from the influenza virus. In fact, it's just as vital for kids to get vaccinated as adults, particularly for young children, who are more likely to get seriously ill from the flu.

But there are also some necessary precautions you should know before getting your kids a flu shot. Here's what you need to know about flu shots for kids and the best way to vaccinate your child.

Why getting the flu shot is important for children

As long as your child is six months or older, they should get a flu shot every year.

Getting a flu shot for your child is so important because most children haven't built up any flu antibodies yet. Antibodies are the proteins your immune cells use to fight off specific infections, and until you are exposed to the flu virus, you won't develop the antibodies to fight it.

"While adults have a lifetime of exposure to the influenza virus and influenza vaccination, children don't have this immunological history and this leaves them especially susceptible to infection," says Laura Haynes, PhD, a professor of immunology at the University of Connecticut.

Because children's immune systems have no "memory" of how to fight off the flu, Haynes says, they are at greater risk for more severe infections that can require hospitalization. The Centers for Disease Control and Prevention (CDC) estimates that each year, between 7,000 and 26,000 children under five are hospitalized for the flu.

Younger children, especially children under five, are at risk for complications and are more likely to need medical care to recover from the flu. Some complications young children may face include:

• Dehydration
• Ear or sinus infections
• Pneumonia, a type of lung infection

It's rare for children to die from the flu, but not getting a flu shot can raise this risk. During a severe flu outbreak in 2009, 80% of the children who died from the flu were not fully vaccinated.

Vaccines for children

Children should get vaccinated for the flu every year, and the CDC recommends getting the vaccine before the end of October. But there are special precautions you should take when vaccinating children, according to the age of the child.

The flu shot for children

Children can get the same flu shot as adults, as long as they are over the age of six months. The vaccine won't work for babies under six months because their immune systems aren't able to build up adequate flu antibodies.

Children over six months should only avoid the flu shot if they have life-threatening allergies to the flu vaccine or any ingredient in the flu vaccine, such as eggs or latex.

The nasal spray for children

While the flu shot uses a dead flu virus, the nasal spray contains live virus microbes, which may pose a risk for some younger children. Still, healthy children ages 2 years and older are safe to get the nasal spray vaccine.

However, children under 2 years old should not get the nasal spray, as it can cause wheezing. Children should also avoid the nasal spray if:

• They have had a severe allergic reaction to any ingredient in the vaccine
• They have a weakened immune system, or are immunocompromised
• They live with someone with a weakened immune system, since they must avoid contact with that person for 7 days to avoid transmitting the virus in the vaccine
• They are ages 2 to 17 and are taking medications that contain aspirin or salicylate
• They are ages 2 to 4 and have had asthma or a history of wheezing in the past 12 months

For a complete list of who should avoid the nasal spray and who should take special precautions, see the CDC's website.

Getting 2 flu vaccines may be necessary for some kids

For adults, getting one vaccine per year works to build up enough antibodies to fight off the flu. However, "unlike adults, most children do not have any pre-existing immunity to influenza," Haynes says. For this reason, kids under the age of eight may need to get two vaccines to make up for their low antibody levels.

Children who have never gotten a flu vaccine before or who have had only one vaccine in the past should get two flu shots for the current flu season. The two shots should be given at least four weeks apart.

If a child needs two vaccines, it's best to get the first shot around early September, as the protection against flu won't begin until two weeks after the second vaccine. If you aren't sure if your child needs two vaccines, ask your pediatrician.

The bottom line

It's important for most kids over six months to get the flu shot each year to guard against the flu and prevent more serious complications. If you aren't sure which vaccine to get for your child, talk to your pediatrician to find the best option for you.

Related articles from Health Reference:

• How to prevent the flu, according to doctors
• Yes, the flu is contagious. Here's when you're most likely to spread the virus
• You can't get the flu from the flu shot, but there are side effects
• How long the flu should last and when you should see a doctor
• The flu vaccine is not 100% effective but you should still get it every year