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Seasonal Influenza and Children

Who Should Be Vaccinated

The Advisory Committee on Immunization Practices recommends annual vaccination of all children aged 6 months to 18 years should begin as soon as the 2009-2010 influenza vaccine is available. All children ages 6 months to 8 years who have not been previously vaccinated at any time with either live, attenuated flu vaccine (Flumist) or trivalent inactivated flu vaccine should received two doses of vaccine, four weeks apart.

Children and adolescents at higher risk for influenza complications should continue to be a focus of vaccination efforts as providers and programs transition to routinely vaccinating all children adolescents, including those who:

  • are aged 6 months to 4 years (59 months);
  • have chronic pulmonary (including asthma), cardiovascular (except hypertension), renal, hepatic, cognitive, neurological/neuromuscular, hematological or metabolic disorders (including diabetes mellitus);
  • are immunosuppressed (including immunosuppression cased by medications or by human immunodeficiency virus);
  • are receiving long-term aspirin therapy and therefore might be at risk for experiencing Reye syndrome after influenza virus infection;
  • are residents of long-term facilities; and
  • will be pregnant during influenza season.

Children younger than 6 months cannot receive influenza vaccination. Household and other close contacts (e.g. daycare providers) of children aged 6 months or younger, including older children and adolescents, should be vaccinated.

Who Should Not Be Vaccinated
Some people should not be vaccinated without first consulting a physician. They include:

  • People who have a severe allergy to chicken eggs.
  • People who have had a severe reaction to an influenza vaccination in the past.
  • People who developed Guillain-Barré syndrome (GBS) within 6 weeks of getting an influenza vaccine previously.
  • Children less than 6 months of age (influenza vaccine is not approved for use in this age group).
  • People who have a moderate or severe illness with a fever should wait to get vaccinated until their symptoms lessen.

Emergency Warning Signs
In children, emergency warning signs that need urgent medical attention include:

  • Fast breathing or trouble breathing
  • Bluish skin color
  • Not drinking enough fluids
  • Not waking up or not interacting
  • Being so irritable that the child does not want to be held
  • Flu-like symptoms improve but then return with fever and worse cough
  • Fever with a rash

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