Influenza Prevention

Goldsboro Pediatrics > Newsroom > Influenza Prevention

David Hill, MD, MSPH1Megan A Moreno, MD, MSEd, MPH2

JAMA Pediatr. Published online November 25, 2019. doi:

Every year, between 10% and 40% of children get influenza, usually between November and March, but no season is completely safe.

Even the luckiest of these children often miss days of school, require physician visits, and experience complications such as middle ear infections, sinusitis, and pneumonia. Influenza is the cause of hospitalizations of 7000 infants and 26 000 toddlers each year; childhood deaths from influenza number from 46 to 288 annually. There are steps you can take to protect your child from influenza and its complications.

Some children face an especially high risk of serious complications from influenza. Infants and toddlers younger than 2 years as well as children with asthma, other forms of lung diseases, heart conditions, conditions that affect the brain or nervous system, obesity, and those receiving aspirin therapy or medicines to suppress the immune system are at high risk. Around half of children hospitalized with influenza are completely healthy with no risk factors at all.

The flu vaccine is the single most effective way to prevent influenza. That does not mean that other measures are not worthwhile. Avoiding people with sickness, diligent handwashing, sleeping well, reducing stress, and having a healthy diet have all been shown to reduce people’s risk of getting sick, but all of these efforts together cannot match the power of the flu vaccine.

Around one-third of parents in 2018 chose not to vaccinate their children against influenza, often because of misinformation. Some parents do not vaccinate because they think the vaccine can cause influenza. The flu shot (inactivated influenza vaccine [IIV]) is made of tiny pieces of the flu virus and cannot cause flu any more than a steering wheel and a tailpipe can drive down the street. The nasal spray vaccine (live attenuated influenza virus [LAIV]) can cause mild flu symptoms, but no one has to use this vaccine unless they choose to.

It is true that the flu vaccine is not 100% effective. In most years, the vaccine prevents between 50% and 90% of flu infections and a bit less for children younger than 2 years. However, not vaccinating for this reason is like not wearing seat belts because they do not prevent 100% of motor vehicle injuries.

Some parents worry about adverse reactions from the vaccine. Like any vaccine, the flu vaccine can cause fever and fussiness in some children and, in rare cases, patients can have an allergic reaction. We now know that people with egg allergies can receive the flu vaccine safely. The live attenuated influenza virus should not be given to children with suppressed immune systems. However, compared with getting the flu, adverse reactions from the vaccine are minimal.

Everyone aged 6 months and older should receive a flu vaccine every flu season. Because the flu virus is constantly changing, prior years’ vaccines provide little protection against this season’s flu. Mothers who receive the flu vaccine during pregnancy can protect infants from getting the flu once they are born. Up to age 8 years, children need 2 doses of flu vaccine the very first time they get it. After that, or starting at age 9 years, they need only 1 dose a year.

In addition to preventing the flu using the vaccine, there are 4 medicines that can help treat flu: oseltamivir phosphate (Tamiflu), zanamivir (Relenza), peramivir (Rapivab), and baloxavir marboxil (Xofluza). In some cases, physicians prescribe these medications to high-risk patients who have been exposed to influenza to protect them from getting sick, but they are still no substitute for the flu vaccine.

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The JAMA Pediatrics Patient Page is a public service of JAMA Pediatrics. The information and recommendations appearing on this page are appropriate in most instances, but they are not a substitute for medical diagnosis. For specific information concerning your child’s medical condition, JAMA Pediatrics suggests that you consult your child’s physician. This page may be photocopied noncommercially by physicians and other health care professionals to share with patients. To purchase bulk reprints, email

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Article Information

Published Online: November 25, 2019. doi:10.1001/jamapediatrics.2019.4646

Conflict of Interest Disclosures: None reported.