Dr. Wendy Sue Swanson, a pediatrician at The Everett Clinic in Mill Creek, a member of Seattle Children’s medical staff and executive director of Digital Health, and author of the Seattle Mama Doc blog, addresses questions about the nasal flu vaccine and what you need to know for this year’s flu season.
What is the CDC’s recommendation about flu vaccines this year, specifically about nasal flu vaccine?
Like years past, flu vaccination is recommended for all children over the age of 6 months. The flu vaccine is an essential and safe vaccine that should be given every year.
One thing that’s new this year: the American Academy of Pediatrics (AAP) recently endorsed recommendations by the Advisory Committee on Immunization Practices (ACIP) to avoid use of flu mist vaccine this coming flu season.
The Centers for Disease Control (CDC) will review the recommendations shortly. If the CDC accepts the recommendation it will become official U.S. policy for the 2016–2017 season to recommend flu vaccination to all children over 6 months of age with a shot only.
What does this mean for those who have used the nasal flu vaccine in years past?
To be clear, those who received the nasal flu vaccine were given a safe vaccine and are in no danger.
However, the effectiveness has varied and was, unfortunately, very low. Last year, for example, the 2015–2016 nasal flu vaccine is estimated to have been only 3% effective in protecting against any strain of flu. The injected flu vaccine has an estimated 63% effectiveness.
What should providers tell parents who may already be wary of vaccinations?
I think we have the opportunity to build trust in the flu vaccine. The reality is that the best way to protect a child or high-risk individual from getting influenza and/or complications from the infection is to get immunized. The flu vaccine is safe and offers added protection for children and their families outside of avoiding those who are ill during the flu season.
How can providers reassure parents that the vaccine is effective?
Flu vaccines are different from most other vaccines because the influenza virus shifts and drifts from one strain to the next each year. The vaccine is prepared annually to improve the likelihood of it working against the type of flu that eventually arrives and causes infection.
Because it’s prepared annually based on predictions for circulating strains, and because the strains shift and change, flu vaccine effectiveness varies from year to year. However, vaccines aren’t 100% effective in all who get them. The influenza vaccine typically has an effectiveness rate between 50% and 60%, but it’s the best way to protect high-risk groups, which includes young children.
The science behind flu vaccine effectiveness is always changing because of the nature of the infection and ongoing vaccine development. Close tabs are kept on vaccine effectiveness to help us know the best ways to protect our patients.
What tips can you offer providers to help vaccinate kids with severe needle phobia?
- Don’t promise no-needle visits ever! A nasal flu vaccine will likely be back, but there is no certainty when. We’ll likely get to offer it in upcoming seasons, but this year we’re back to offering just the shot.
- Acknowledge and recognize that needle phobia is real. We have to treat the anxiety that children and their families feel with respect and work with the care team to minimize anxiety with shots.
- Consider teaching children and teens the “cough trick.” It’s a distraction technique where a child or teen coughs just as the needle goes in. Ask your patient to cough as the shot is being administered. Studies have shown that kids feel less pain when using this trick.
- Children watch their parent’s experience with shots and we all clearly know a nervous parent makes a nervous child at times. We can remind families how far their reactions go to build calm and trust in their child at flu shot visits. In addition, I recommend family flu shot visits where everyone gets immunized at once!
- Treats (ice cream, special snack, time at a special park or restaurant) after shot visits are awesome incentives!
Why is it still important for children – and everyone – to get the flu vaccine?
Clearly influenza and complications from the infection are hardest on infants and young children, pregnant women, the elderly and those with underlying health conditions that make it harder to deal with the infection (e.g., diabetes, asthma, neurologic conditions and problems with the immune system).
Depending on the season, influenza can cause anywhere from 4,000 to 50,000 deaths per year in the United States. Thankfully, only a couple hundred of those deaths each year are children. But children are exposed to infections more than adults because of the nature of their play, interactions and school settings.
The flu vaccine is recommended for all infants and children ages 6 months and older to protect them from the infection, their community, and severe complications.
To learn more, read Swanson’s blog post, No Nasal Flu Vaccine This Year: Flu Shot for All Over 6 Months.