Health news and recommendations in the month of October invariably brings the annual campaign to get those flu shots.  Actually, even the term is simplistic  as influenza vaccine has for some years come as in a nasal spray form as well as the more familiar injection.  And this year the number of vaccines available is more than ever, with many products covering four rather than the previous three strains of influenza.

But these are the details.  The very strong message from the CDC,  the AAP, and many other respected sources is that most of the population over six months of age should be immunized, with young children and the elderly at the highest risk.

We pediatricians, having to often advance  the vaccine persuasion effort  year-round, find ourselves with this additional seasonal immunization job.  For a variety of reasons many parents often resist “the flu shot” for their children, which is unfortunate.  There are many reasons why flu immunization is important, but one should be particularly convincing:  almost every year there are between 100-200 fatalities in children, a high percentage of which are in previously well children without recognized risk factors. And many, many hospitalizations.

And what about all the reasons parents express for not choosing to protect their children?  In a recent Houston presentation on the subject,  Dr. Julie Bloom of Texas Children’s Hospital and Baylor College of Medicine addressed these concerns.


  • “The flu vaccine causes the flu.”  This is a widespread misconception, as for several reasons beyond our scope here, this simply does not happen.  Given the high number of viral illnesses kids get each year, it  often happens that the vaccine is given at a time when a viral infection is just starting  without recognized symptoms, or begins days after the vaccine.   If flu season has already begun,  the illness might  be already be on its way by the time the vaccine has produced immunity.   Further,  although many side effects are attributed to the vaccine, about the same number of recipients of saline placebo reported them (except for the local soreness) in one study.
  • “Flu vaccine doesn’t work–my child(ren) got it anyway last year.”  Well, it’s true that immunization is not 100%, but even when it reduces the risk and, important to consider, highly reduces a worse case with a serious outcome. Perhaps just less school missed.
  • Or, “my kids don’t need  the vaccine, because they are healthy and never get the flu.”    It is also true that healthier people may not demonstrate the more classical or significant symptoms.  The infection may even be an asymptomatic one.  But exposure of others, especially young infants,  elderly people, high risk individuals  to such infected children may introduce the virus to someone else who could go on to a serious case.  So yes, there is a public safety element beyond just benefit to one’s own children. And  this is not trivial.
  • If parents have concerns, they should be openly discussed with their children’s caregiver.   As is the case with all vaccines, the decision rests with parents, but at least that decision making  should be based on good medical evidence rather than vague,  non-descript vaccine anxiety and avoidance.

And some family web resources:,,