Flu Vaccines are Important for Children

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Children younger than 5 years old–especially those younger than 2–are at higher risk of developing serious flu-related complications. Children of any age with certain chronic health conditions are also at higher risk; during the 2022-2023 flu season, 66 percent of children 0 to 17 years old hospitalized with flu had at least one underlying health condition, such as asthma, neurologic disease, obesity, or immune suppression. More information is available about children at higher risk of potentially serious flu complications.

While not at higher risk, children 5 years and older can spread flu to their higher risk family members, like infants younger than 6 months old and adults who are 65 years and older or people of any age who have certain chronic health conditions. It’s important to vaccinate everyone 6 months and older in your family against flu each year to help protect those most at risk. A flu vaccine offers the best defense against flu and its potentially serious complications and also can reduce the spread of flu to others.

In children, annual flu vaccination has been shown to:

  • Reduce flu illnesses, doctor’s visits for flu, and missed school days
  • Reduce the risk of flu-related hospitalization and death.

Information on this page summarizes vaccine recommendations for children. More information on vaccine benefits is available.

Children at Higher Risk

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Children younger than 5 and of any age with certain chronic health conditions are at higher risk of developing potentially serious flu complications.

Flu can be dangerous for children

Flu illness is more dangerous than the common cold for children. Each year, millions of children get sick with seasonal flu; thousands of children are hospitalized, and some children die from flu. Children commonly need medical care because of flu, especially children younger than 5 years old.

  • Complications from flu among children in this age group can include:
    • Pneumonia: an illness where the lungs get infected and inflamed
    • Dehydration: when a child’s body loses too much water and salts, often because fluid losses are greater than from fluid intake)
    • Worsening of long-term medical problems like heart disease or asthma
    • Brain dysfunction such as encephalopathy
    • Sinus problems and ear infections
    • In rare cases, flu complications can lead to death.
  • Flu seasons vary in severity; however, every year children are at risk
    • CDC estimates that from the 2010-2011 season to the 2019-2020 season, flu-related hospitalizations among children younger than 5 years old each flu season have ranged from 6,000 to 27,000 annually in the United States.
    • While relatively rare, some children die from flu each year. From the 2004-2005 season to the 2019-2020 season, flu-related deaths in children reported to CDC during regular flu seasons have ranged from 37 to 199 deaths. (During the 2009 H1N1 pandemic, 358 flu-related deaths in children were reported to CDC from April 2009 to September 2010.)
    • Importantly, among reported flu-related deaths in children, about 80% occurred in children who were not fully vaccinated.
    • Also of note, even though each flu death in a child is supposed to be reported to CDC, it is likely that not all flu-related deaths in children are captured and that the actual number of deaths is higher. CDC has developed statistical models that account for the underreporting of flu-related deaths in children to estimate the actual number of deaths. During 2019-2020, for example, 199 flu-related deaths in children were reported to CDC, but statistical modeling suggests approximately 434 deaths may have occurred. More information about flu-related deaths in children since the 2004-2005 flu season is available in the FluView Interactive web application.

Vaccination is the best protection against flu

Note: Visit Frequently Asked Flu Questions 2023-2024 Influenza Season for flu and flu vaccine information specific to the current flu season.

picture of a child getting vaccinated

The best way to prevent flu and its potentially serious complications is by getting an annual flu vaccine. Even when flu vaccination does not prevent illness entirely, it has been shown in several studies to reduce severity of illness in people who get vaccinated but still get sick.

CDC recommends that everyone 6 months and older get a seasonal flu vaccine each year. Keep in mind that vaccination is especially important for certain people who are higher risk of developing serious flu complications or who are in close contact with people at higher risk. This includes children at higher risk of developing serious complications from flu illness, and adults who are close contacts of those children.

Flu vaccines are updated each season to protect against the four influenza viruses that research indicates will be most common during the upcoming season. This season’s flu vaccine has been updated from last season. More information is available on this season’s flu vaccine composition.

Types of flu vaccines for children

CDC recommends annual flu vaccination for everyone 6 months and older with any licensed, age-appropriate flu vaccine.

There are many vaccine options:

  • Flu shots are given as an injection (with a needle) and are approved for use in people 6 months and older. (Indications vary by vaccine.)
  • Nasal spray vaccine (also known as the Live attenuated influenza vaccine or LAIV4) is approved for use in non-pregnant, healthy people 2 through 49 years. However, there is a precaution against the use of nasal spray flu vaccine (LAIV) in people with certain underlying medical conditions. More information can be found about the nasal spray flu vaccine.


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Your child’s health care provider will know which vaccines are right for your child.

For more information on the different types of flu vaccines available, visit CDC’s Different Types of Flu Vaccines page.

When Should Children get a Flu Vaccine

Children should be vaccinated every flu season for the best protection against flu. For most people who need only one dose of flu vaccine for the season, September and October are generally good times to be vaccinated. Ideally, everyone 6 months and older should be vaccinated by the end of October. Some children need two doses of flu vaccine. For those children, it is recommended to get the first dose as soon as vaccine is available—even if this is in July or August—because the second dose needs to be given at least four weeks after the first. Vaccination during July and August also can be considered for children who need only one dose. However, getting vaccinated later can still be protective, as long as flu viruses are spreading—even into January or later. Since it takes about two weeks after vaccination for the body to develop antibodies against flu virus infection, it is best to get vaccinated so they are protected before flu begins spreading in their community.

Special vaccination instructions for children aged 6 months through 8 years old

  • Some children 6 months to 8 years old need two doses of flu vaccine.
  • Children in this age group getting vaccinated for the first time, those who have only previously received one dose of flu vaccine, and whose flu vaccination history is unknown, should get two doses of vaccine this season.
  • For those children it is recommended they get the first dose as soon as vaccine is available, because the second dose needs to given at least 4 weeks after the first.
  • Your child’s health care provider can tell you if your child needs two doses.

Other Preventive Actions

In addition to getting a flu vaccine, children and caregivers should take the same everyday preventive actions CDC recommends for everyone, including avoiding people who are sick, washing hands often, and covering coughs.

Symptoms and Treatment

Symptoms

Flu symptoms include fever, cough, sore throat, runny or stuffy nose, body aches, headache, and fatigue. Some people may also have vomiting and diarrhea, which are more common in children than adults. People may be infected with flu and have symptoms without a fever.

More information on when to seek emergency care is available online.

Treatment

Your child’s health care provider can help decide whether your child should take antiviral drugs if they become sick with flu. Antiviral drugs for children come in the form of pills, liquid, inhaled powder, or intravenous solution. They fight flu by keeping flu viruses from reproducing in the body. Antiviral drugs must be prescribed by a doctor — they are not available over the counter (OTC).

More information on children and flu antiviral drugs is available.

Emergency Warning Signs of Flu

People experiencing these warning signs should obtain medical care right away.

In children

  • Fast breathing or trouble breathing
  • Bluish lips or face
  • Ribs pulling in with each breath
  • Chest pain
  • Severe muscle pain (child refuses to walk)
  • Dehydration (no urine for 8 hours, dry mouth, no tears when crying)
  • Not alert or interacting when awake
  • Seizures
  • Fever above 104 degrees Fahrenheit that is not controlled by fever-reducing medicine
  • In children less than 12 weeks, any fever
  • Fever or cough that improve but then return or worsen
  • Worsening of chronic medical conditions

In adults

  • Difficulty breathing or shortness of breath
  • Persistent pain or pressure in the chest or abdomen
  • Persistent dizziness, confusion, inability to arouse
  • Seizures
  • Not urinating
  • Severe muscle pain
  • Severe weakness or unsteadiness
  • Fever or cough that improve but then return or worsen
  • Worsening of chronic medical conditions

These lists are not all inclusive. Please consult your medical provider for any other symptom that is severe or concerning.