Each year, many children get sick with seasonal influenza (the flu). Some of those illnesses can lead to hospitalization and even death. The timing of flu is unpredictable and can vary from season to season. Flu activity most commonly peaks in the U.S. in January or February. However, seasonal flu activity can begin as early as October and continue to occur as late as May.

Curt Stankovic, M.D, division chief and research director in Emergency Medicine on staff at DMC Children’s Hospital of Michigan, answers some common questions regarding the influenza virus and flu shots in kids.

1. Why is it important for children to be protected against the flu?

According to the Centers for Disease Control (CDC), it is estimated that each year an average of 20,000 children under the age of 5 are hospitalized because of flu complications. Severe complications are more common in children younger than two years of age. Children with chronic health problems like asthma, diabetes and disorders of the brain or nervous system are also at high risk of developing serious flu complications. Parents should check with their pediatrician so the vaccine or nasal-spray is given when it is available.

2. Should all kids receive a flu shot or nasal-spray flu vaccine?

The CDC recommends that all children six months of age and older receive a flu shot. Children who are two and older can also receive the nasal-spray flu vaccine. Flu Shots or the nasal-spray flu vaccine (LAIV) offer the single best way to protect children from the flu.

3. How does the vaccine and nasal-spray flu vaccine protect children?

They both cause antibodies to develop in the body about two weeks after vaccination which protects against infection with the viruses that are in the vaccine. Strains of viruses used in the flu vaccines are updated every year based on the prior year’s strains. Parents should consult with their child’s pediatrician to get an update on the flu virus strains used in the current vaccine.

4. Are there children who should not be vaccinated against the flu?

Children with the following conditions should not be vaccinated against the flu.

• People who have a severe allergy to chicken or eggs.
• People who have had a severe reaction to an influenza vaccination.
• Children younger than 6 months of age (influenza vaccine is not approved for this age group), and

5. If your child does have the flu, what are signs that he/she should seek treatment in the hospital?

In children, warning signs that warrant urgent medical attention include; breathing difficulties, bluish or gray skin color, not drinking enough fluids, persistent vomiting, not waking up or interacting and being highly irritable. Also seek care if flu-like symptoms improve but then return with a fever and bad cough.

Families are encouraged to touch base with their pediatrician to receive a flu shot or nasal-spray vaccine to provide the best protection against the flu. For those without insurance, you can visit the Immunization Station for resources on immunizations.