It's the first week of September, so most parents are probably more preoccupied with stocking up on school supplies than prepping for flu season (understandably). But health experts want to remind you that the flu shot should probably be on your to-do list as well.
The American Academy of Pediatrics (AAP) released a policy statement on Monday that urged parents to get children vaccinated against the flu as soon as the vaccine becomes available—and definitely by the end of October. Additionally, the AAP recommends parents choose the flu shot over the nasal spray whenever possible. In an August 30 update, the Centers for Disease Control and Prevention (CDC) echoed many of these recommendations for adults. But children (especially those below the age of 5) are more likely to experience severe complications from the flu, so it's especially important for them to be protected.
Each year, experts try to predict which flu viruses will be circulating and formulate that year's vaccine to protect against the three or four strains that research suggests will be the most common. This year's vaccines will protect against two types of influenza A (H1N1 and H3N2) and one type of influenza B (Victoria). The vaccine also comes in a four-strain variety that will protect against an additional influenza B strain.
There are some big differences in who can—and should—get the shot versus the spray.
The biggest difference, obviously, is that the shot is injected into muscle and the spray is inhaled through your nose. So, people who are averse to needles or injections may prefer the spray.
But the flu shot contains inactive flu virus while the nasal spray uses live (but weakened) flu virus to trigger an immune response that protects you from the flu, Amesh A. Adalja, M.D., senior scholar at the Johns Hopkins Center for Health Security, tells SELF. That's why the spray is not recommended by the CDC for people who are pregnant, under the age of 2, over the age of 49, or who have certain underlying medical conditions. People in those categories (or their parents) should talk to their doctor about the best way to stay safe this year.
This past spring, the CDC’s Advisory Committee on Immunization Practices (ACIP) voted 12 to two to bring back FluMist. This was after AstraZeneca (the pharmaceutical company that makes FluMist) reformulated the vaccine and found in a new clinical trial that it performed better than the previous version, which did not perform as well as the shot against the influenza A H1N2 strain, as SELF reported previously.
Still, there isn't as much data to support the nasal spray as there is for the shot, Dr. Adalja points out, which is one reason why the AAP is still recommending the shot as the best choice. "The AAP has expressed a preference for inactivated influenza vaccine [the shot] as the primary choice for all children because, even though the new formulation of [the nasal spray] looks to be better in some ways, the effectiveness of the [nasal spray] is unknown against A/H1N1 for this upcoming season," statement co-author Mary Anne Jackson, M.D., chief of the pediatric infectious disease section at Children’s Mercy Kansas City and professor of pediatrics at the University of Missouri School of Medicine, tells SELF.
Whether you choose the shot or the spray, the most important thing is to get your vaccine.
So, the spray is preferred if a child would otherwise not get vaccinated, Melissa Held, M.D., assistant dean of medical education at Connecticut Children’s Medical Center, tells SELF. “Also, should a health care office run out of the inactivated influenza vaccine and only have the live attenuated intranasal vaccine available, use of the intranasal vaccine would then be recommended,” she adds.
That said, some offices won’t carry the nasal spray. “Our clinic isn’t getting it this year,” Gina Posner, M.D., a pediatrician at MemorialCare Orange Coast Medical Center in Fountain Valley, Calif., tells SELF. But that doesn't mean people don't want it.
"Parents have been dying to try the nasal spray because who wants to get a shot when you can get a spray in your nose?" Danelle Fisher, M.D., chief of pediatrics at Providence Saint John’s Health Center in Santa Monica, Calif., tells SELF. Her office plans to have both options available, but to focus on the shot.
The recommendation to get vaccinated by the end of October may seem early, but it's reasonable.
"The main reason [for the early deadline] is that we really don’t know when the flu season will be starting," Dr. Posner says. "We had an early flu season last year, and we want more people covered as early as possible." For most people, it takes about two weeks after getting the vaccine for antibodies that protect you against the flu to build up in your body, the CDC says. So it would make sense to get your shot on the earlier side.
If your kids are in certain age groups or have never been vaccinated before, it can take even longer to build up their immunity. "For children under 9 years, never previously immunized, they need two shots 28 days apart, and that means they need six weeks to be protected," Dr. Jackson says. So, starting earlier also means getting fully vaccinated sooner. As a reminder, the vaccine is recommended for all kids over the age of 6 months.
But if you don’t happen to get you or your kids vaccinated before Halloween, that doesn’t mean you should give up. “Obviously, it is important to get the influenza vaccine whenever possible, so if parents don’t or cannot meet that deadline, they should still get their child vaccinated as soon as they can,” Dr. Held says. The CDC notes there are still benefits to getting vaccinated even as late as January and beyond.
So, if you have questions about getting your kids vaccinated against the flu or choosing between your vaccination options, talk to your child’s pediatrician.