2023-01-31

2022-2023 Pediatric Flu Vaccine Guidelines

The flu vaccine is essential for children, but many parents and caregivers feel hesitant about vaccinations. Plus, there are many products available, each with different license requirements. How do you choose the right one? Here’s what to know.

Types of Flu Vaccines Available

Flu vaccines contain three or four strains of influenza: one influenza or H1N1, one influenza A or H3N2, and one influenza B. A three-strain vaccine is called a trivalent, and a four-strain vaccine is a quadrivalent, which has an additional influenza B strain.  The World Health Organization sets the strain recommendations for the season, and manufacturers create different types of vaccines.

Inactivated Influenza Vaccine (IIV)

An inactivated vaccine contains a nonliving influenza virus and is available in trivalent or quadrivalent form. Some have adjuvants that promote a stronger immune response, while others do not. The IIV comes in as a trivalent or quadrivalent in standard or high doses. A high dose contains four times the amount of viral antigen.

Live Attenuated Influenza Vaccine (LAIV)

A live attenuated vaccine contains a live but weakened influenza virus. The virus is grown in an egg-based solution and then developed into the final product in a trivalent or quadrivalent format. LAIV versions are available as a nasal spray and don’t contain any adjuvants.

Differences in Flu Vaccines

The main difference between flu vaccines is how they’re made. Some are for the general population, and others for older adults. However, each flu vaccine is considered based on a patient’s age, allergies, and health conditions.  In general, you can give healthy people aged 6 months and older most forms of non-adjuvanted trivalent or quadrivalent IIV, though the dose varies. However, influenza B is likely to cause severe illness in children aged six to 23 months, so a quadrivalent vaccine should be offered for better protection.

Vaccine Contraindications for Pediatrics 

Contrary to popular thought, you can give egg-based flu vaccines to a child with a known egg allergy. Evidence indicates that the risks of an adverse event associated with trace amounts of ovalbumin in vaccines are low.  However, patients can be allergic to other components. Children who have previously reacted to an influenza vaccine shouldn’t receive another one. These include:

  • Anaphylactic reactions
  • Guillain-Bare syndrome within 6 weeks of a flu vaccine

Additionally, LAIV nasal sprays are not recommended for children who have:

  • Immune-compromising conditions, except stable HIV
  • Severe asthma
  • Wheezing within seven days of vaccination

A LAIV also isn’t recommended for children:

  • Younger than 24 months of age
  • Aged two to 17 years taking aspirin
  • Taking influenza antiviral agents unless under a specific timeline

What Are Current NACI Guidelines?

The National Advisory Committee on Immunization (NACI) guidelines recommend you offer the influenza vaccine every year to anyone six months and older who doesn’t have contraindications to the vaccine. Caregivers of infants less than six months and pregnant mothers should also receive a flu vaccine to lower the likelihood of infants getting sick.  General pediatric vaccine recommendations are as follows:

  • Age six to 23 months:
    • IIV in a standard dose
    • Adjuvanted or non adjuvanted
    • Trivalent or quadrivalent
  • Age two to 17 years: 
    • IIV in a standard dose
    • Trivalent or quadrivalent
    • LAIV quadrivalent nasal spray

Can You Vaccinate a Sick Child?

Yes. Vaccinations are safe to give when a child has a mild or moderate illness. However, a nasal spray might not work well if the child has too much nasal congestion. You can wait until symptoms improve or give a different vaccine. Vaccines should only be delayed in pediatrics if a child has a severe, acute illness.

How To Explain the Importance of Vaccination to a Caregiver

The most effective way to explain the importance of vaccination in pediatrics is to openly discuss the risks of influenza and the safety, effectiveness, and potential risks of vaccines. Give caregivers accurate information and answer any questions.  Inform parents that:

  • Influenza can cause severe disease and hospitalization.
  • Vaccination is the best way to prevent influenza.
  • You don’t get the flu from the flu vaccine or pass it on to others.
  • Allergic reactions and serious injuries are possible, but these are rare.

What Patients Need To Know After Vaccination

Children might have some mild side effects from the flu vaccine. These are normal immune responses and go away within a few days. Common symptoms include:

  • Headache
  • Fever
  • Muscle aches
  • Tiredness
  • Red, swollen, sore arm where the needle was given
  • Runny nose and wheezing after a nasal spray

Pediatric influenza vaccines change every year and it is essential for physicians and pharmacists to stay up to date on current clinical guidelines. Join the MDBriefCase community for free.

Author Agreement

In submitting your work (the “Work”) for potential posting on the MDBriefCase Healthcare Leadership Academy website (the “Website”), you (“You”) expressly agree to the following:

Review: MDBriefCase is pleased to consider the publication of Your Work on the Website.   The suitability of the Work for posting shall be determined by MDBRiefCase at its sole discretion. Nothing herein shall obligate MDBriefcase to post or otherwise publish the Work, or the maintain its posting in future.   

Editing; Identification: MDBriefcase shall have the right to edit the Work to conform to our standards of style, technological requirements, language usage, grammar and punctuation, provided that the meaning of the Work is not materially altered.  If posted, You will be identified as the author of the Work, or co-author if applicable.  

Grant of Rights:  As a condition of publication and for no monetary compensation, You hereby grant to MDBriefCase the following rights to the Work in any and all media whether now existing or hereafter developed, including print and electronic/digital formats:  (1) the exclusive right of first publication worldwide;  (2) the perpetual non-exclusive worldwide right to publish, reproduce, distribute, sell, adapt, perform, display, sublicense, and create derivative works, alone or in conjunction with other materials; (3) the perpetual non-exclusive worldwide right to use the Work, or any part thereof, in any other publication produced by MDBriefCase and/or on MDBriefCase’s website; and (4) the perpetual non-exclusive worldwide right to use the Work to promote and publicize MDBriefCase or its publications.  The grant of rights survives termination or expiration of this Agreement.    

Warranty:  You warrant that the Work is original with You and that it is not subject to any third party copyright; that You have authority to grant the rights in this Agreement; that publication of the Work will not libel anyone or infringe on or invade the rights of others; that You have full power and authority to enter into this Agreement; that the Work has not been published elsewhere in whole or in part; and that You have obtained permission from the copyright owner consistent with this Agreement for any third party copyrighted material in the Work.  This warranty survives termination or expiration of this Agreement.

Submission Agreement

Thank you for your interest in writing an article for the MDBriefCase Healthcare Leadership Academy website.

Audience and Appropriate Topics

The  Healthcare Leadership Academy welcomes submissions on all topics relevant to leaders in healthcare. Our topics include Leading in Healthcare, Leadership Lessons from COVID-19 and others. We prioritize stories that provide leadership advice to executives and managers in healthcare companies, offer actionable strategies for executing successful projects, and provide interesting angles on current healthcare topics. Submissions must be original work of the authors and unpublished.  When submitting, authors represent that they have included no material that is in violation of the rights of any other person or entity.

Parameters

Articles must be educational and non-promotional. If they mention the author’s company or any of the company’s products or services by name within the text, such mention should be very limited and used for reference only, not for promotion. (For example, an author might cite a survey conducted by his company but not describe his company’s product as a solution to a business problem.) Articles will be edited for clarity, style and brevity. The final headline is determined by the editor.

Length of Submissions

Guest articles for the MDBriefCase Healthcare Leadership Academy may run between 500 and 1000 words. 

Review

MDBriefCase reserves the right to accept or reject any submission  and the right to condition acceptance upon revision of material to conform to its criteria.   

No Compensation

There is no payment for contributed articles. However, MDBriefCase will give the author a byline. Authors are invited to link to the article on personal  websites, corporate websites and social media platforms.

Author Agreements

Each author understands and agrees that any submission accepted for posting is provided subject to MDBriefCase’s Author Agreement