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11/21/13blog post

every child needs a flu shot...especially those with special needs!

By: Patricia Abboud, MD

As a pediatrician that works in the critical care unit, I see children at their sickest. During the winter season our ICU is full of children with difficulty breathing due to a variety of reasons including the flu. The youngest infants, especially those less than 6 months of age, are generally the sickest because of their small size, vaccination status and several other reasons. Certain populations, specifically those children with special need, should have their flu vaccine every year due to the increased risk for serious complications and death from flu for children in this group. These children often have a more complicated illness that puts them in a life or death situation.

During the H1N1 pandemic in 2009, more than 40 percent of children reported to have died from flu-related causes had an underlying neurological condition (intellectual disability and epilepsy identified as the most common two conditions). For a better perspective, children were a small number of deaths in general compared to the adult population. Findings from the 2011-2012 flu season showed that only 50 percent of parents of children with special needs intended to vaccinate against the flu.

My fellow Dr. Mom Blogger, Dr. Meyer has outlined nicely in the Kohl’s A Minute for Kids radio spots the indications for the flu vaccine. The AAP recommends annual seasonal influenza immunizations for all people including all children and adolescents 6 months of age and older during the 2013-14 season. Special efforts should be made to vaccinate:

  • All children including preterm infants who are 6 months and older with increased risk of complications from the flu ( chronic medical conditions such as asthma, diabetes, heart disease, immune problems, neurologic and neurodevelopmental disorders)
  • Children of American Indian/Alaskan Native heritage
  • All household contacts and out of home care providers of
    • Children with high risk conditions and
    • Children younger than 5 years old especially infants less than 6 months
    • All health care personnel
    • All women who are pregnant, are considering pregnancy, have recently delivered or are breastfeeding during flu season

Barriers listed by parents for NOT getting the flu vaccine included:

  • Not being able to get to the doctor or healthcare provider
  • Concern about vaccine safety
  • Concern about vaccine effectiveness and adverse reactions

As pediatricians it is our job to make sure our patients and families are educated and well informed. Please be sure to talk to your pediatrician about your concerns. There are certain circumstances where the flu vaccine is not recommended (although rare). The type of flu vaccine (shot or mist) that is recommended also varies depending on other health conditions.

Sometime the risk of not getting the vaccination is worse than your fears. Make sure all your questions are answered appropriately.


CDC. Influenza vaccination practices of physicians and caregivers of children with neurologic and neurodevelopmental conditions-United States, 2011-12 influenza season.

Dr. Abboud is a pediatric intensivist at Dayton Children’s and the mother of three kids. As part of the “Dr. Mom Squad,” Dr. Abboud blogs about her experiences as both as doctor and a mom and hopes to share insight to other parents on issues related to both parenting and kids health. Learn more about Dr. Abboud!