Please refer to our previous “Swine Flu Update” for information about H1N1. Most of what we wrote there is still true. The only major change is that public health officials are no longer insisting that children who develop an “influenza like illness” (IFI) be kept home for 7 days. The new (more reasonable) recommendation is that they be kept home until they have been fever-free for 24 hours with no fever control medications (Tylenol, Motrin, etc.).

What are our policies and advice regarding the H1N1 vaccine?

Ideally, we would like all of our high risk patients to receive this vaccine as soon as possible. Other patients may receive it electively, contingent on adequate supplies.  Unfortunately every parent understandably thinks of their own child as "high risk", and demand has far outstripped our supply...  read more here.

What about “regular” Influenza vaccine?

It’s the same story year after year: seasonal or swine, when it comes to Influenza vaccines the manufacturers and the government public health officials never seem to stop finding new and creative ways to over-promise and under-deliver. Nevertheless, we are pleased to announce that we have finally received the large shipment of seasonal flu vaccine that was originally promised to us in mid-September. That means we now have plenty of seasonal flu vaccine to give to everyone.

· We strongly recommend that patients in high-risk categories for complications of seasonal flu get vaccinated as early in the season as possible. Click here for a definition of who qualifies as high-risk. Our computerized medical record is able to identify those patients, and we will be contacting their families to bring them in to get vaccinated as soon as we have the vaccine available.

· Although we are happy to give the flu vaccine to low-risk patients whose parents want them to receive it, we do not feel strongly that this is necessary or important. The vaccine is safe, but how well it works to prevent illness varies from year to year. The seasonal flu could cause a low risk patient to miss school for a few days, but is unlikely to make them very sick. We will not be contacting low-risk patients, but if you want your child to receive this vaccine, just ask. You can do this by scheduling an appointment in one of our flu shot clinics, or by mentioning it at the beginning (when you are being checked in) for any regular sick, well, or followup visit.

· Seasonal flu vaccine is available in two versions – the standard injected form can be given from age 6 months up, costs less, but involves a shot. The nasal spray version can be given from age 24 months up, costs more, but avoids the shot and may actually work a bit better. The nasal spray version may not be covered by all insurances, and cannot be given to children with a history of asthma or wheezing. Neither version of seasonal flu vaccine should be given to children with egg allergy.

· Neither version of seasonal flu vaccine will protect against H1N1.

How many doses of flu vaccine are needed for protection?

There is one vaccine for seasonal flu, and when it arrives there will be another vaccine for H1N1. The two vaccines can be given at the same time, but the H1N1 vaccine will require two doses for full protection in children up to 9 years old. That’s a minimum of three doses to be fully vaccinated against both types of flu. Children who under age 9 who have never received seasonal flu vaccine before will need a second dose of that one too, for a total of four doses.

What about timing?

For children in the high-risk group we recommend they come in for the seasonal flu vaccine ASAP (as early as possible in the season), and then get the H1N1 vaccine later ASAP after it comes out.

For children who are low-risk but want both types of vaccine, it may be better to wait until the H1N1 vaccine becomes available, and then come in for a single visit to get both vaccines at the same time. Not only will this be more convenient for you, but also it is usually easier on a child (emotionally) to get two vaccines together in “one swoop” than to have them at separate visits.

For children who need a second dose of either or both vaccines, this should occur ideally 4 weeks after the first dose (3 weeks at the soonest, 8 weeks at the latest).

Where & when should my child be vaccinated?

If your child has an upcoming physical or followup appointment for some other reason, we can give the flu vaccine at the same time. Otherwise...

At this time, we are not booking any NEW appointments for flu shots.  If you had an appointment that was CANCELED by our office, we will call or email you with a new time/date IF we receive more vaccine.

The state DPH is concerned enough about influenza this year that they will likely be opening flu vaccination clinics in schools for both seasonal and H1N1. As usual, a variety of other establishments (hospitals, pharmacies, even libraries) will be offering the seasonal (and perhaps the H1N1) vaccine as well.  If your child’s school is offering the vaccine, we recommend you let them get it there. Please obtain a written record of that so that we can add it to their chart at our office, however.

Remember...

Remember to keep flu and flu like illness in perspective. For most children both versions of the flu are mild, self limited illnesses. The most important thing always is always to keep a close eye on your child when they are sick, and if you are worried about their symptoms bring them in to the office.