From Vincent Iannelli, M.D.,
Your Guide to Pediatrics.
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About.com Health's Disease and Condition content is reviewed by Kate Grossman, MD

Q. I know that flu season is coming. Do my kids needs a flu shot?

A. If they have a chronic medical condition, such as asthma or diabetes, if they are between 6 and 59 months old, or if you also have an infant less than 6 months at home that they are exposed to, then yes they should, with the best time to get a flu shot beginning during October or November (although you can get it later too). They should also get a flu shot if you simply want to help them avoid getting the flu.

Keep in mind that the recommendation to vaccinate all healthy children between the ages of 2 and 5 years with a flu shot began last year.

Although the flu season in the United States usually extends from November to April, flu cases usually peak in late December to mid March. Getting a flu shot too early might not protect you later in the season. Protection begins about two weeks after you get your flu shot.

Also remember that if your children are under 9 years of age and are getting the flu shot for the first time, they will need two shots one month apart, and it would be best to get started in October. People at high risk for flu complications (persons aged >65 years, persons aged 6 months to 64 years with certain medical conditions, and healthy children aged 6 to 59 months), or who have household contacts of persons at increased risk for influenza-related complications, should also get their shot in October.

There is an alternative to the flu shot too. FluMist, a nasal spray flu vaccine (no shots), can be given to healthy children and adults from age 2 to 49 years.

Who Needs a Flu Shot

Fortunately, experts do not anticipate any flu shot shortages this year, so anyone should be able to get a flu shot once your doctor gets them.

Who Should Be Vaccinated With the Flu Shot This Season

High risk groups who should get a flu shot this flu season include:

• children aged 6–59 months
• pregnant women
• persons aged 50 years and older,
• children and adults with most chronic health conditions, including asthma, diabetes, and immune system problems
• residents of long-term care facilities
• household contacts and out-of-home caregivers of children aged <6 months or in other high risk groups above
• health-care personnel who provide direct patient care

Keep in mind that the 'household contacts' part places a lot of extra kids into a high risk group who should get a flu vaccine. For example, if you have a 3 year old and a 10 year old, they should both get a flu vaccine, because the 10 year old is a household contact of the 3 year old. Or if one child in your family has asthma, then everyone should get a flu vaccine. The child with asthma is in a high risk group and everyone else is a household contact of someone in a high risk group.

And remember that even if your child is not in a high risk group, he can still get a flu vaccine if you want to simply reduce his risk of getting the flu this year.

Other Vaccination Recommendations

• Healthy persons who are 5-49 years of age and not pregnant, including health-care workers (except those who care for severely immunocompromised patients in special care units) and persons caring for children aged less than 6 months can be vaccinated with intranasally administered live, attenuated influenza vaccine (Flumist).
• People should not get a flu vaccine if they have a severe allergy to chicken eggs, have had a severe reaction to an influenza vaccination in the past, have developed Guillain-Barre syndrome within 6 weeks of getting an influenza vaccine previously, if they are less than 6 months old, or if they have a moderate or severe illness with a fever.

One thing to keep in mind is that although thimerosal has been removed from all routinely recommended childhood vaccines, the flu vaccine does still contain thimerosal. This is not necessarily a reason to not get your child immunized though, especially if he is in a high risk group. And a limited amount of influenza vaccine that are thimerosal free or have a reduced thimerosal content will be available for the 2007-2008 influenza season. According to the CDC, 'the benefit of influenza vaccine with reduced or standard thimerosal content outweighs the theoretical risk, if any, from thimerosal.'

Updated for the 2007-2008 Flu Season.

For more information, please visit our guide to Kids and the Flu.