This past February, in the middle of the worst flu season ever, as I prepared to have a baby I had to decide whether to vaccinate myself and my older children against the flu. Obviously, for those reading this, I clearly had not already made the choice to do so. While some may think this is a simple decision, it is not one I take lightly, nor do I think many other parents do either. With everything we see, hear, and read about vaccines it is sort of like the wild west. We are damned if we do and damned if we don't. This is probably one of the most controversial topics on social media, in every mommy group, and even within families. To vaccinate or not to vaccinate, which vaccines to give or not to give, and when to give them is a hot button topic.
While it may seem as though last year's absolutely awful flu season just ended, it is actually already the beginning of this year's season. In the United States, flu season falls during the fall and winter months, in the Northern Hemisphere beginning in late October/November and not being considered fully concluded until May. The peak of the season is usually December and January, although last year's flu reached epidemic proportions with an extended period of high activity during January and February, and remaining higher than usual in March. With a total of 180 children dying from the flu last season, the highest since the CDC began tracking these numbers in 2004 with the exclusion of the 2009 pandemic, pediatricians everywhere are already urging parents to vaccinate their kids and to vaccinate them early.
Just last week the American Academy of Pediatrics issued their Flu Vaccine Recommendations for the 2018 - 2019 season. The AAP is recommending that all children over the age of 6 months receive a flu shot before the end of October. While there is a nasal spray vaccine, the use of which is also supported by the AAP and CDC, the injection is still the preferred method as the nasal spray was not as effective the past few seasons and the effectiveness is unknown for this season's influenza A/H1N1 strain.
With last year's flu vaccine being touted as 'ineffective' by anti-vaxxer's nationwide, the AAP stands by its position that the vaccine still significantly reduces the risk of severe influenza and death in children. An approximate 80% of last years pediatric deaths occurred in children who were NOT vaccinated against the flu. While the vaccine does not necessarily prevent the flu, it lessens the intensity and duration of symptoms along with the risk of severe complications. According to Flor M. Munoz, MD, FAAP, a member of the AAP Committee on Infectious Diseases, "being immunized reduces the risk of a child being hospitalized due to the flu."
Vaccine effectiveness varies from one season to the next with pharmaceutical companies working feverously with data obtained from the flu strains, rates, spread, and complications occurring in countries in the Southern Hemisphere whose flu season precedes ours.
The standard of care for flu vaccines varies from child to child based on age and vaccine history:
- Children 6 months - 8 years old require 2 doses of the vaccine the first time being vaccinated.
- Children over 9 only require 1 dose regardless of prior vaccine history.
- The nasal spray vaccine is only available to those 2 years of age or older.
- Children with an egg allergy can receive the standard flu vaccine.
- Pregnant women can receive the flu vaccine any time during pregnancy.
- The flu vaccine is an inactivated virus which means it cannot cause the flu itself.
- The 2018 - 2019 vaccine contains 3 or 4 strains, including one new strain of influenza A and one new strain of influenza B.
- The flu vaccine is available at pediatricians offices, pharmacies, and even many schools are offering the shot this year.
While anti-viral medications such as Tamiflu are available during flu season, these drugs are not the recommended course of treatment as the vaccine is the first line of defense. Last season, pharmacies across the country frequently ran out of the antiviral medications because of the high incidence of prescription and sheer number of people affected by the flu. Many pediatricians were even recommending Tamiflu prophylactically for children in the same family once one was positive for the flu because of how contagious the virus is. For parents who question the efficacy and safety of the flu vaccine, the possible side effects of the antiviral drugs are not any better.
As parents we all have hard choices to make when it comes to the health and safety of our children. Deciding whether or not to vaccinate, and what if any vaccines to give is one of those incredibly tough decisions. But, it is just that...a personal choice, a family decision. It is not up to the doctors, your child's school staff, your in-laws, or your parents, it is a decision you as a parent(s) must make for yourself and each of your children. Herd immunity is not a valid reason for or against, fear-mongering Facebook posts are not a valid reason for or against, and judgmental commentary from friends and family is not a valid reason for or against vaccines. Be strong, be tough, and be wise Mama. Educate, inform, and empower yourself to stand up for the best interests of you and your kids in today's scary world.
Deciding which medications to take and which to avoid is a constant struggle. When the health of both yourself and your children is in your hands you simply have to ask: Are we over medicated? When is it enough?