- Influenza
- For Children
Which children should receive influenza vaccine?
ACIP recommends annual influenza vaccination for all children age 6 months and older who do not have a contraindication to the vaccine.
Last reviewed:
August 11, 2024
Ask the Experts: Influenza: For Children
Results (9)
- Influenza
- For Children
What influenza vaccines may be used in children for the 2024-25 influenza season?
All six 2024-25 season influenza vaccines approved for children are trivalent, containing two influenza A strains and one influenza B strain.
There are five injectable inactivated influenza vaccine (IIV) options for children. Four egg-based IIVs and one cell culture-based (ccIIV), all given as intramuscular (IM) injections, are approved for children age 6 months and older:
- Afluria (CSL Seqirus): 0.25 mL/dose for age 6 through 35 months; 0.5 mL/dose for age 3 years and older
- Fluarix (GSK): 0.5 mL/dose for age 6 months and older
- FluLaval (GSK): 0.5 mL/dose for age 6 months and older
- Fluzone (Sanofi): 0.25 mL or 0.5 mL per dose for age 6 through 35 months; 0.5 mL/dose age 3 years and older
- Flucelvax (ccIIV, CSL Seqirus) cell-based (no egg antigen): 0.5 mL/dose for age 6 months and older
One egg-based live attenuated nasal spray vaccine, FluMist (LAIV, AstraZeneca), is an option for healthy, non-pregnant people age 2 years and older: 0.2 mL (intranasal, 0.1 mL in each nostril).
Last reviewed:
August 11, 2024
- Influenza
- For Children
Which children younger than age 9 years need 2 doses of influenza vaccine this influenza season?
Children age 6 months through 8 years should receive a second influenza vaccine dose 4 weeks or more after the first dose if they meet one of the following three criteria: 1) they are receiving influenza vaccine for the first time, or 2) they have not received a total of at least two doses of any seasonal influenza vaccine before July 1 of the current year, or 3) their vaccination history is unknown. The two previous doses need not have been received during the same season or consecutive seasons.
A child who is 8 years old and is recommended to receive two doses during the current season and turns 9 during the current season before receiving dose 2, should still receive dose 2.
Immunize.org’s handout titled “Guide for Determining the Number of Doses of Influenza Vaccine to Give to Children Age 6 Months Through 8 Years” provides additional guidance on this issue; it is available at www.immunize.org/catg.d/p3093.pdf.
Last reviewed:
August 11, 2024
- Influenza
- For Children
When determining whether a child age 2 through 8 years needs one or two doses of influenza vaccine this season, can we count doses of FluMist (LAIV) administered in past years?
Yes. Doses of FluMist administered in past seasons can be counted.
Last reviewed:
August 11, 2024
- Influenza
- For Children
Can a child age 6 months through 8 years who needs 2 doses of influenza vaccine this season receive different products for the two doses or do they have to be the same?
The two doses may be the same or different products.
Last reviewed:
August 11, 2024
- Influenza
- For Children
If a child received Afluria vaccine (0.25 mL) at age 34 months for the first time and then returns for the second dose at age 37 months, should we give another 0.25 mL dose of Afluria or should we give the 0.5 mL dose that is indicated for age 3 years and older?
The child should always receive the dose appropriate for his or her age at the time of the clinic visit; at age 37 months that would be a 0.5 mL dose of Afluria.
Last reviewed:
August 11, 2024
- Influenza
- For Children
Can a clinic vaccinate children younger than age 3 years with influenza vaccine taken from a multidose vial (MDV) of influenza vaccine? The MDVs contain thimerosal as a preservative.
Yes. Multidose vials of inactivated influenza vaccine contain a small amount of thimerosal to prevent bacterial and fungal growth in the vial. Thimerosal-containing vaccines are safe to use in children. No scientific evidence indicates that thimerosal in vaccines causes adverse events unless the patient has a severe allergy to thimerosal. Despite this, a few states have enacted legislation that restricts the use of thimerosal-containing vaccines in children. To find out if your state has such restrictions, check with your state immunization program (see www.immunize.org/official-guidance/state-policies/state-resources/ for program contact information).
Last reviewed:
August 11, 2024
- Influenza
- For Children
Could any child age 9 years ever need two influenza vaccine doses during an influenza season?
Yes, but only if the 9-year-old meets all of the criteria below:
- they turned 9 years old during the current season, and
- they had received one dose during the current season before turning 9, and
- they have no or unknown history of receiving any previous dose of influenza vaccine before July 1 of the year of the current season.
Last reviewed:
August 11, 2024
- Influenza
- For Children
There is a debate within my pediatric clinical department about not allowing influenza vaccine to be given with DTaP and pneumococcal conjugate vaccine (PCV). Are there data that state these should not be given concomitantly?
A CDC study showed a small increased risk for febrile seizures during the 24 hours after a child receives the inactivated influenza vaccine at the same time as the PCV13 vaccine or DTaP vaccine. However, the risk of febrile seizure with any combination of these vaccines is small and ACIP recommends giving these vaccines at the same visit if indicated. The risk for febrile seizures in children who received PCV15 or PCV20 concurrently with an influenza vaccine has not been studied.
See www.cdc.gov/vaccine-safety/about/febrile-seizures.html for more information about febrile seizures after vaccination.
Last reviewed:
November 13, 2024