Expert / 29 October, 2019 / Dr Mark Bennett
The word “flu” is used to represent the illness and the collection of symptoms caused by the influenza virus. Sometimes we might be thinking of a bad cold when we mention “the flu”. Many viruses can cause cold symptoms, but really, only the influenza virus causes “the flu”. This is what healthcare professionals are keen to vaccinate against. So how can you know if your child has “the flu”, and should you give your child, toddler or baby the flu vaccine?
These symptoms generally only last for one week however the cough component can last a bit longer, sometimes remaining for up to two weeks.
Babies often go through periods of being sniffly, but unless the combination of symptoms is like that above, then it probably is not “the flu”. A child’s immune system becomes more capable of fighting the virus. The younger the child, the fewer viruses the child would have come across and the less “experienced” their immune system will be. This is why so many toddlers naturally pick up coughs and colds when they start spending more time with other children in their age group. Their immune system is developing with every new encounter.
The flu season runs from September to February in the UK. During this season, as a general rule, if someone has a fever with one or more of the airways symptoms and one or more of the gastrointestinal symptoms, then their illness is very likely to be “the flu” or a “flu-like illness”.
There are many types of influenza virus and some of these can make a child or adult very unwell. A vaccination will give the child’s immune system enough information about the virus so that it can naturally create antibodies to the virus. Then they will be ready in case the child becomes exposed to the virus in the future. A healthy person’s immune system can respond to millions of different viruses, proteins and substances. In fact, the body needs systems in place to make sure that the immune system doesn’t attack the body itself!
The nasal flu vaccination works best for those over 2 years old because it’s easy and convenient to give it in this way and works well. The nasal spray is a weakened form of the flu virus but cannot cause someone (with a normal immune system) to have the flu. Being given in this weak form generates a good immune response from the body.
Flu vaccinations are recommended because some of the influenza viruses can cause a child or adult to become particularly unwell. For example, they may experience every symptom of the flu. If that person is young, pregnant, or older, with a certain health condition, (e.g. asthma) then the person could become particularly unwell. There have been a couple of really serious flu epidemics in history. Most people remember the “Swine flu” in 2009. There was also the “Spanish flu” in 1918. These flu-epidemics (technically pandemics because they affected several parts of the world) claimed the lives of some individuals because they went on to develop even more serious illness beyond the basic flu symptoms above.
The flu virus changes itself slightly every year. Sometimes the change is very slight so your immune system might recognise it straight away and start fighting it immediately. However, to make anti-bodies, the shortest time your child’s body needs is 14 days. The flu virus has usually been and gone and had its impact on your child within just 7 days. Protection from the flu can be given through vaccination and each year scientists try to predict which of the individual influenza viruses will be the important ones to offer people protection against. By having a flu vaccination your child’s immune system has that 14 days’ notice well in advance and is ready to fight the virus the same day it encounters it, thus preventing a serious flu virus.
The NHS provides flu vaccination for children aged 6 months to 17 years. Children under the age of 2 only receive a vaccination if they have certain medical conditions. Those under two years old will receive the vaccination by injection. Children over the age of two receive the flu vaccination nasally.
The flu vaccination can be given to children between the ages of 6 months to 17 years. Those aged 6 months to 2 years and those 11-17 years need only to have it (by injection) if they are in a medical risk group (those with kidney, liver, lung or neurological disease, diabetes and immunosuppression).
The nasal vaccination is more effective, simpler to give, lasts longer and it covers more types of influenza virus. The nasal vaccination is not licenced for children under the age of 2 and also if given in this form may increase the risk of wheezing and developing a respiratory tract infection a few weeks later. As a precaution, the nasal vaccination (a live vaccination) is usually not given if there is a family member who has a medical condition which makes them immunocompromised. Having said this, the live attenuated influenza virus vaccination actually gives more effective protection against the influenza virus than the “inactivated” injected flu vaccination as stated above.
Babies under the age of 6 months are too young to receive the flu vaccination but they will get some protection from anti-bodies in present in mum’s breast milk. This is, therefore, another good reason for pregnant women to have the flu vaccination.
Your child may experience the same some minor side effects from the flu vaccination (nasal spray or the injection). These can be a runny or blocked nose, be a bit off food, have a headache or be a little grumpy. Also, if they received an injection, the area around the injection may be slightly sore for a few hours only. If there is anything beyond this then please contact your doctor. It is perfectly fine to give paracetamol or any fever or pain relief as per the instructions on side of the medicine bottle.
Mark Bennett, General Practitioner at private walk-in GP, London Doctors Clinic