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Question About Flu Shots for a Child

Dear Dr. Kagen,

My 6-year old daughter just got her flu shot this past Friday. The doctor said she should get an annual flu shot ever since she had the pneumonia when she was 2 years old.

I remembered last year Annie threw up last year when she had the shot and a slight fever. This year, she had a fever over 100 degrees the day after the shot, and she also threw up. By Sunday her fever broke, and was slowly returning back to her normal self.

Before getting the flu shot, my husband asked the nurse to ask the doctor how much dosage will Annie be getting. The nurse said she will getting the regular adult dosage for the shot.

I am a bit surprised that a 6-year child (weight about 55 lbs.) would get a full adult dose. But this is what was given to her. Do all children at this age and weight get the full dose? As I have explained above, Annie had a pretty bad reaction. (I do not know which dosage she received last year). Should she get the adult dosage next year?

Also, to mention as well, Annie does have some type of allergies-- runny nose, cough, and maybe some asthma. She had been taking Claritin, but that doesn't seem to be helping her a lot.

Thank you for your advice.

Mille T.

Dear Millie,

Thanks for asking about flu shots for children with a past history of pneumonia.

It is common practice in the US to advise the yearly administration of influenza vaccination in children with respiratory illnesses such as asthma and in patients with other chronic ailments such as diabetes. A child with a past history of a single episode of pneumonia without any symptoms of asthma may or may not benefit from the flu shot. In your e-mail, you describe that your child does not respond well to the flu shot, and thus it would seem fair to conclude that next year you may wish to "see how things go" without it.

Not all patients benefit from the influenza vaccine. Toxic reactions to it include local irritation, fever, muscle aches, fatigue and other symptoms of the "flu". In my clinical practice, if the flu vaccine is not well tolerated, I do not recommend it again for at least several years.

The dose used in children is dependent upon their weight although it is difficult to determine exactly how each patient's immune system will process the antigens in the vaccine which changes each year depending upon the strains of the flu virus expected to occur.

Allergy symptoms which do not improve with the non-sedating antihistamine Claritin suggests the need for your daughter to see an Allergy Specialist. She may need to have diagnostic allergy skin tests to make an accurate diagnosis of her problems.

Also, not all patients with mild asthma benefit from receiving flu shot as by now I am certain you are aware of.

I hope this brief information is useful to you and your family. Be certain to discuss the flu vaccine's usage with your doctor as I am unable to give medical advice over the Internet especially as I have not seen nor evaluated your Annie.

Good luck.

Steve Kagen, M.D.
Allernet.com