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Lisa Black

Experts advise that children receive the vaccine as soon as it is available, preferably by Halloween

The American Academy of Pediatrics recommends that all children ages 6 months and older be vaccinated for influenza this fall, as vaccines remain the best way to prevent severe illness and keep kids in classrooms.

In a policy statement, “Recommendations for Prevention and Control of Influenza in Children, 2022–2023,” the AAP observes that vaccination coverage lagged last season and that, historically, the flu has taken a disproportionate toll on families who are Black, Hispanic or American Indian or Alaska Native.

The policy statement will be published in the October 2022 Pediatrics (published online Sept. 6). A detailed review of the evidence supporting the recommendations is published in an accompanying technical report.

“As a pediatrician and a parent, I consider the flu vaccine as critical for all family members,” said Kristina A. Bryant, MD, FAAP, lead author of the policy statement, written by the AAP Committee on Infectious Diseases.

“We should not underestimate the flu, especially when other respiratory viruses like COVID-19 are circulating within our communities. Besides making your child miserable and wreaking havoc on your family’s routine, influenza can also be serious and even deadly in children.”

The AAP urges families to catch up with all vaccinations for their children and to ask their pediatrician for the flu vaccine as soon as it is available this season. During the 2021-22 flu season, only 55% of children were vaccinated to protect against influenza, and coverage levels were 8.1 percentage points lower for Black children compared with white children, according to the Centers for Disease Control and Prevention.

The overall rates of influenza infection dipped last year, likely due to safety precautions in place to prevent COVID. But as children return to school and pre-pandemic activities, the flu and other respiratory viruses are expected to rise. Historically, they have caused disproportionate harm to some ethnic and racial communities.

In one cross-sectional study spanning ten influenza seasons, Black, Hispanic, and American Indian/Alaska Native people had higher rates of influenza-associated hospitalizations and intensive care unit admissions, and disparities were highest in children under age 4. Influenza-associated in-hospital deaths were 3- to 4 times higher in Black, Hispanic, and Asian/Pacific Islander children compared with white children, the study found.
AAP has called for eliminating disparities and inequities in health care access and services for all children.

The AAP recommends:

  • All children ages 6 months and older be vaccinated annually with influenza vaccine. AAP has no preference for a specific type of flu vaccine; depending on the child’s age and health, they may receive either the inactivated influenza vaccine (IIV), given by intramuscular injection, or attenuated influenza vaccine (LAIV), which is a nasal spray.
  • Any licensed influenza vaccine appropriate by age and health status can be used.
  • Emphasis should be placed on ensuring that high-risk and medically vulnerable children and their household contacts and caregivers receive annual influenza vaccine.
  • Increased efforts are needed to eliminate barriers to immunization in all persons experiencing higher rates of adverse outcomes from influenza.
  • Children who are eligible for both a flu and COVID-19 vaccine can receive them at the same visit.
  • Children 6 months through 8 years who are receiving the flu vaccine for the first time or who received only one dose prior to July 1, 2022, or whose vaccination status is unknown should receive two doses of influenza vaccine at least four weeks apart. All other children should receive one dose this season.
  • Pregnant women may receive the flu vaccine at any time during pregnancy to protect themselves and their infants. Influenza vaccination during breastfeeding is safe for mothers and their infants.

“This is a busy time for most families, with the start-up of school, sports and other favorite activities, like socializing with friends,” Dr. Bryant said. “Getting the flu vaccine helps protect everyone and allows for less disruption caused by illness. Don’t let the flu stop you this season.” resource for parents: Which Flu Vaccine Should Children Get?


The American Academy of Pediatrics is an organization of 67,000 primary care pediatricians, pediatric medical subspecialists and pediatric surgical specialists dedicated to the health, safety and well-being of infants, children, adolescents and young adults.

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