Atlanta, GA – Children younger than five years old–especially those younger than 2–are at higher risk of developing serious flu-related complications. Children of any age with certain chronic health conditions are also at higher risk; during the 2022-2023 flu season, 66 percent of children 0 to 17 years old hospitalized with flu had at least one underlying health condition, such as asthma, neurologic disease, obesity, or immune suppression.
More information about children at higher risk of potentially serious flu complications is available.
While not at higher risk, children five years and older can spread the flu to their higher-risk family members, like infants younger than six months old and adults who are 65 years and older or people of any age who have certain chronic health conditions.
It’s important to vaccinate everyone six months and older in your family against flu each year to help protect those most at risk. A flu vaccine offers the best defense against flu and its potentially serious complications and also can reduce the spread of flu to others.
In children, annual Flu Vaccination has been shown to:
- Reduce flu illnesses, doctor’s visits for flu, and missed school days
- Reduce the risk of flu-related hospitalization and death.
Information on this page summarizes vaccine recommendations for children. More information on vaccine benefits is available.
Flu can be Dangerous for Children
Flu illness is more dangerous than the common cold for children. Each year, millions of children get sick with seasonal flu; thousands of children are hospitalized, and some children die from the flu. Children commonly need medical care because of flu, especially those younger than five.
- Complications from flu among children in this age group can include:
- Pneumonia: an illness where the lungs get infected and inflamed
- Dehydration: when a child’s body loses too much water and salts, often because fluid losses are greater than from fluid intake)
- Worsening of long-term medical problems like heart disease or asthma
- Brain dysfunction, such as encephalopathy
- Sinus problems and ear infections
- In rare cases, flu complications can lead to death.
- Flu seasons vary in severity; however, every year, children are at risk
- CDC estimates that from the 2010-2011 season to the 2019-2020 season, flu-related hospitalizations among children younger than five years old each flu season have ranged from 6,000 to 27,000 annually in the United States.
- While relatively rare, some children die from the flu each year. From the 2004-2005 season to the 2019-2020 season, flu-related deaths in children reported to CDC during regular flu seasons have ranged from 37 to 199 deaths. (During the 2009 H1N1 pandemic, the CDC reported 358 flu-related deaths in children from April 2009 to September 2010.)
- Importantly, among reported flu-related deaths in children, about 80% occurred in children who were not fully vaccinated.
- Also of note, even though each flu death in a child is supposed to be reported to CDC, it is likely that not all flu-related deaths in children are captured and that the actual number of deaths is higher. CDC has developed statistical models that account for the underreporting of flu-related deaths in children to estimate the actual number of deaths. During 2019-2020, for example, 199 flu-related deaths in children were reported to CDC, but statistical modeling suggests approximately 434 deaths may have occurred. More information about flu-related deaths in children since the 2004-2005 flu season is available in the FluView Interactive web application.
Vaccination is the best protection against the Flu
An annual flu vaccine is the best way to prevent flu and its potentially serious complications. Even when flu vaccination does not prevent illness entirely, it has been shown in several studies to reduce the severity of illness in people who get vaccinated but still get sick.
CDC recommends that everyone 6 months and older get a seasonal flu vaccine each year. Keep in mind that vaccination is especially important for certain people who are higher risk of developing serious flu complications or who are in close contact with people at higher risk. This includes children at higher risk of developing serious complications from flu illness, and adults who are close contacts of those children.
Flu vaccines are updated each season to protect against the four influenza viruses that research indicates will be most common during the upcoming season. This season’s flu vaccine has been updated from last season. More information is available on this season’s flu vaccine composition.
An annual flu vaccine is the best way to prevent flu and its potentially serious complications. Even when flu vaccination does not prevent illness entirely, it has been shown in several studies to reduce severity of illness in people who get vaccinated but still get stick.
CDC recommends that everyone 6 months and older get a seasonal flu vaccine each year. Keep in mind that vaccination is especially important for certain people who are higher risk of developing serious flu complications or who are in close contact with people at higher risk. This includes children at higher risk of developing serious complications from flu illness, and adults who are close contacts of those children.
Flu vaccines are updated each season to protect against the four influenza viruses that research indicates will be most common during the upcoming season. This season’s flu vaccine has been updated from last season. More information is available on this season’s flu vaccine composition.Your child’s healthcare provider will know which vaccines are right for your child.
For more information on the different types of flu vaccines available, visit CDC’s Different Types of Flu Vaccines page.
When Should Children Get a Flu Vaccine?
Children should be vaccinated every flu season for the best protection against flu. For most people who need only one dose of flu vaccine for the season, September and October are generally good times to be vaccinated. Everyone 6 months and older should be vaccinated by the end of October. Some children need two doses of flu vaccine.
It is recommended for those children to get the first dose as soon as the vaccine is available—even in July or August—because the second dose needs to be given at least four weeks after the first. Vaccination during July and August also can be considered for children who need only one dose.
However, getting vaccinated later can still be protective, as long as flu viruses are spreading—even into January or later. Since it takes about two weeks after vaccination for the body to develop antibodies against flu virus infection, it is best to get vaccinated so they are protected before the flu begins spreading in their community.
Special vaccination instructions for children aged 6 months through 8 years old
- Some children 6 months to 8 years old need two doses of flu vaccine.
- Children in this age group getting vaccinated for the first time, those who have only previously received one flu vaccine and whose flu vaccination history is unknown, should get two doses this season.
- For those children, getting the first dose as soon as the vaccine is available is recommended because the second dose needs to be given at least four weeks after the first.
- Your child’s healthcare provider can tell you if your child needs two doses.
Other Preventive Actions
In addition to getting a flu vaccine, children and caregivers should take the same everyday preventive actions CDC recommends for everyone, including avoiding people who are sick, washing hands often, and covering coughs.
Symptoms and Treatment
Flu symptoms include fever, cough, sore throat, runny or stuffy nose, body aches, headache, and fatigue. Some people may also have vomiting and diarrhea, which are more common in children than adults. People may be infected with flu and have symptoms without a fever.
More information on when to seek emergency care is available online.
Your child’s healthcare provider can help decide whether your child should take antiviral drugs if they become sick with the flu. Antiviral drugs for children come in the form of pills, liquid, inhaled powder, or intravenous solution. They fight the flu by keeping flu viruses from reproducing in the body. A doctor must prescribe antiviral drugs — they are not available over the counter (OTC).
More information on children and flu antiviral drugs is available.
Emergency Warning Signs of Flu
People experiencing these warning signs should obtain medical care right away.
In Children
- Fast breathing or trouble breathing
- Bluish lips or face
- Ribs pulling in with each breath
- Chest pain
- Severe muscle pain (child refuses to walk)
- Dehydration (no urine for 8 hours, dry mouth, no tears when crying)
- Not alert or interacting when awake
- Seizures
- Fever above 104 degrees Fahrenheit that is not controlled by fever-reducing medicine
- In children less than 12 weeks, any fever
- Fever or cough that improves but then returns or worsens
- Worsening of chronic medical conditions
In Adults
- Difficulty breathing or shortness of breath
- Persistent pain or pressure in the chest or abdomen
- Persistent dizziness, confusion, inability to arouse
- Seizures
- Not urinating
- Severe muscle pain
- Severe weakness or unsteadiness
- Fever or cough that improves but then returns or worsens
- Worsening of chronic medical conditions
These lists are not all-inclusive. Please consult your medical provider for any other severe or concerning symptoms.
