Influenza and children

Influenza vaccine: use in children

Influenza infection rates are generally highest in children.  Healthy children are also the major cause of the spread of influenza viruses in the community. Vaccination of healthy children has the potential to substantially reduce influenza-like illness and related costs in both the children themselves and their families.

Influenza vaccination recommendations vary between countries. The United States (U.S.) recommends annual vaccination for all persons from 6 months of age.

The United Kingdom influenza vaccination programme includes annual vaccination for all children aged 2–8 years with a live attenuated nasal spray influenza vaccine with the strategy to offer both individual protection and herd immunity. This type of influenza vaccine is expected to be more effective in children but is not currently available in New Zealand.

New Zealand current strategy

The current New Zealand strategy for children is to offer free influenza vaccination to those with certain medical conditions most likely to lead to serious influenza-related complications.

Children aged 6 months to less than 9 years of age who are receiving the influenza vaccine for the first time should receive two doses four weeks apart, as they may be immunologically naive and so get a better response from a two dose priming regime.
Children who have received an influenza vaccination any time in the past only need a single dose in the current season.

Age Dose Number of doses
6-35 months 0.25 mL 1 or 2*
3-8 years 0.5 mL 1 or 2*
≥9 years 0.5 mL 1

*Two doses separated by at least four weeks if an influenza vaccine is being used for the first time.

Use of paracetamol following immunisation

The routine prophylactic use of paracetamol or any other antipyretic to control fever either prior to or following vaccine administration is not recommended. Evidence shows that the immune response to some antigens can be reduced. However, there is no evidence that this causes individuals to be less protected from disease.

The current recommendations are as follows:

  • Do not use routine prophylactic antipyretics pre or post vaccination in the absence of pain or significant discomfort
  • Infants who are uncomfortable with fever should first be managed with appropriate removal of clothing and other cooling measures such as cool drinks or tepid sponging
  • Only use analgesics (paracetamol or ibuprofen) for relief of pain or significant discomfort post vaccination

Anyone with concerns following immunisation should seek medical advice.

NOTE that treatment advice may differ for other groups. For example, it is important to manage fever carefully in pregnant women because of the potential risks to mother and baby. Seek specialist advice as appropriate.