The 2018 flu season and the influenza vaccine for children

The following information is general advice and may not be medically appropriate for all individuals and families. For specific advice, and if you have any concerns or questions, you should contact your paediatrician, GP or local immunisation service.

An update from Dr Brian Conway:

The SA State Government has recently announced that flu vaccination will be made free for children from 6 months to 5 years of age as soon as the government obtains stock. It is expected that this vaccine will be available for this State program from mid-May.

Some older children and teenagers with certain medical conditions, as well as pregnant women and Aboriginal teens over the age of 15, can also get the vaccine for free under a Federal program, and possibly earlier than May. 

Families may wish to consider seeing their paediatrician or GP for a script and paying for the vaccine so that they can have their children immunised earlier. 

Our paediatricians recommend flu vaccination for all children 6 months and older. The flu can be very unpleasant and debilitating.  Occasionally, complications of influenza can be very severe. Children tend to catch the flu more readily and require more hospitalisations than adults. When sick with flu, younger children are more likely to pass the flu virus onto other children and adults.

It is best to avoid catching the flu.

The majority of childhood flu-related hospitalisations and deaths occur among children without underlying medical conditions. (HealthyWA)

We are already starting to see influenza cases in children, so anytime from now is a good time to have your children vaccinated.

There is a lot of reliable information available already. We have set out, below, some useful material to help you.

The South Australian 2018 Annual Influenza Program

Under the South Australian State Funded Childhood Influenza Program Children aged 6 months to less than 5 years of age are eligible to receive influenza vaccine for free.

  • Children aged 6 months to less than 3 years of age are eligible to receive the FluQuadri Junior® vaccine
  • Children aged 3 years to less than 5 years of age are eligible to receive FluQuadri® vaccine.

Eligible children for free vaccines under the national immunisation Program:

  • all Aboriginal and Torres Strait Islander children aged 6 months up to 5 years of age

  • all Aboriginal and Torres Strait Islander people 15 years of age and over

  • people 6 months of age or older with the following underlying chronic medical conditions: cardiac disease, chronic respiratory conditions including severe asthma, other chronic illnesses requiring regular medical follow up or hospitalisation in the previous year, for example diabetes, chronic renal (kidney) failure, chronic metabolic disease and haemoglobinopathies, chronic neurological conditions that may impact on respiratory function including multiple sclerosis, spinal cord injuries, seizure disorders and other neuromuscular disorders, people with impaired immunity, including HIV infection, malignancy and chronic steroid use, children on long term aspirin therapy

What makes Influenza such a concern?

Dr Margie is a paediatrician from the Royal Children’s Hospital in Melbourne. She explains why influenza is a big concern on her blog. We have reprinted some of her explanation here:

 What is the flu?
Flu is a viral infection that causes: fever, cough, runny nose, headaches, muscle aches and pains, nausea, vomiting and diarrhoea in some people. Neurological complications, such as seizures, encephalitis (inflammation of the brain), confusion or disorientation or paralysis can occur in up to 10% of hospitalised children, with half being previously healthy kids and half having underlying medical conditions (See article by Khandaker below).
 The flu strains that circulate in the community can be either A or B strains.
 Flu can be a very severe illness and young kids are at higher risk.
 Of all vaccine preventable diseases, influenza or the ‘flu’ is the leading cause of hospitalisation among Australian children under five years of age. Many parents simply don’t know that. In fact, nearly 1,500 kids are admitted to hospital for confirmed flu each year and healthy kids under five are the most likely age group to be hospitalised for complications related to flu.
 Children can die from the neurological and other complications related to flu. A recent study looking at all admissions to paediatric intensive care units in Australia and New Zealand over a 17-year period (1997-2013) for kids up to 16 years old found that half of the children who died with flu-related admissions were previously healthy kids. This is a very important reminder about how serious flu can be.
 Kids are also more likely to catch the flu compared to adults (20-30% of kids compared to 10-30% of adults) and kids contribute greatly to the spreading of the disease in the community.

The recommended vaccines for the 2018 influenza season

Children under 18 should only be vaccinated with one of 3 recommended Quadrivalent Vaccines. Quadrivalent means that the vaccine immunises against four influenza strains (two influenza A strains and two influenza B strains). 

If your child is aged between 6 months and 9 years old, and this is your child's first ever flu vaccination, they will need a second dose 4 weeks later. This is to maximise the immune response to the vaccine strains.

From 6 months to 35 months

For the 2018 influenza season, the following quadrivalent influenza vaccine will be registered and available for use in children from 6 months to 35 months inclusive (less than 3 years):

  • Sanofi-Aventis - FluQuadri Junior

From the age of 3 years

For the 2018 influenza season, in addition to the vaccine for 6 months to 35 months inclusive mentioned above, the following quadrivalent influenza vaccines will be registered and available for use in children from the age of 3 years:

  • GlaxoSmithKline - Fluarix Tetra
  • Sanofi-Aventis – FluQuadri (this is the one the SA State Govt will give free for 3 to 5 year olds) 

Is the flu vaccine safe for children?

Flu vaccines are safe and children worldwide have been vaccinated against the flu for many years.

What about flu vaccine and febrile convulsions in children? Febrile convulsions (fever related seizures or fits) after flu vaccination are rare. By comparison, the flu virus itself is a major cause of febrile convulsions in young children. In a recent study from Europe, the flu virus accounted for 10 per cent of all hospitalisations among children during flu season and 1 in 5 of the children admitted with flu had a febrile convulsion.

See HealthyWA for more info.

Where can I get my children vaccinated?

For children under 16 years, your GP, local council, community health centre or Aboriginal health centre can give the flu vaccination to children. Other family members should be able to have their vaccination with their GP -call to arrange an appointment. See SA Health for more information on immunisation services.

For teenagers 16 years and over and adults, flu vaccination is also available at approved pharmacies. In SA, since early 2015, some pharmacists have been able to administer influenza vaccine to anyone in this age group not eligible for the free national program. SA Health regulates pharmacist approval for this vaccination service.

Please note that Paediatrics at Burnside is unable to provide vaccinations, however we can provide prescriptions and advice about the flu vaccine during your consultation.

The influenza strains covered in the 2018 vaccines

This year, five Quadrivalent and two Trivalent influenza vaccines will be available.

Children under 18 should only be vaccinated with one of 3 recommended Quadrivalent Vaccines. The Trivalent vaccines should not be given to this age group.

The 3 Quadravalent Vaccines for use with children 18 years or under are:

  1. FluQuadri Junior

  2. FluQuadri

  3. Fluarix Tetra

The Quadrivalent vaccines include two influenza A strains and two influenza B strains, and there are products available for all age groups from 6 months of age.

These vaccines will contain the following strains:

  • A (H1N1): an A/Michigan/45/2015 (H1N1)pdm09-like virus;
  • A (H3N2): an A/Singapore/INFIMH-16-0019/2016 (H3N2)-like virus;
  • B: a B/Phuket/3073/2013-like virus;
  • B: a B/Brisbane/60/2008-like virus.

Click here for more info from the Therapeutic Goods Administration about the 2018 vaccines.