The 2019 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 2019 flu season is getting off to an early start. South Australia is currently experiencing its highest number of recorded flu cases for this time of year in more than a decade.

Paediatrics at Burnside recommends having your children vaccinated as soon as possible.

The SA State Government has recently announced that the flu vaccination (Fluarix® Tetra) will be available for free for children from 6 months to 5 years of age.

Under the National Immunisation Program, people with certain medical conditions, or who are Aboriginal or pregnant can also get the vaccine for free. 

It is important to get another influenza vaccine each year. This is because their effect wears off over time. Also, the vaccines are designed to cover the strains predicted to be a problem over the coming season. Some of these strains of concern are Influenza A H3N2 and a new Influenza B strain.

Children aged between 6 months and 9 years who are receiving the influenza vaccine for the first time require 2 doses at least 4 weeks apart. More information about the vaccines and dosage is available here. The vaccine takes about 2-3 weeks before it starts to help protect from flu virus infection.

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 2019 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 the Fluarix® Tetra influenza vaccine for free.

Others eligible for free vaccines under the national immunisation Program:

  • All Aboriginal and Torres Strait Islander people over 6 months of age

  • Pregnant women

  • People 6 months of age or older with the following underlying chronic medical conditions: cardiac disease, chronic respiratory conditions (including severe asthma), chronic neurological conditions, and other at risk conditions, including those with impaired immunity due to disease or treatment, or children aged 6 months to 10 years on long term aspirin therapy. Click here more information on eligible medical at risk factors.

  • Persons aged 65 years and older

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 2019 influenza season

Children and adults under 65 should be vaccinated with one of the appropriate Quadrivalent Vaccines. Quadrivalent means that the vaccine immunises against four influenza strains (two A strains and two B strains). See the table below for the available options:

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?

Children and adults eligible for the free flu vaccine can receive the vaccine through their GP, local council, community health centre or Aboriginal health centre - contact them to arrange an appointment. See SA Health for more information on immunisation services.

Those not eligible for free vaccines can also access the flu vaccine through approved pharmacies. In SA, since early 2015, some pharmacists have been able to administer influenza vaccine to anyone over the age of 16 who are not eligible for the free national program. SA Health regulates pharmacist approval for this vaccination service. Otherwise, you can usually receive the vaccination in an appointment with your GP.

Please note: Our paediatricians at Paediatrics at Burnside can provide prescriptions and advice about the flu vaccine during your consultation. However, the practice cannot store vaccines or administer them to patients.

What flu virus strains do the 2019 vaccines help prevent?

This year there is a new A strain (H3N2) and a new strain for the B Victoria linage.  Influenza virus strains included in the 2019 seasonal influenza vaccines are:

  • A (H1N1): an A/Michigan/45/2015 (H1N1)pdm09 like virus

  • A (H3N2): an A/Switzerland/8060/2017 (H3N2) like virus

  • B: a B/Colorado/06/2017 like virus (not included in the trivalent vaccine)

  • B: a B/Phuket/3073/2013 like virus

Four different quadrivalent influenza vaccine brands are being supplied under the Program in 2019 for people aged under 65. These are Afluria Quad® (Seqirus), Flu Quadri® and Flu Quadri Junior® (Sanofi) and Fluarix Tetra® (GSK).

Source: Australian Government Department of Health

The 2019 flu season is starting early

Families should consider seeking the influenza vaccination as early as possible. The influenza vaccine is effective for around 4 months. As the flu season is starting early and may be a longer one, families should consider repeating the vaccination later in the flu season. For example, you might have your children vaccinated in April and then also again in August or September. Speak to your GP or paediatrician for more information.