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By: Dr. Harold Farber, Pediatric Pulmonologist

Fall and winter are times to start thinking about the flu (Influenza). In Texas, Influenza infection usually peaks in January or February, but can peak as early as October. Influenza can cause severe – even life-threatening – illness. Even healthy people can get severe influenza.

To prevent the flu, there are two important steps:

  1. Wash your hands
  2. Get vaccinated

Everyone over 6 months old should get vaccinated!
As an adult, the best way to protect yourself from the flu is to get BOTH yourself AND your children vaccinated. Protection is best when the whole family is vaccinated. If your child is in a high risk group – such as a child with asthma, diabetes, heart disease, immune problems, or disabilities like epilepsy, cerebral palsy or muscular dystrophy – then getting the flu vaccine each year is doubly important.

What if I am pregnant, breastfeeding, or thinking about getting pregnant?
If you are pregnant, thinking about getting pregnant, or you are breastfeeding then influenza vaccination is especially important – and it does double duty. It helps to protect BOTH you and your baby!

What if my child is ill?
The flu shot can be given even if a child has a mild illness (such as a cold or ear infection) even if there is a fever. If your child has a moderate or severe illness, wait until he or she has gotten better, then get the flu vaccine.

The Centers for Disease Control and Prevention has lots of great information about the flu. You can find it at

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Flu shot or FluMist (nasal spray)?
The flu shot contains inactivated (killed) virus. It cannot give you the flu; it just helps your body to learn to mount an immune response to the flu. However, it is a shot with a needle.

The FluMist (nasal spray) contains attenuated (weakened) virus. It works by giving you a very mild infection. It is a nose spray – not a shot. So if you hate needles this may be the one for you or your child.

Which one to choose? Both work. The choice depends on if you prefer a shot or a nose spray. FluMist (nasal spray) should only be used for healthy, non-pregnant persons aged 2-49 years. People with asthma or other chronic diseases should get the flu shot instead.

Trivalent or Quadrivalent.
Trivalent is the old tried and true influenza vaccine. Trivalent means it protects against 3 strains of flu. Quadrivalent in the new version, just released this year. Quadrivalent means that it protects against 4 different strains of flu. The quadrivalent vaccine may give a bit better protection than the trivalent, but supplies are limited and it may cost more. Right now, we really don’t know if one is all that much better than the other. In my mind, the important thing is not trivalent or quadrivalent. The important thing is to get one or the other of them! The flu vaccine that you can get easily will be much better than the flu vaccine you have trouble finding or have to wait for.

What if my child has Egg Allergy?
The American Academy of Pediatrics advises that egg allergy is no reason to avoid getting the flu shot. If the history of reaction to egg is mild (such as hives alone) your pediatrician should be able to give your child the flu shot. If the history of reaction to egg is severe, ask for a referral to an allergist to be sure that your child can get the flu shot safely.

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The flu shot has been well studied in egg-allergic children. The nose spray (FluMist) has not. So if there is concern about possible egg allergy you are probably best going with the flu shot.

Where do I get the flu vaccine?
Most doctors should have the flu vaccine. Many pharmacies can give the flu vaccine also. Be sure to ask your child’s doctor or your pharmacist.

To find a location near you, use this online tool:

The influenza vaccine is now available at all Texas Children’s Pediatrics practices, so if your child is a patient at one of our offices, please call today to schedule an appointment.

When should I get the flu vaccine?
Get it as soon as you can. Sometimes the flu starts early and you want to make sure that you and your loved ones are protected. Each year the flu vaccine is usually ready and released by early or mid-September. This year’s vaccine is already out. So call your doctor or pharmacist about getting the flu shot for your child and yourself. Don’t delay.

About Dr. Harold Farber, Pediatric Pulmonologist


I am a Pediatric Pulmonologist at Texas Children’s Hospital and Associate Professor of Pediatrics at Baylor College of Medicine, and Associate Medical Director of Chronic Conditions for Texas Children’s Health Plan.

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