Be Prepared For Flu Season

Q: When does flu season start?

A: Influenza viruses typically circulate year-round, however in most years in the Northern Hemispehere, flu activity is highest in December and February, but we don’t know exactly when it’s going to hit each year or how severe it will be. The COVID-19 pandemic has changed the timing of many other respiratory viruses, and influenza may also follow a different pattern this year. That is why it is important to have your child vaccinated as soon as possible.

Q: When should children and youth be vaccinated for the flu?

A: The best time for children to be vaccinated is in September and October before the flu infections start to peak. However, people should continue to get vaccinated through the late fall and winter if they were not vaccinated earlier in the season.

Q: What’s the most important thing parents can do to prepare for flu season this year, given the ongoing COVID-19 pandemic?

A: It’s important to have everybody in the whole family vaccinated against the flu. The recommendation is for everybody 6 months and above to have the flu vaccine each year. That is by far the best way to be prepared for the flu.

In addition, the measures that we are taking to protect ourselves and our children from COVID can also help reduce the risk of flu. Model and remind your child/children to:

• Wash hands frequently for 20 seconds with soap and water. Use hand sanitizer if not available.
• Wear a mask when out in public (except children younger than 2)
• Practice social distancing, staying 6 feet away from others

Though the flu vaccine is the best protection against the flu, it will not protect against COVID-19.

Q: Why do you need a flu vaccine every year?

A: There are two main reasons for getting the flu vaccine every year. First, as time passes, the body's immune response to the vaccine declines, which means you're not as well protected as the next year approaches. Second, flu viruses change every year, so only the most recent vaccine can be effective.

Q: If I get the flu vaccine, can I still get the flu?

A: Yes. The flu vaccine is created to be as much of a match to the viruses for the current flu season, but it's not perfect. The flu virus can change during the flu season, so the vaccine might not match the virus as well. In these cases, it's possible to come down with the flu, but the vaccine will still provide you with protection and you will likely have a milder illness.

Q: How does the flu and COVID-19 differ?

A. The flu is caused by influenza viruses (more than one type) and COVID-19 is caused by a new coronavirus (SARS-CoV-2). Both the flu and COVID-19 are respiratory illness with some similar symptoms, but they do not share all symptoms. In both cases, children can experience only some of the symptoms associated with each illness. In general, the flu can be more severe than COVID-19 in children. It can be hard to tell the difference between them based on symptoms alone and testing may sometimes be needed to confirm a diagnosis. The CDC keeps updated information on the difference between these virus. It is possible that the flu virus and the virus that causes COVID-19 will both be spreading this upcoming flu season, both of which can cause respiratory illness.

Q: If a child does get sick, what can parents do to care for their children at home?

A: Plenty of fluids and rest are important, and if a child has a fever, treat it with acetaminophen or ibuprofen. Children should not receive aspirin, especially those with influenza. You should monitor your child closely, especially if they cannot express themselves well. If they are reasonably comfortable, able to drink, voiding every 6-8 hours, and have no trouble breathing, they can be safely treated at home, regardless of the flu or COVID-19.

If you have family members who are under the age of 2 or over 65, you especially want to keep them away, as they are the people who most frequently develop complications from the flu. If there are family members over age 65, the CDC highly recommends that these family members get the high-dose flu vaccine, which is designed to provide better protection against the flu.

Q How long should my child stay home?

Typically, children who have the flu should stay home from school and should not be exposed to others until 24 hours after their fever has resolved without any medications and their symptoms are improving.

The isolation period of flu and COVID-19 differ. If you or any member of your household had or likely had COVID-19 please see the CDC’s latest recommendations on isolation, as these recommendations have changed as we learn more about COVID-19.

Q: When should parents call their doctor?

A: Generally, if a fever runs beyond 3-4 days, it’s worth checking in with your doctor. If a child has an increasing cough or certainly if a child has difficulty breathing, you should call because a bacterial pneumonia can complicate the flu. And if your child has underlying problems, especially respiratory problems like asthma or cystic fibrosis, then you want to be especially careful, and it may be worthwhile to check in with your doctor sooner. If your child presents with a new rash or swelling, it is safest to call your doctor’s office.

Q: What temperature would be a cause for contacting a doctor?

A: We define a fever as 100.4 degrees F or higher. Fevers up to 104 degrees F are common. If the fever gets to the 105 range, that’s a reason to call.

Q: Are there certain populations who are considered high risk for developing flu-related complications?

A: Yes. Children under age 5, adults over age 65, pregnant and two-week postpartum women are considered high risk. If any of your family members have health conditions, such as asthma, diabetes or kidney or liver disorders, they're also considered high risk for developing serious flu-related complications if they get the flu. It's especially important for them to be vaccinated against the flu.

Q: Can my child get a flu vaccine if they had COVID-19?

A: Children should get a flu vaccine, even if they had a prior COVID-19 infection. As they are two different diseases, one will not protect from the other.

Q: Can my child get the flu vaccine and COVID-19 vaccine at the same time.

A: For those that are eligible for the COVID-19 and Flu vaccines, they can get both at the same time.

Q: Is there anything else people should know?

A: If a child is running a high fever and is miserable in the first 24-48 hours, then you should check in with your doctor. There are some antiviral drugs that are specific for the flu, but it’s not always an easy call because you don’t always know whether a child has the flu or not. Just because they have a fever doesn’t mean they have the flu that these drugs will deal with. These medicines are more effective if started within about 48 hours of the onset of the flu.

Be prepared

The last thing you want when you or your child gets sick is another errand. Here are a few things you should have on hand during flu season.

• Tissues
• Digital thermometer
• Fever-reducing medicine: ibuprofen or acetaminophen
• Throat lozenges
• Antibacterial wipes
• Hand sanitizer
• Masks

Learn more about the flu

• Centers for Disease Control and Prevention: Seasonal Influenza (Flu)
• Centers for Disease Control and Prevention: Caring for Someone Who Has the Flu
• Seasonal flu information from Massachusetts General Hospital
• Flu Overview, a series of videos by Andy Gottlieb, NP, a nurse practitioner at Mass General, answering common questions about the flu
• Benefits of the Flu Vaccine

Reviewed by Alexy Arauz Boudreau, MD, and Vandana Madhavan MD, MPH, October 2021