Is flu really that bad in kids this winter?
Author: Associate Professor Margie Danchin FRACP
Murdoch Children's Research Institute and University of Melbourne
Paediatrician, The Royal Children's Hospital
18 July 2022
We are now well and truly into winter and flu is hitting us hard.
What most people don’t know is that flu can make kids very sick, even those who are generally healthy. Parents often tell me flu is not that bad, but it is generally much more severe than other respiratory viruses. In fact, flu is the leading vaccine-preventable disease that causes hospitalisation for kids under five years.
I’m a paediatrician, and unfortunately, I’ve looked after many kids in hospital who are severely ill from the flu. I strongly recommend giving your kids the flu shot as soon as possible to help protect them. The great news is that vaccines for flu are available and, for the first time, free for anyone over 6 months in most states in Australia.
Kids can be admitted to hospital with complications as serious as pneumonia or inflammation of the heart or brain, which can sometimes lead to death. This year, around half of hospitalised flu cases have been in people under 19 years of age, including in children and infants younger than 5 years of age.
We are all much more vulnerable to getting very sick this year, especially kids.
The last two years or so of measures to prevent the introduction and spread of COVID-19 reduced case numbers for most respiratory viruses, especially flu. Until this year we had seen very little flu in Australia. Last year, we had a historically low number of flu cases when there were only 300 confirmed cases by the end of May 2021. Now that international borders are opening again and we are able to socialise more freely, flu is circulating widely.
Kids just haven’t been able to build up their immunity to flu during the pandemic, because they were not exposed to flu and have had lower vaccine coverage over the last two years. Children under two years have never seen a flu season and are especially vulnerable.
The severity of flu depends on which strain is most dominant, and it changes every year. By 3 July in Australia there have already been around 187,431 cases of flu confirmed by laboratory testing with around 1,323 hospital admissions due to flu. These numbers are much higher than we would expect at this time of the year and the flu season has taken off much earlier. In fact, the number of cases since mid-April 2022 are significantly larger than Australia’s five-year average. The number of cases this May was roughly twice that of our last big flu season in 2019.
The other concern I have about flu, as a health professional, comes from the thousands of new COVID-19 cases that we’re still seeing every day in Australia. Hospitals and health care services have fewer resources to deal with flu when there are also so many people ill with COVID-19, including within the workforce.
And once you’ve had COVID-19, you’re often not as well-equipped to deal with another virus, especially if you were very unwell. There have also been reports of people contracting COVID-19 and flu at the same time, unofficially called ‘flurona’. The combined infection not surprisingly may be associated with more severe symptoms than either illness on its own.
Flu can be treated by bed rest, pain relief and increasing fluid intake. There are also anti-viral medications which can help to reduce how long the symptoms last. But to work well, they have to be given within 48 hours – which is quite hard for many parents to manage.
So, the best way to prevent the flu is vaccination. A bit like the COVID-19 vaccine, the flu vaccine is not perfect and your child may still get infected, but it reduces their chance of getting seriously ill and needing to go to hospital.
The first time kids under nine receive the flu vaccine, they have two doses one month apart, and after that it is one shot a year. If your child is sick, basic measures such as handwashing, wearing masks and sneezing into your elbow help to reduce the spread of flu – but the most important thing is to keep your child home from kinder or school if they are sick, even if they have a negative COVID-19 test.
Flu vaccines are safe, and monitoring for side effects occurs through AusVaxSafety. So far this year, in kids under five, 21% have had one reported side effect, mostly a local reaction, fatigue or fever. Fewer than one in a hundred kids needed to see a doctor about their side effects. You can look up flu vaccine safety data at any time to check what has been reported.
The flu vaccine is especially important for kids and adults who may be at higher risk, such as all children six months to five years, all people over six months with certain medical conditions, pregnant women, adults older than 65 years and all Aboriginal and Torres Strait Islander people.
The only way to give some protection to babies under six months is for their mother to have the flu vaccine in pregnancy – it’s two-for-one protection as the vaccine protects both mother and baby by passing protective antibodies across the placenta to the baby. So if you’re pregnant, it is especially important this year to get your flu vaccine at any time while pregnant.
The flu vaccine protects you for at least six months. Everyone should get one at the beginning of the flu season, usually in April or May, to help protect you over winter. While the flu season is in full swing, it is not too late to get the vaccine!
We know that everyone is a bit tired of hearing about vaccines, but this year we need to take flu and COVID-19 seriously and protect ourselves and our families. Kids can get their flu shot easily at the GP, local council clinics, or pharmacy (if over five years, or over 10 years in Tasmania).
And the good news is that you can get your flu vaccine and COVID-19 vaccine, if due, at the same time!
We all want our kids to enjoy being back at school, doing their activities and sports and seeing their friends, so please protect them, and yourself, from flu this winter.
VaxFacts presented by Associate Professor Margie Danchin and University of Melbourne
Science of Immunisation: questions and answers developed by the Australian Academy of Science in partnership with the Australian Government Department of Health
AusVaxSafety, an NCRIS-led collaboration