Updated August 28, 2020.
As if the coronavirus pandemic hasn’t been enough to deal with this year, another respiratory virus is on the horizon. Flu season is quickly approaching and with it, many questions and concerns about its interaction with COVID-19. As the pandemic continues, U.S. health officials fear the overlap of the two viruses could further worsen public health and strain healthcare systems. Thankfully, there are ways you can protect both you and your family this fall. Here’s what you need to know to keep your kids healthy this flu season:
What is the Flu?
The flu is a highly contagious respiratory virus that comes on suddenly. Symptoms, such as body aches, fever, and a cough, come on suddenly and typically develop one to four days after exposure, lasting from a few days to two weeks. Having the flu may include any or all of the following symptoms:
- Fever (usually 100.4°F or higher, lasting for several days), often with chills
- Body aches or muscle aches
- Sore throat
- Runny or stuffy nose
- Eye pain, such as burning, pain on eye movement or sensitivity to light
Gastrointestinal symptoms, such as diarrhea or nausea and vomiting, are fairly uncommon in adults, but can be found more frequently in children suffering from the flu. And because the flu is caused by a virus, antibiotics that are effective against bacteria aren’t useful when you have the flu.
How do you get the flu?
The flu is spread person-to-person primarily from droplets that can travel through the air from coughing and sneezing, as well as by physical contact with contaminated surfaces like door handles, shared toys, or anything else an infected person touched recently. So teach your children cough and sneeze techniques and practice good hand hygiene to keep your family and those around you healthy during flu season. Widespread mask use and practicing consistent social distancing will also dramatically reduce the spread of the flu.
Should my child get a flu shot?
Yes! At One Medical, we encourage all our patients who are eligible, including infants age 6 months and older, children and teens, to get vaccinated against the flu. It’s the single best way to protect yourself and your loved ones from getting the flu. In fact, the flu shot not only reduces your child’s risk of getting the flu and lessens symptoms if he or she does get sick, it also helps prevent the flu from spreading to others. Getting vaccinated can also reduce the chances of your child developing complications like pneumonia. Moreover, the flu shot is especially important for infants and children, anyone pregnant (or planning to become pregnant), those over the age of 50, those with a chronic medical condition, and those caring for someone who is at risk for complications of the flu. These special groups are at high risk of serious complications of flu, like hospitalization, pneumonia and even death. The best way to protect your child is for the entire family to get vaccinated against the flu.
Does my child need a flu shot every year?
Yes, it’s recommended. Each year, the flu vaccine is updated to better match the strain of flu expected to cause the majority of flu cases during the upcoming flu season. Because flu viruses can mutate from season to season, it’s important to get a flu shot every year to ensure you and your loved ones are protected. While it’s possible immunity from a prior year’s shot can be protective, One Medical stands with other bodies such as the Centers for Disease Control and World Health Organization in recommending annual flu vaccination for everyone 6 months and older.
Are there special recommendations based on my child’s age ?
Yes, some infants are too young to be vaccinated for the flu, while older infants and young children may need 2 flu shots to be completely vaccinated. Here’s the breakdown by age:
- Babies under 6 months are too young to receive the flu vaccine. The best way to protect newborns and young infants is to make sure the people who care for them and spend time with them are vaccinated.
- Between 6 months and 8 years, some children will need 2 doses of the flu vaccine to be protected. If it is the first time your child is receiving the flu vaccine, or if your child has only received one flu vaccine in the past, he or she will need 2 doses of the vaccine this season. It is best to begin with the first dose as early as possible. The second dose should be given at least 28 days after the first dose. Children who need 2 doses, but only receive 1 dose of the vaccine may have reduced or no protection from the flu.
- Children between 6 months to 8 years who have received 2 doses of the flu vaccine in the past, will only need one flu shot this season.
- Children over 8 years old will need one flu shot this season.
When is the best time for my child to get a flu shot?
For children 6 months and up, it’s best to get the flu shot before flu season starts, so we recommend getting vaccinated in September or October when the current season’s vaccine becomes available. It is especially important for children who need 2 doses of the vaccine to start the process early, as the second dose is given at least 28 days after the first. Because flu season in the U.S. can last as late as May, it’s still worth getting vaccinated even after October. Babies who turn 6 months in the midst of flu season should start the 2 dose vaccine series as close to 6 months as possible. Also, it can take up to two weeks after vaccination for antibodies to develop and protect your child against the flu, so keep that in mind when planning to get vaccinated.
Are flu vaccines safe?
Yes, absolutely. Flu vaccines have been studied carefully and are very safe. Even though some people get sick despite getting a flu shot, the flu shot itself cannot give you the flu. Some people report symptoms such as body aches and low-grade fevers after getting a flu shot. This is due to your body’s developing a healthy immune response to the vaccine. These symptoms usually resolve within 24-48 hours. There has been an association between the flu shot and a serious complication called Guillain-Barre Syndrome (GBS), but this is extremely rare - fewer than 1 or 2 people per million who receive the vaccine will develop this syndrome, and the vaccine has been shown over and over to be safe and effective. If you have concerns about the vaccine’s safety, you can read more from the CDC here. Talk to your provider if your child has had a bad reaction to a vaccine in the past before they get their next flu shot.
How much does the flu shot cost?
The vaccine is completely covered by most insurance plans. Alternatively, if you don’t have insurance, you can pay out of pocket: $45 for the regular, pediatric and egg-free vaccines, and $75 for the high-dose. Please check with your insurance carrier if you have questions concerning your coverage.
How is the flu different from COVID-19?
This flu season is particularly complicated because the U.S. is still fighting to control the spread of COVID-19. Both the flu and COVID-19 are contagious respiratory illnesses, but are caused by different viruses. COVID-19 is caused by the novel coronavirus called SARS-CoV-2, while the flu is caused by various strains of influenza viruses. As both viruses cause many of the same symptoms and are transmitted via close personal contact and through respiratory droplets, it can be difficult to distinguish one from the other. There are a few differences though. First, with COVID-19, symptoms typically tend to appear two to fourteen days after exposure, whereas with the flu, symptoms usually develop one to four days after infection. Additionally, COVID-19 is believed to be more contagious and involved in more superspreading events than the flu. The symptoms of COVID and flu largely overlap except you may experience loss of taste or smell with COVID, but the rest of the symptoms are often indistinguishable without a test. Another big key difference is that an annual vaccine may protect you from the flu, whereas a vaccine for COVID-19 is still in development. The flu may also be treated with antiviral drugs for people at high risk for harm from the flu. Meanwhile, no drugs have been approved by the FDA to treat mild cases of COVID-19. Read more about the similarities and differences between the flu and COVID-19 here.
Is COVID-19 more dangerous than the flu?
Flu and COVID-19 can both cause serious illness and complications that may result in hospitalization and death. While current data suggests COVID-19 to be more deadly than the seasonal flu, much is still unknown about the virus and thus, it is too early to draw definitive conclusions. The death rate for COVID-19 varies by location, age, and the presence of underlying health conditions. It’s hard for scientists and public health officials to arrive at one singular mortality rate, given the number of people who have contracted the virus is still largely unknown. Though children may not be at higher risk of catching either flu or COVID-19, research is showing that healthy children are at higher risk of complications from flu than COVID-19. Meanwhile, infants and children with underlying medical conditions are at increased risk of severe illness from both viruses. Kids with COVID-19 are also at higher risk of Pediatric Multisystem Inflammatory Syndrome, which is very likely rare. As both the flu and COVID-19 can be fatal, we should all do our part to help reduce transmission of both viruses to help protect the most vulnerable and to prevent overwhelming our healthcare system.
Can my child get the flu and COVID-19 at the same time?
As the flu and COVID-19 are caused by different viruses, it is possible to have both respiratory illnesses at the same time. Public health officials do not yet know how common or likely coinfection is or how dangerous it may be. With so much unknown, it is especially important for your child to get a flu shot this year to better protect them and your loved ones.
Will a flu shot protect my child against COVID-19?
The flu vaccine isn't known to protect against COVID-19 directly. However, flu vaccination has many related benefits, including keeping your child from getting sick with flu, reducing the severity of your child’s illness if they do get the flu, reducing their risk of hospitalization, and helping protect them from the possibility of contracting flu and COVID-19 at the same time.
How can I protect my child from the flu and COVID-19?
The good news is that many of the same health and safety precautions we’ve taken over the last few months to prevent the spread of COVID-19 also help prevent the flu. Here are some steps you can take to protect your family during COVID-19:
- Practice social distancing and keep space between your kids and others outside your home. This means avoiding crowded places and group gatherings, as well as keeping them 6 feet away from other people. If you are quarantining with others or are a caretaker during this time, here is how to stay safe at home.
- Wear a cloth face covering or face mask when in public settings or when around people you are newly exposed to, especially in places with a high density of people, such as grocery stores or transit centers. The CDC recommends that children 2 years and older wear a cloth face covering when in a community setting. It is especially important that your child wear a mask or face covering if they are experiencing symptoms or need to be around those who may be considered high-risk. Children under 2 years old should not wear cloth face coverings.
- Wash your hands often with soap and water for at least 20 seconds, especially after going into public or touching common surfaces. If soap and water aren’t available, use an alcohol-based hand sanitizer. A trick to encouraging 20 seconds of handwashing is having your child wash a toy while washing their hands or sing one of their favorite songs. Singing “Happy Birthday” twice, for instance, is roughly 20 seconds. You should encourage your child to wash their hands upon entering the house, after using the restroom, and before eating.Avoid touching your eyes, nose, and mouth with unwashed hands and encourage your child to do the same.
- Avoid close contact with people who are sick. Close contact is considered spending more than a few minutes within 6 feet of a sick person, or sharing common surfaces or utensils.
- Cover your cough or sneeze with a tissue, then throw the tissue in the trash.
- Keep your kids home when they are sick.
- Regularly clean and disinfect frequently touched objects and surfaces.
- Wash stuffed animals and other plush toys, following manufacturer’s instructions, and using the warmest water possible.
What should I do if my child has flu or COVID-19 symptoms?
Because it is often difficult to distinguish COVID-19 from the flu, the best way to determine your child’s course of care this flu season is for them to get tested for COVID-19. Until you receive your child’s results, we recommend that your child remain isolated until the following::
- At least 10 days have passed since their symptoms first appeared
- They have had no fever for at least 24 hours without the use of fever-reducing medication
- Other respiratory symptoms have improved
If someone in the household becomes ill, it is safest to keep them separate from other family members and have them stay in a specific room and use their own bathroom if possible. You might consider designating one adult to care for a sick child if there are multiple children in the home. For more information on caring for someone with COVID-19, see here.
While several prescription antiviral drugs have been approved by the FDA to treat the flu, most kids with the flu have mild illness and do not need medical care or antiviral drugs. In most cases your child should stay home and avoid contact with other people except to get medical care. Your child should rest, stay hydrated and take a fever-reducing medicine like ibuprofen or acetaminophen (Tylenol) if they need to. We are aware some medical professionals are advising against using ibuprofen in cases of COVID-19, but there is currently no strong evidence that ibuprofen or other NSAIDs worsen coronavirus infections. It’s important to note that children under 19 years old should not use aspirin unless directed to do so by their medical provider. And remember, antibiotics won’t help your child recover from the flu.
An antihistamine like Zyrtec or Claritin may help reduce your child’s congestion regardless of whether it’s caused by a virus or allergies. If you’re a One Medical member, use Treat Me Now or a virtual visit on our app to speak with a member of our medical team. They’ll make sure your child gets the care they need, including an office visit if necessary.
Should my child take an antiviral medication like Tamiflu?
Antiviral medications, such as oseltamivir (Tamiflu) or the inhaled drug zanamivir (Relenza), offer little benefit for most healthy adults and children so we don’t routinely recommend antiviral medication except under certain circumstances. Kids who are very sick with the flu (like children whose illness is so severe they need to be hospitalized) and those who are at risk of developing serious flu complications (children under 5 years or because of a chronic health condition) and children living with infants under 6 months of age are recommended to take antiviral medication. Antiviral medications can lessen the severity and shorten the duration of symptoms if given within 48 hours of the illness. However, if taken longer than 48 hours after the onset of symptoms, they have little effect.
Sometimes these medicines are also used as prophylaxis to lower the risk of infection if an infant or child has been in close contact with an infected person. Oseltamivir can be used to treat cases of the flu in all ages, and may be used as prophylaxis in kids who are 3 months and up. Zanamivir can be used to treat the flu for kids aged 7 years and up, and as prophylaxis in age 5 years and older. Some side effects of these medications include nausea, diarrhea, and headache. If you’re unsure if it is recommended for your child to take antiviral medication, or you have additional questions, please contact a member of your care team.
For more information on the 2020 flu season, see here.
The One Medical blog is published by One Medical, an innovative primary care practice with offices in Boston, Chicago, Los Angeles, New York, Phoenix, Portland, the San Francisco Bay Area, Seattle, and Washington, DC.
Any general advice posted on our blog, website, or app is for informational purposes only and is not intended to replace or substitute for any medical or other advice. The One Medical Group entities and 1Life Healthcare, Inc. make no representations or warranties and expressly disclaim any and all liability concerning any treatment, action by, or effect on any person following the general information offered or provided within or through the blog, website, or app. If you have specific concerns or a situation arises in which you require medical advice, you should consult with an appropriately trained and qualified medical services provider.