October 25, 2021
With the potential for a big outbreak of flu this winter, it is more important than ever to make sure that children get the flu vaccine as soon as possible, according to flu trackers. The American Academy of Pediatrics recommends everyone over the age of 6 months get an annual flu shot, ideally by the end of this month.
Two mathematical models predict a rebound in the number of flu cases and how severe they will be in 2021-22. Last year's flu season failed to show up when public health measures brought in to control COVID-19 seemed to have the added benefit of stopping the flu.
But both analyses, posted to the medRxiv preprint server and not yet peer-reviewed by other experts, have come to the same conclusion: The flu could make a comeback this year.
There is already some evidence that children might be at higher risk of respiratory infections than usual as the public health measures that were brought in to fight COVID-19 are relaxed, says Flor Munoz, MD, an associate professor of pediatrics at Baylor College of Medicine in Houston who was an author of the American Academy of Pediatrics policy.
There were more cases of respiratory syncytial virus and other viruses among children this summer, even though these illnesses are not normally reported that time of year.
"It's clear that children are being exposed to respiratory viruses, and the moment that influenza starts taking hold in the community, they will be at risk," Munoz says.
More People at Risk
After last year's missing flu season, there is no question that there are now more people who are prone to catch the flu, says Munoz. "A lot of people haven't had the flu for about 2 years, and with low vaccination numbers, that means there will be a larger pool of susceptible people," she says.
That lack of herd immunity, which usually comes from a combination of vaccinations and people who were exposed to related strains of the virus, means children in particular could be at high risk of infection this year, says Mark Roberts, MD, director of the Public Health Dynamics Laboratory at the University of Pittsburgh.
In a normal year, around 180-200 children die from the flu. But last year, only one death was recorded. "Very few kids got influenza last year, so young kids have almost no natural immunity," he says.
Children are also a fairly large transmitter of the flu, Roberts says, which makes infections in kids a danger not only to themselves, but to other susceptible people they might come into contact with.
"So it is really important to vaccinate children," he says.
With the approval of COVID-19 vaccinations for children younger than 12 expected soon, some parents might be inclined to hold off on flu shots for their kids to avoid any complications. But the CDC says it is safe to get both vaccines close together, or even at the same time.
Munoz says people should be aware that both vaccines can cause reactions and plan ahead, especially if they have had reactions in the past.
"You can take them at the same time, or at different times, as long as you get both vaccines," she says.
It is never easy to forecast what the upcoming flu season will look like.
"There could be not just more flu this year, but more severe disease as well," Munoz says.
But it is also possible that we have another mild season if the influenza virus takes longer to bounce back from the extremely low numbers seen over the past year.
"Every flu outbreak is different and unpredictable," she says.