Annual Flu vaccination: 2018-2019

It's time for flu vaccines, and we're here to help!

This page contains online scheduling for your flu vaccines. If you've come to our flu clinics before, you can jump right in with scheduling. But if you need more info, you'll find it in the FAQs and info section found below the forms. As always, please review all instructions carefully, it makes coordinating hundreds of patients much easier. Thanks for your help!

Ready to schedule?

Important notes:

  • Seasonal flu vaccines are usually in limited supply, and we will allocate based on the order in which we receive your forms - please respond promptly.

  • Flu clinics are busy and time slots are brief. But we can still keep them smooth and positive with your help - please be flexible with scheduling options and punctual during the flu clinics (we do not do reminder calls for the flu clinics). Thank you!!

  • Information you'll need to complete the form (details below in FAQs and info section):

    • Dose of vaccine (based on child's age)

    • How many doses each child will need (see below)

    • When you'll be getting the vaccine (either during a flu clinic or a well check)

Online Scheduling Forms

Please select the number of children you'd like to schedule for the vaccine:

For help with any of the items on these forms, reference the FAQs and info section below. Your form will open in a separate tab or window so you can keep this page open for reference.

Frequently asked questions and info

Is the flu vaccine recommended for my child?

Annual flu vaccination is recommended for all children ages 6 months and up. For infants less than 6 months old, those around them (parents, caregivers) should receive the vaccine. If you would like more information about the risks and benefits of the flu vaccine, we've included a more in depth discussion of the pros and cons following these FAQs below.

Should we do the nasal or the injection?

Injection/shot - this is just like other shots you're accustomed to. It is a preservative-free, inactivated virus vaccine (no live virus). It is a great option this year - it is effective, has slightly fewer side effects, and works great for children and adults of all ages above 6 months old. We use the quadrivalent, preservative-free option at our clinic.

Nasal Spray (FluMist). We anticipate that we will get our shipment of the FluMist nasal spray vaccine at the end of October, so if you are interested in the nasal spray vaccine, please sign up for the November or December flu clinics. The FluMist version of the vaccine is a good option for some children older than age 2 years. The nasal spray was not an option for the past two seasons, and we are excited to have it back. If you are interested in the flu vaccine but want to avoid a poke with a needle this season, this is a better option than skipping the flu vaccine altogether.

How many doses does my child need this year?

For children less than 9 years old, immunity doesn't built up until they've had at least 2 flu vaccines at some point. So if they haven't yet had those first two, they need two this year to jump-start the engine, so to speak. Every year after that, or for any child aged 9 years and older, only 1 dose is needed. Here's a simple guide on what your child needs this year:

Children 9 years and older

  • Only 1 dose.

Children aged 6 months through 8 years

  • If your child has had at least two doses of flu vaccine (cumulatively) at some point, they only need 1 this year.

  • If they've never before had the flu vaccine, or only had 1 flu vaccine (cumulatively) since birth, they'll need 2 this year.

If you find any of this confusing, or you're not sure what they've had, no problem! Just check two dates to be safe and leave a note in the comments box of the form stating that you'd like us to double check the info for you.

When can we get the vaccine?

  • During a well check: If your child has a well check coming up and scheduled before the end of the year, it's preferable to do the flu vaccine during your well check. Simply note this on your form, and we'll reserve a dose for your well check.

  • During our flu clinics: Since many kids are not due for well checks during this season, we reserve a few afternoons in the fall for families to come in for our annual "flu clinics". Each child is given a specific 5 minute appointment within that period. Due to the massive volume of appointments we cannot accommodate specific time requests within that window. Basically, let us know which clinic you'd like to attend, and we'll send you a confirmation with your time slot. Please do everything you can to be as punctual as possible, it really helps things go much more smoothly.

Want more information?

Here is the link for the CDC's info page about the flu vaccine for children. You can also read my in depth discussion of influenza vaccination below.

Ready to schedule? 

Navigate back to the top of this page and open the appropriate form. See you soon!

Should we do the flu vaccine this year?

A more in depth discussion.

We do advise annual flu vaccines for all children. The influenza vaccine is an often misunderstood vaccine, so it may help to clarify just what it does and doesn’t do, as well as what risks it does and doesn't have. In brief, for young children aged 6 months to 5 years, the benefits far outweigh the risks, so it's a pretty easy decision. This is also true for children with medical conditions such as asthma, heart disease, and developmental delays. For healthy, older children ages 6 years and up, the benefits still outweigh the risks, but it's not as dramatic, so we get a lot of questions about it — hopefully this will help.

What does the vaccine protect against?

The “flu shot” protects against a very specific virus called influenza. Many people casually refer to different illnesses as “the flu”, though in reality many of these are caused by other viruses. Influenza is a doozy not to be mistaken for the common cold: high fevers (easily in the 104-105 range), heavy cough, trouble breathing, vomiting, abdominal pain, muscle aches, headache, etc. We often see complications such as ear infections or pneumonia, and young children may need to be admitted to the hospital for rehydration, oxygen, or antibiotic therapy. It can also result in quite a bit of medical interventions such as x-rays and antibiotics to look for and treat bacterial complications, and various other drugs due to the severity of symptoms. The likelihood of severe illness is highest in young children and decreases with age. The risk is also greater for children with chronic medical conditions such as asthma or heart disease.

What's the overall chance of catching the flu? This ranges from about 10% to 20% each year, and can be higher in pandemic years. As you can imagine, these numbers vary depending on many factors, such as whether or not a child is in daycare, whether or not they are breastfed, their constitution, the severity of a particular flu season as a whole, and how many people in your community vaccinate.

While infants are less likely to catch the flu, they are much more likely overall to end up in the hospital. School-aged children are the most likely to catch the flu, but are the least likely overall to end up in the hospital. The reason this is important is that some parents will mistakenly think “because my baby stays at home they will be protected.” Most babies are also at home, but still have the highest risk out of all healthy children simply because it's harder than you'd think to keep all virus out of your house, and when they do catch it, it can be awfully severe.

Another misconception is that only kids with medical problems come to harm from the flu. Actually, only about half of influenza fatalities have a recorded underlying medical condition! Having such a condition (asthma, heart disease, etc) definitely increases your risk, but not having any conditions is not necessarily a guarantee for safety.

What does the vaccine not protect against?

The flu vaccine does not protect against other viruses, like the common cold. It also doesn’t protect against ALL influenza strains, though in general it does a pretty good job. Each year the strains that are most predominant in a community change, and the vaccine strains are selected based on which strains are most predicted to be prevalent that year. So the effectiveness varies year to year. Some years it’s great, other years it’s so-so. Even in off years it still provides reasonable protection, though. On average, you could estimate its effectiveness at around 70%.

What is the chance the flu vaccine will help my child this year?

Because the flu is so unpredictable, and vaccine effectiveness varies year to year, it can be misleading to think of it in terms of whether the vaccine will help your child this year. It could be huge, or it could be nothing! The best analogy would be trying to decide whether to invest in your family’s retirement based on predictions for the stock market tomorrow. It may go up or down on any one day, but if you don’t invest regularly you are virtually guaranteed to have less money when you retire. If your child gets the flu vaccine routinely each year, some years it may help, others it may not, but when used routinely over a period of time your child is highly likely to see more benefit than harm.

Looking at just one year, if we estimate that on average 17% will catch it without the vaccine and the vaccine is 70% effective, then 5% would catch it without the vaccine. There’s clearly a benefit there, but this apparent 12% absolute drop in a given year doesn’t tell the whole story. Let’s look what happens over 10 years:

10 years without vaccine: 52% would catch it more than once, 23% more than twice, while only 16% won’t catch it at all

10 years with vaccine: 8% would catch it more than once, only 1% more than twice, while 60% won’t catch it at all

These are rough numbers, but should give you a basic idea of why your risk on any one given year doesn’t tell the whole story. There is a much more dramatic difference between the two groups when you look over time, which is how the vaccine is meant to be used — it really shines at preventing kids from getting either really sick or from getting sick over and over again. Bottom line: if you’re only looking at one single season, the risk is too unpredictable year to year to make sense of it, which is why a lot of people question it. But if you look at your risk of getting sick over the decade, or your risk of severe complications, there is a huge drop. And those are the things we care about most.

What’s in the vaccine?

The vaccine contains four stains, two influenza B strains and two influenza A strains. The vaccines that we purchase here do not contain aluminum or thimerosal and are all preservative-free.

What type of reactions can be seen from the vaccine?

The risk of any significant reaction to the vaccine is very low. It has been around for a long time, and as you can imagine it would need to be a really well tolerated vaccine in order for it to be given on a yearly basis. Local reactions are common as with all vaccines, and can be seen in up to 15-20% (soreness, redness, swelling, etc). These reactions are brief, mild and resolve on their own quickly. General symptoms, like fever and malaise, are uncommon and only reported in about 1% of vaccine recipients (more common with the nasal vaccine). Allergic reactions are quite rare, but people who have extremely severe egg allergies should let me know because there are traces of egg in the vaccine.

Does the vaccine weaken my child's immune system?

No. It is a misconception that flu vaccines weaken your immunity against other illnesses. This stems from the fact that people receive the flu vaccine at the start of a cold season, right before they are about to start getting sick, which makes you feel like the vaccine was what kicked it all off. But this is just a false perception due to the timing of events. However, there is some suggestion that catching the actual flu on a regular basis could give you more lasting immunity against the flu virus in the long term because the immune response is stronger. It's not conclusive though, and you'll have to decide for yourself if the risk of catching the flu regularly is worth the long term boosted flu immunity, or if you'd prefer to catch the flu less often and less severely in exchange for simply decent flu immunity.

Other considerations

Here are some factors that many families find it helpful to consider: if your child got sick for 5 days with high fever, heavy cough and vomiting, but eventually recovers completely, how do you feel about the discomfort they experience during the illness? What if you could snap your fingers when they are vomiting at 2 am and make it all go away? How readily are you able to care for them? Some don’t mind this, and for others it’s a huge burden: staying home from work, coming in for a few doctor’s visits, sometimes needing an antibiotic, etc. For some people, getting a vaccine every year feels like a larger burden than your child getting sick periodically, and for others, it’s the opposite.

Other important things to consider: How much would a flu illness cost your family (i.e. missed work, copays, medications, possible hospital bills, etc)? How does your family view your responsibility in your community to stop the spread of the virus to others who are at higher risk? Children with weakened immune systems won't respond to the vaccine, so they rely on others in the community to reduce the flu burden to protect them, especially considering the flu is extremely serious in those with compromised immunity. For healthy kids, the risk of a fatality or permanent complication is quite low, but definitely not zero—how comfortable are you with this risk? These are the types of (sometimes difficult) questions your family will want to discuss.

As always, whether or not you choose to do the vaccine remember these other important points about staying healthy this winter:

  • wash your hands

  • wash them again

  • definitely wash them before you touch your nose

  • cough into your elbow, not your hand (pose like a vampire)

  • get plenty of sleep

  • reduce stress

  • stay warm

  • eat healthy foods

Hope this helps, just let us know as soon as possible because supplies are usually limited.