DOES MY CHILD NEED A FLU VACCINE - I ASKED GOOGLE

Being an ENT Specialist with a considerable Paediatric practice, I am frequently asked by parents whether their child needs the annual Flu Vaccine. They often tell me "according to the Internet she/he should get it". Following this line of reasoning, I decided to abandon my textbooks for a change and ‘Google’ it. 

This is what I learnt:

The top results that came up after typing in "Should my child get a Flu Vaccine?" are as follows:

Caring For Children:

All children over 6 months old should get a flu shot each year. That would mean a child from 6 months to 18 years of age.

Mayo Clinic: 

In most cases, yes. The Centers for Disease Control and Prevention (CDC) recommends a yearly flu (influenza) vaccine for all children 6 months and older - ideally given as soon as the vaccine is available each year.

KidsHealth:

The Centers for Disease Control and Prevention (CDC) recommends a flu vaccine for everyone 6 months of age and older. But it is especially important for those who are at greater risk of developing health problems from the flu, including: all kids 6 months through 4 years old (babies younger than 6 months are also considered high risk, but they cannot receive the flu vaccine)

So, as per the most credible information that I have gathered from Google, any child above the age of 6 months should get an annual flu vaccine. But it may be necessary for children between 6 months and 4 years.

Now I enter - 'Flu Vaccine for children India' so that I can get a local context. These are the top results:

The Indian Express; EXPRESSPARENTING. The write-up talks about certain Indian statistics and then takes a quote from the Country Head of Sanofi Pasteur, one of the largest vaccine manufacturers. Most of the views are those expressed by this gentleman. So now we are taking health advice from someone who has a strong business interest in how many vaccines are sold.

The Hindu; Science. Talking about the advantages of the Quadrivalent Influenza Vaccine, the article quotes:

If you want to reduce the influenza burden in adults, then we must target children as they act as reservoirs. (Dr. Su-Peing Ng, Sanofi Pasteur, Head of Global Medical Affairs).

Once again, we have Industry persons advising us about the need for vaccines. The article goes on to state:

The Correspondent visited Sanofi Pasteur’s vaccine manufacturing unit at Val de Reuil, near Paris, at the invitation of Sanofi Pasteur.

Babycenter.in: 

It is recommended that your child gets the influenza (H1N1) vaccine, even though it is an optional vaccine in our country. Since the H1N1 pandemic (popularly called swine flu) in 2009, medical experts have advised that the flu vaccine be given to every child between six months and three years of age.

So now, half an hour into my search, I am informed that any child above 6 months of age, to any child up to 4 years, or up to 3 years, should receive the annual flu shot. Confused, I decide to search more authentic sources, hoping for more reliable guidelines.

So I enter ‘WHO’ hoping to get an unbiased scientific view. Though WHO itself received a lot of flak for the declaration of the 'False Swine Flu Pandemic', where Drug Companies made billions of dollars in selling vaccines against a mild disease.

This is what WHO has to say about the Flu Shot:

WHO recommends annual vaccination for children aged between 6 months to 5 years.

For another unbiased opinion I decided to see what the largest Government Healthcare organization in the world, the NHS, was recommending for the current year:

In the autumn/winter of 2019/20, the vaccine will be available free on the NHS for eligible children, including:

Children aged 2 and 3 on 31 August 2019. That is, children born between 1 September 2015 and 31 August 2017

All primary school children (5 to 11 years old)

Children aged 2 to 17 with long-term health conditions

I decide to make my search more Indian; looking for a specific Indian context I search for 'Indian Academy of Paediatrics'. There is a very comprehensive document: Immunization Schedule for Children, published by the IAP, which gets updated periodically:

The latest available influenza vaccine can be administered after 6 months of age, 2-4 weeks prior to the influenza season: two doses at the interval of one month in the first year, and one dose annually before the influenza season up to 5 years of age.

The vaccine is safe. It is generally now accepted that even children with egg allergies can be given the vaccine. The nasal spray is not yet easily available in India.

After having gone through these various recommendations, it seems that the most acceptable vaccination schedule would be to give the latest flu vaccine every autumn (October) to a child between 6 months and 5 years of age.

Now we come to a tricky section: children between 6 and 18 years of age. There are two considerations here:

- Easy affordability  

- What harm can it do?

To get an expert opinion on these concepts I asked a senior and renowned Paediatrician,

Dr HPS Sachdev. He is on the panel of the IAPs Immunization Schedule and an authority on the subject. He says that parents find the vaccine is not easily affordable. In which case, only high-risk children should be vaccinated, such as those who are immune compromised, on steroids, have Type 1 diabetes or with a chronic lung disease etc.

On the other hand, when money is not a consideration, parents ask “where is the harm if I want to vaccinate my child who is 8 years old, just to make sure he does not fall ill with influenza?” Dr Sachdev answers this by saying that they can go ahead, the vaccine is safe, but it does carry a slight morbidity risk, related to mild flu-like symptoms.

There is a general consensus that no flu shot is required for healthy individuals between 6 and 65 years of age.

To conclude, I would like to caution that knowledge from Google should be judiciously used. Google is an unbridled monster of knowledge; it must be tamed in order for it to give you the results you seek.

In this instance, as we see, two of the more cerebral newspapers of the country gave opinions regarding flu shots. These opinions are purely industry-sponsored. This is unavoidable - it is up to you to make sense of it.