Ask Dr. Marla: H1N1 Vaccine

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I have two children, ages three and six. Should I have them get a flu shot and an H1N1 vaccine?

Influenza, or the flu, is caused by viruses. The presentation of influenza is usually the same, regardless of the particular virus causing the illness. Fever, muscle aches, sore throat, fatigue and cough are the typical symptoms, although children can have diarrhea as well.
H1N1, also called swine flu, is the novel virus that has been identified as causing the present pandemic. Its behaviour has been somewhat different from typical flu viruses in that young healthy persons and pregnant women have had more severe illness than other groups. However, that might change with time. The recommendations from the Public Health Agency of Canada are that the following groups and individuals, as well as the people who care for them, be first in line to get immunized against H1N1:

  • children six months to five years of age
  • pregnant women
  • people with chronic medical conditions under 65
  • people living in remote or isolated areas
  • people who look after those who cannot safely receive the vaccine (infants under six months and people with weakened immune systems)

Public Health further recommends the vaccine to children ages five to 18, emergency medical personnel, poultry and swine workers and all adults. The H1N1 vaccine is available in November. For some groups, two doses are necessary.

The H1N1 vaccine does not confer immunity to the seasonal flu, so vaccination is still your best strategy for primary prevention. The seasonal flu shot is recommended to children over six months unless they have a true egg allergy (the vaccine may contain egg protein), a history of Guillain-Barré syndrome or a previous anaphylactic reaction to a flu vaccine. All household contacts of children under the age of six months should also be vaccinated, for the benefit of the infants as well as themselves.
Children who have a chronic illness such as asthma, diabetes or arthritis, are at greater risk of getting sicker from influenza. Health Canada notes babies ages six to 23 months are particularly susceptible to complications from the flu and are more likely to be hospitalized because of them.
The seasonal flu shot is typically given between September and November. Children up to age nine who have not previously had a seasonal flu shot will require two doses taken at a spaced interval. Seasonal flu and H1N1 vaccinations should be given a few weeks apart in order to monitor vaccine safety. According to Public Health, each jurisdiction is determining who should get the seasonal flu shot first and when, based on who is most at risk and who would benefit the most from immunization, given that the priority is to get the H1N1 vaccine. For more information about flu vaccines in your region, talk to your doctor or visit Public Health at

Published in Winter 2009

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