Expert Q&A: Flu Shots for Children with JA

UPDATED 11/5/20

Question: My child has JA. Is it safe for her to get a flu shot?

Answer: Yes. Many children with juvenile arthritis (JA) are on medications that suppress their immune system, which puts them at an increased risk for developing the flu and having a more severe bout of illness. We also worry about flu complications, which can include pneumonia and ear infections. Additionally, any infection, including the flu, can flare arthritis symptoms. There are two types of flu vaccines — the flu shot and a nasal spray flu vaccine. Children on immunosuppression should not get the nasal spray flu vaccine as it is a live vaccine. Because the flu shot contains an inactivated (dead) form of the virus, your child can’t catch the flu from the vaccine.

Flu shot recommendations are the same for kids with and without arthritis. All children over six months old should get an annual flu vaccine. The CDC recommends getting the flu vaccine by the end of October. The peak of influenza season is usually from December to February, but cases can be identified as early as October and late into Spring. Getting a flu shot this season is more important than ever given the coronavirus pandemic. Doing so will help minimize the risk of illness with fever (which could mimic COVID-19), decrease the risk for potentially long school absences and reduce the burden on the health care system. 

All your child’s family members and close contacts should also get vaccinated. Unfortunately, vaccines aren’t perfect, which means there is still a chance that children who get the vaccine may still get the flu. If your child is surrounded by people who are protected against the flu, her risk will decrease. Teaching your child to be diligent about infection prevention, which includes frequent handwashing with soap and water (or hand sanitizer) and avoiding close contact with anyone who appears to be sick, may also help. These infection prevention techniques now also include wearing a face mask and practicing social distancing given the coronavirus pandemic. 

Julia G. Harris, MD

Pediatric Rheumatologist, Children’s Mercy Kansas City

Associate Professor of Pediatrics

University of Missouri-Kansas City School of Medicine