Should kids get flu shot or nasal spray vaccine?

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As flu season heats up, the Centers for Disease Control and Prevention is urging Americans 6 months and older to get vaccinated.

This year parents have two choices: the flu shot or the FluMist nasal spray vaccine, available for kids 2 and older.

So, which is a better bet for your child?

The American Academy of Pediatrics recommends the shot over the nasal spray vaccine, saying the shot offers the most consistent protection for children.

Atlanta pediatrician and WebMD medical editor Dr. Hansa Bhargava agrees.

"I usually do the flu shot," Dr. Bhargava says.  "I think it's quick, and it's easy."

For kids 2 and older, the FluMist nasal spray vaccine is available again, after disappearing for a couple of flu seasons.

The AAP recommends the nasal spray as backup to the shot, for kids afraid of needles, or pediatricians who run out of the injectable vaccine.

"I think some parents feel like that's an easier way to get the flu vaccine," Dr. Bhargava says.  "And, if it's the right candidate, I would certainly let them have it."

But, Bhargava says, the nasal spray vaccine is a "live" vaccine, made with a weakened form of the virus.

On the other had, the injectable vaccine is made with an inactivated virus that cannot cause the flu.

So, she says, the nasal spray is not a good fit for anyone with underlying health problems.

"Typically, it has to be a healthy person between the ages of 2 and 49," Bhargava explains.  "If there is any risk of illness, especially diseases that can have respiratory symptoms or can make a child sick, it's probably best not to get that and get the injection."

In the 2017-18 flu season, 179 children died of flu-related complications, and many more ended up in the hospital.

The Centers for Disease Control and Prevention in Atlanta says about 80% of the children who died were not vaccinated against the flu.

The AAP says kids 8 and under who have not been vaccinated before will need 2 shots, given a month apart.

Children 9 and older need only 1 vaccination, regardless of their vaccine history.

"I think that parents should be aware that the flu shot is very mild in general, that it only takes a few seconds, and that usually there is very little reaction to it," Dr. Bhargava says.