Episode Transcript
[00:00:01] Hello and welcome to a Wonder Care podcast. I'm Sheena Mitchell, pharmacist and mum of three. I combine healthcare and practical advice to support you on your parenting journey. This week I'm talking all about the children's flu vaccine. I want to explain why I chose to vaccinate my own children and why as a community pharmacist, I'm being proactive in helping to vaccinate our communities through schools to enable, as many parents who can to access the flu vaccination service for free for children within our communities. I also want to discuss some of the side effects and I want to explain how the vaccine works. I suppose it's a little bit of myth busting. Try and get rid of some of that fear that you might have about getting your child vaccinated. I'm very much one for holistic health and I don't over medicate my children. In fact, when it comes to my children's health, I try to fuel and optimize their health by providing as balanced a diet as they'll let me and by trying to keep them active. I can tell you now that getting the nasal flu vaccine is a much easier win than trying to give a balanced, healthy diet every day.
[00:01:08] First of all, why would you bother vaccinate your child for flu? You might think, well, my child never gets flu or it's only a flu, so your children don't get sick from flu. These are common things that I hear in response to flu vaccination service for children. But actually in the past ten years in Ireland, almost 5000 children were admitted to hospital with complications of flu. Almost 200 children had treatment in intensive care and 40 children died. 40 children? Is 40 children too many for a disease that we have a vaccine for 40 children is 40 families who've grieved the loss of their child just because of flu? It is important to consider giving the flu vaccine because if we can prevent grief or hospital trauma or discomfort or pain in your child, then I really can't see a reason not to. The side effects of the nasal spray flu vaccine are no worse than you would get from any other vaccine. So if you have given your child all of their vaccines to date, don't be quick to dismiss this one. You gave your child the other childhood vaccines because you wanted to safeguard their health. We are lucky to be in a position to have access to an annual flu vaccine and we shouldn't dismiss it just because of a perception that flu is not serious. As a parent, it's also very difficult to juggle family and work life when you have children constantly outsick. So there is an element of supporting general family health and well being by reducing flu circulating in the household. Not only does it impact on your ability to work if you're at home minding your child, but it also impacts their ability to attend school and receive an education children by their nature are super spreaders. Even after COVID, I still struggle to get my children to wash their hands every single time that they go to eat or sneeze or touch something. Children just don't have the same emphasis on hygiene as adults do. They're happy playing in their own world and they do not want to be disrupted to be told go wash your hands, go wash your hands. So no matter how hard we try, there is a higher risk of spreading flu viruses amongst children and from children to other adults and the elderly. Other thing is because children may have no immunity to flu strains that they're coming across and adults will have gained immunity over their lifetime. But because children haven't, it's much likely that they'll have a higher viral load than adults because they will have a weaker immune response. This is because as an adult growing up, you'll have come across plenty of flus and you may have fallen foul of a few over the years. Your body remembers those flu viruses and it's quick to respond and shut down the virus when you meet it. Next, if your child has never had the flu, their immune system won't react as quickly. It's for this reason that we give a weakened strain of the virus through a simple nasal spray in a format which it cannot actually cause infection, but it can promote an immune response and therefore the production of antibodies. This will mean that if your child comes across flu, their body is going to be primed and ready to respond to it and shut down that infection. So you're not giving them a fake or unreal protection. Their body is producing real antibodies and that will stand them. And what's more, every year you get the flu vaccine. You're adding to their body's knowledge of flu strains because every year the strains are updated along with antigenic drift and shift patterns which reflect the mutating virus. Each year we are giving their body an arsenal of antibodies to promote their health as children and also into adulthood. So let me just explain how the vaccine works. I said there that we give a weakened strain and that is true. Fluan's tetra is the name of the nasal spray flu vaccine. All children between two and twelve years of age are eligible to get this for free. Last year children up to 17 were able to access it for free. But unfortunately this year it's just the two to twelve age group. There is one exception, and that is for young people between the ages of 13 to 17. If they have a long term health condition, cancer, an impaired immune system due to disease or treatment, a high body mass index of over 40, down syndrome or regular contact with poultry, waterfowl or pigs, they can get a free nasal vaccine. They can also get a free nasal vaccine if they live in the same house as someone who is at risk of flu because of a medical condition or if they live in a long term residential care facility. So if you think that your child who's age between 13 and 17 falls into one of these groups, go in and speak to your community pharmacist because they'll be able to administer the nasal flu vaccine for free. But children two to twelve don't need to meet any of that criteria. All children two to twelve are able to get a free flu vaccine. So back to how it works.
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[00:06:31] The reason we have to give an annual flu vaccine is because every year the vaccine changes slightly. The World Health Organisation make recommendations on which flu strains should be included for vaccination. The two A strains and two B strains in fluence tetra will be updated every season and this makes sure that we get the best possible protection that we need. It's also worth noting that because fluence tetra, the nasal flu vaccine, contains a weakened live strain, it means that it's actually more effective than getting the injection flu vaccine. This is because as the season goes on, if there are any little changes or small mutations to the viral strains that are within the virus, the vaccine will actually recognize those mutations. So, for example, as an adult I received my flu vaccine recently and that covers me for the strains recommended by the World Health Organizations. But later in the season, come February and March, if those strains start to mutate at all, the vaccine won't offer me the same level of coverage, whereas my children who received the live nasal flu vaccine will actually be able to respond much better to any of those little changes. So it offers a really great level of protection right up into the spring.
[00:07:52] How do we know that it's safe to give a vaccine in this way? A lot of people have worries when they hear the word live a live vaccine. But really I want to reassure you that this live virus has been weakened so much that it's not possible for it to cause general flu infection in your body. It's also really clever. I love the way they've designed it. They've made it so that it's heat sensitive. So, as you're aware, it's a nasal flu vaccine. So as a pharmacist, I spray a little bit of nasal spray in each of your child's nostrils. Your nostrils are colder than the rest of your body because in essence they're sticking out on your face because your nostrils are colder. The flu virus can replicate within your nasal passageway and in effect cause flu of the nose. Once those viruses start to try and move into the rest of the body they have been specially designed to be killed by normal body temperature. I think this is really, really clever. In effect it means all you can get is flu of the nose. It's super science and I always explain that to kids when I'm vaccinating them and they think it's pretty cool too. As a result of flu of the nose your child may end up having a little bit of nasal congestion for a couple of days after vaccination and they sometimes can get a very mild fever and that's all completely normal. They cannot catch flu systemically from this vaccine. It isn't possible. It's been weakened and it's been made heat sensitive. So this vaccine is safe and I think that's really important to understand. I love science and I just think that that's really reassuring as a parent to know exactly how it's working. So we know why the kids should get the flu vaccine now. We know that it can prevent complications like pneumonia, bronchitis, inflammation of the brain and encephalitis and it can keep kids out of hospital and it can protect them in the long term from any serious complications of flu. But it is important to note that there are a few kids who cannot receive the nasal flu vaccine. These kids include children who have had a severe allergy to a previous dose of the flu vaccine or any of its ingredients or if they have really severe asthma and if they've been really wheezy and needed their inhaler more than usual in the three days before the vaccine. So what we would do in that situation is wait until your child is feeling well and they have no wheeze for three days and then we can safely administer the vaccine. It's also not recommended for children taking medications known as Solicylates, which include aspirin. These are only given to children on prescription and there is an increased risk of Ray's disease when it's administered with the flu vaccine because it's a live vaccine. We also recommend that children who have a severely weakened immune system don't receive the nasal vaccine. They would go with a regular injection vaccine and that is also free of charge for all children two to twelve. So just because you can't get the nasal spray does not mean you can't be vaccinated. If your child is living with someone who has recently had something like a bone marrow transplant or a disease or treatment that is causing them to have a really severely weakened immune system then it's not advisable for them to have the nasal flu vaccine. We would recommend the injection in that case as well. This actually happened in my own house a few years ago. I actually ended up in hospital with flu because I have an autoimmune condition, which is basically arthritis of my spine. But long story short, my immune system was really, really bad and I was on immunosuppressants and I had had neutropenia as a result of my experience with flu. So that year we decided to give my children the injection version of the vaccine. But as my condition has stabilized, I'm still on the immunosuppressants, but I'm not considered to be severely immunosuppressed anymore. And so my children received the nasal flu vaccine this year and last year, children who have cancer and are taking medications called combination checkpoint inhibitors and children who have severe neutropenia. So that's really low levels of white blood cells should not receive the nasal vaccine. It's also not advised if they've taken antiviral medication for flu within the previous 48 hours or if they have a condition, which means that they have a risk of leak of cerebrospinal fluid, the fluid that threatens the brain. So if you think that your child falls into any of these categories, do talk to your community pharmacist and they'll be able to talk you through vaccination options that are suitable for your child. Another group who should have a little chat with the GP perhaps before getting their nasal flu vaccine are those that have had a cochlear implant. Children can receive their flu vaccine in most community pharmacies or in GP surgeries. I would encourage patients to reach out to their community pharmacist because we know that the GP surgeries do get very busy at this time of year, and this is something that we are highly experienced with. In my own pharmacy, we visit schools and that's been going really well this year. The uptake is really popular because, like in my own kids school, it's hard to find time to work and bring them out to be vaccinated. So it's convenient for children to receive it in school. And because it's a simple nasal spray, the children are a doddle to vaccinate. In fact, I have so much fun doing it. Little kids come in, and obviously the older ones, you're explaining that they're receiving a vaccination, giving them a courteous amount of information and reassuring them and letting them know what to expect. But for the really, really little kids, three and four year olds who I've vaccinated, I like to challenge them to see what it smells like. So I've had every answer, from pineapple to mint to chocolate ice cream to lavender. It goes on. Their imaginations are amazing. So you can see that this is not a traumatic experience. We literally just do a little spray in each nostril. There's no pain, and they can just continue to breathe normally while getting vaccinated. They don't have to sniff it, they don't have to take a deep breath, nothing like that. I hope that answers some of your questions on a practical level and also on a clinical level. As a parent, I know that for many reasons it was the right decision for me to get my children vaccinated for flu. As a healthcare professional and as a mom of three, I highly recommend you to get vaccinated too. The more children that are vaccinated, the more likely we are to reduce the impact of the flu season on our health service and within our schools and on our families. Obviously, there are high risks for children with flu, as I discussed at the start of the episode, and the next group who are more likely to end up in hospital due to flu are grandparents. So there are multiple reasons and multiple benefits of vaccinating for flu this year. It costs you nothing, and it gives you a lot of reassurance and protection. I'm happy to answer any questions you may have about the flu vaccine on my instagram at Wondercare underscore IRL, and I'm even happy to visit schools with the consent of the principal and roll out of vaccine service. If you're living in the Dublin Meader Kildare area, so do just get in touch if you want to know more about that. We'll be resuming vaccinating in schools in November once midterm has ended and the Halloween Sugar, Sugar Lows have begun. Thank you so much for listening. I hope I've made this decision easier for you. If you enjoyed this podcast, please follow or subscribe on Spotify or Apple podcasts or wherever you get your podcasts and leave a review. A review really benefits the show. Thank you so much for listening. Talk soon.
[00:24:12] This time of year can be quite stressful between RSV and flu and just trying to figure out what is wrong with your child.
[00:24:21] I just want to let you know that I sourced some home tests which, with one nasal swab, check for all three of the main respiratory diseases in one go.
[00:24:40] So with one nasal swab, you can find out if it's RSV, flu A or Flu B or COVID that your child is displaying symptoms of.
[00:24:55] Look, ultimately, a screening test like this is really helpful to know what you're up against, but as always, if your child's symptoms are worrying you, you respond in the same way you visit the doctor.
[00:25:18] Sometimes children can have multiple infections at once.
[00:25:22] It's not unheard of for a child to have both flu and RSV at the same time.
[00:25:34] You I'll pop a little link to these tests for anyone who wants to avail of them in my show notes or otherwise. You can find them on Wondercare Ie by searching floracare. That's flu.
[00:25:59] That's F-L-U-O-R-E-C-A-R-E. That's fluorecare. And they're available for home delivery.
[00:26:15] I do like to swab my children because I like to have an idea of what I'm dealing with, but it doesn't change the treatment outcomes.
[00:26:26] If your child has any difficulty breathing or signs of dehydration, then absolutely bring them to the doctor.
[00:26:34] You can listen back to my past episode on RSV and also on managing a fever.
[00:26:41] For more info.
[00:27:00] I do really strongly feel about vaccinating against illnesses that we can prevent.
[00:27:07] At the moment, there is not an RSV vaccine that we can avail of for our babies or children, but there is a flu one. So in this episode, I hope you I so in this episode, I hope to make your decision a whole lot easier on whether or not to avail of the free nasal flu vaccine that is being offered by the HSE through community pharmacies and GP surgeries.
