The Centers for Disease Control and Prevention reports that 172 children died from flu-related illnesses and complications in the 2017-18 season, 80 percent of whom had not received a flu vaccination. That season was the highest in pediatric deaths in 10 years, except for the 2009 swine flu pandemic.

This year, the flu vaccine will be available as a nasal spray (live attenuated influenza vaccine, or LAIV4) as well as traditional flu shots (inactivated influenza vaccine, or IIV3/4). However, the American Academy of Pediatrics says the inactivated vaccine flu shots remain their primary recommendation, since the nasal spray has not been proven effective against all strains of flu.

Nasal spray vaccines are not approved for children younger than 2, pregnant women, or people older than 50. People with asthma or other health conditions that put them at high risk of flu complications are urged to use caution before receiving the nasal spray vaccine; it is not approved for children with asthma aged 2-4.

The nasal spray vaccine was dropped from CDC’s recommended vaccines list in 2016 due to ineffectiveness, particularly after the 2009 pandemic and the H1N1 virus. AstraZeneca, the parent company of the manufacturer of the nasal spray vaccine, reworked the drug’s formulation to better treat H1N1, and early data indicates it may be more effective.

Annual seasonal influenza vaccination is recommended for everyone 6 months and older, as vaccination remains the best available preventive measure for the spread of flu among individuals, families and the community.

How Flu Affects Asthma

Children with asthma are at high risk for complications of the flu, and researchers in Canada say one reason could be that the presence of a flu infection makes asthma more difficult to treat.

The researchers found that emergency asthma treatments for children were likely to fail 40 percent of the time when the child also had flu. Treatment failure was 20 percent for kids with other respiratory viruses – except colds (rhinovirus), which did not affect asthma treatments.