DEAR MAYO CLINIC: My 5-year-old son is afraid of needles. He cries and fusses anytime we have to visit the doctor. When it's time for an immunization or vaccination, he squirms and screams, and he has to be held down. Afterward he admits that it wasn’t so bad, but he never seems to get over his fear. Does my son need a flu shot? Can we do anything else to minimize his risk for the flu?

ANSWER: It can be hard for any child to visit a health care provider, but it can be especially hard if he or she fears needles. Vaccinations are a childhood rite of passage, but they are important, as they can prevent and limit the spread of illness.

The Centers for Disease Control and Prevention and the American Academy of Pediatrics recommend flu shots for children 6 months and older to protect them, as well as their friends and family members, from the flu.

Influenza is a respiratory infection that can cause serious complications, particularly in young children. Getting a flu vaccination is the best way to prevent the flu and its complications. Even when the vaccination doesn't completely prevent the flu, it will help to prevent complications from the flu, such as pneumonia and bronchiolitis. Recent research shows that getting a flu vaccination significantly reduces the risk of dying of the flu for all children.

Flu can spread by kissing, touching and holding the hands of other infected people. The germs can stay on surfaces for many hours or spread through the air when a person coughs or sneezes.

The flu strain can change from year to year. Therefore, people do not stay immunized for more than a season. It is important for people to get the flu shot each year to stay vaccinated for each flu season, which runs approximately from November to April. Getting a flu vaccination is especially important this season because the flu and COVID-19 cause similar common signs and symptoms. The flu vaccination may reduce symptoms that might be confused with those caused by COVID-19.

The good news for your son is that there are two options available: a shot and a nasal mist. In your case, the nasal mist may be the best option for your son. Like the injection, the mist does not cause the flu, but side effects can occur in the initial few days after receiving the vaccination. Your son might experience a runny or stuffy nose, a mild fever, or a headache.

It can be scary for any child to visit a health care provider, particularly if he or she thinks there will be something painful involved. Be honest with your child that an appointment will include a shot. Do your best to explain what will happen in advance so he knows what to expect.

You also may want to prepare your son for any changes that he could see during the vaccination visit. Safety is a priority for your health care provider, so there may be significant changes to spaces and processes, including temperature screening at entrances, masking requirements and limiting the number of people in the building. Take time to explain to your son that these changes are made to create safe environments for him and all in-person visitors, just like the vaccination is meant to protect him from illness.

Before the appointment, check in with your health care provider to confirm if the flu mist is available, as not all providers offer it. If a flu shot is the only option, ask about different options to help with discomfort, including a using an ice pack to numb the skin. Other options include pain-ease spray, numbing cream and oral sugar solution for infants. Most nursing staff should be skilled at making kids feel secure and having parents part of the process.

In addition to being honest with your son about what to expect, consider bringing something to distract him, such as a favorite video or a game that you can pull up on your phone. And while I don't always recommend a treat after a flu vaccination appointment, depending on the age of the child, an incentive — like ice cream after an appointment — can work.

Depending on your health care provider, you may be able to obtain your flu shot at the same time as your son. If you cannot get your vaccination at the same time, consider taking your son with you when you do. But check with your medical clinic to ensure that this will be allowed due to restrictions related to COVID-19.

Though flu season traditionally peaks in February, with December and March being the second and third most common peak months, respectively, it's important not to delay flu vaccination. It can take up to two weeks for your body to begin to build up immunity.

In addition to flu vaccination, families should maintain healthy habits to stay as healthy as possible. These habits include practicing proper hygiene, getting plenty of sleep and eating well. Remind your son about proper hand-washing. A good rule of thumb is to wash hands for 20 seconds — about as long as it takes to sing the ABCs. Also, teach him to cover a sneeze or cough with the crook of his elbow. And do not send your child to school if he is ill.

Flu symptoms may come on suddenly. Although these symptoms might seem like a cold at first, they can escalate to include fever, body aches, muscle stiffness, chills and sweats, cough, headache, and fatigue. Since these symptoms also are shared with COVID-19, it is important for you to contact your health care provider at the first sign of illness. You can have the flu and COVID-19 at the same time. Testing may be performed to see if you have COVID-19 or the flu. — Dr. Jennifer Johnson, Family Medicine, Mayo Clinic Health System, Mankato, Minnesota

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Information in this post was accurate at the time of its posting. Due to the fluid nature of the COVID-19 pandemic, scientific understanding, along with guidelines and recommendations, may have changed since the original publication date. 

For more information and all your COVID-19 coverage, go to the Mayo Clinic News Network and mayoclinic.org.

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