Scroll down for tips for the shot phobic
Influenza is one of the world’s deadliest vaccine-preventable diseases.
The flu is no joke. Even a mild case can be completely miserable. The aches, the coughing, the chills, that horrible feeling that you don’t want to be touched…Nobody wants to get this.
Every year, it kills more children in the United States than meningococcal infection and whooping cough combined. It can also lead to serious complications such as bacterial pneumonia, ear infections and sinus infections. It can worsen chronic medical conditions, such as congestive heart failure, asthma or diabetes.
Back when we were in the midst of the pandemic, there were actually several years of lighter than average flu activity. It isn’t rocket science. When people avoid crowds, wear masks and wash their hands, things don’t spread as easily.
As the world moved out of pandemic behavior, we briefly saw a couple of years with severely increased flu activity but it has mostly returned to a normal pattern.
The 2025-2026 season was considered moderate. The CDC reports that last year, from from October 1, 2025 through April 11 2026 there were:
Between 31 and 54 MILLION Flu illnesses
Between 380,000 and 780,000 hospitalizations
Between 23,000 and 78,000 deaths
191 confirmed influenza-associated pediatric deaths. Approximately 85% of these were children with known vaccination status, who were eligible and were not fully vaccinated.
As you can see, even in a ‘moderate’ year, there were lots of people impacted.
We suggest a reframing of the point of flu shots.
Getting the vaccine is not just about keeping you or your children from getting seriously ill. It is about minimizing spread within your family and community. It means protecting people who are vulnerable, including infants under 6 months who are too young to get the shot.
In the best case scenario, the vaccine will prevent you from getting sick. At the very least, it will alleviate severe symptoms and decrease spread to family members. The point of the shots is to increase antibodies to give your immune system a leg up. It is not, nor has it ever been, to guarantee an infection-free winter.
Here’s a fun fact: a severe case of flu is often much more contagious than a mild case. A shot that perhaps only minimizes the symptoms of illness, even if it doesn’t completely prevent infection, is still doing its job.
In addition, flu vaccines can reduce the burden of flu illnesses and hospitalizations on our health care system.
Keep in mind that babies need two shots the first year
Kids can start getting the flu shot at 6 months. If you have a baby at home who is too young to get vaccinated, please take extra care to make sure that all the household contacts are protected so that you don’t bring the virus home.
Anyone who is under the age of nine, and is getting the flu vaccine for the very first time, needs to receive two doses of the vaccine in order to be considered fully protected.
The two doses need to be separated by at least four weeks.
The first dose “primes” the immune system.
The second dose provides immune protection.
It is confusing, even some doctors aren’t really clear.
We will use our dear friend Nancy as an example. Her baby turned six months at the end of the season last year, so she only got the one shot.
Since she didn’t get 2 in one season, little Sofia needs to get two this year.
Why are two doses necessary?
Over the years we have seen patients who have had only their first shot come down with a significant case of the flu. One dose will not fully protect them.
Scientists designing the flu shot want to choose a dose that is as low as possible, to decrease side effects, while still working to create protection with antibodies. This means that the doses we use on everyone is pretty small. In order for a body to make adequate protection, it needs to see the same dose twice to build antibodies. After that takes place, one dose is sufficient to trigger those old immune-system memories.
Bottom line: If your child has ever had more than two previous doses of any flu vaccine, they only need one this year. If this is their first time, they will need two
Pregnant and nursing moms can and should get the shot.
Women in their 3rd trimester may pass along some of the protection to the baby in utero, so even if it is a bit on the early side, it is worth getting the shot prior to delivery.
If you are pregnant or have young children, double check before you get the shot to make sure yours is preservative free. 93% of the supply this season is, so it shouldn’t be an issue. All “prefilled syringes” are preservative-free in the US.
Flu Shot Timing
It takes about 2 weeks for the shot to take effect.
Since we never really know when the flu season will start with a vengeance, getting your child vaccinated early in the season is your best bet. This usually means a September or October shot, in anticipation of a fall spike. As soon as a baby turns 6 months old you can get them started with their first dose since they need two doses to be fully protected. That means you can get started as early as late August for the first shot and do September booster.
The shot’s peak protection is within 6 months of administration. Immunity wanes after that, but it’s not as if it falls off a cliff. Some protection persists for some people longer than 6 months. Since we can’t predict when the season will be at its worst, it is still best to get protected close to the beginning of the season.
Another factor is that It is impossible to predict possible delays and shortages with the supply, which do happen. The safest way to prevent having an issue with a potential shortage is to get the shot in September, October or early November when there is usually plenty available.
What’s covered in the shot this year?
Every year the disease trackers do the best they can to predict which strains of the virus will circulate and try to match the flu vaccine to the anticipated strain. Typically the vaccine changes from year to year. Some years have better matches than others. Even when they don’t get it exactly right, the shot seems to protect from more severe illness.
For any of you who actually pay attention, this year the trivalent flu vaccines for the 2026–2027 season contain three updated strains: an A/Missouri/11/2025 (H1N1)pdm09-like virus, an A/Darwin/1454/2025 (H3N2)-like virus (egg-based) or A/Darwin/1415/2025 (cell/recombinant), and a B/Victoria lineage virus.
Shot Side Effects
It does seem to vary a bit from year to year, but most of the time the reactions to the flu shot are quite mild. It is common to have a low grade fever and some soreness at the injection site.
Remember that a day or two of aches and a bit of fever is still better than a full-blown case of the flu.
“But the flu shot always gives me the flu.” – This is something we hear from patients all the time, and it’s a perfectly understandable feeling. What’s happening here?
Oftentimes, people will, for one reason or another, delay getting a flu shot until later in the season, say, November, when they hear that flu cases are raging. Remember, it takes the shot 2 weeks to become effectively protective. If you get the shot when flu numbers are already high, due to its significant contagiousness, there is a very high chance you’ll get infected from your community before the shot could do anything to help you. Because the shot does not contain a live virus, it is biologically impossible for it to create a disease or infection.
For others, the body’s immune system mounts such a strong response that it can feel like the flu, but we promise you that the influenza virus infection itself would have been way, way worse.
We believe you when you say that you have been unlucky enough to get sick when you have gotten the shot. Believe us when we say we still think you should get it.
Shot Contraindications/Allergies
There are very few true contraindications to a flu shot. They are:
Age <6 months
Prior severe allergic reaction to an influenza vaccine
Precautions, not contraindications:
Guillain-Barré syndrome within 6 weeks of a previous influenza vaccine.
Moderate or severe acute illness, with or without fever. Mild URI, low-grade fever, antibiotics, etc. are not reasons to withhold vaccination.
Importantly, none of the following are contraindications to an injectable flu vaccine. As a matter of fact, it is recommended that these people especially get the shot: egg anaphylaxis, asthma, pregnancy, immunocompromised, household contact with an immunocompromised person, or taking aspirin.
And once again, because we get this question a lot: a mild illness does not affect how well the body responds to a vaccine, so a little cold is not a reason to put it off.
It is generally a good idea to keep a close eye on your child for at least 30 minutes after the shot. If they seem to be having any breathing issues or exceptional fussiness they should get checked out immediately.
With more than 30 years experience of giving thousands of flu shots, Nurse Judy has only seen one serious reaction (treated in the ER and completely recovered).
Tips for the immunization visit
A little preparation ahead of time for either the flu mist or the shot can make a world of difference.
The flu mist is an option that is approved for healthy, non-pregnant people between the ages of 2-49. This is a nose spray, rather than a shot.
To tell you the truth, getting a 2 or 3 year old to cooperate with something being squirted in their nose can be more of a challenge than the 2 seconds it takes to do the injection.
If you can practice with a little saline in the nose at home, you will have a much better chance for success. If you can’t get them to do this in the safety and comfort of your home, save yourself the trouble of trying in the office and just opt for the shot.
For the injection, get out the doctor’s kit and do a little playing.
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There are also loads of little videos that you can watch in advance. I have one link here - Daniel Tiger gets a shot, but do some homework and see if you can find one that might resonate with your little one.
Make sure you give appropriate choices, such as which arm they want the bandaid, or what kind of treat they might get. Dr. Hurd pops a gummy or piece of chocolate into her kids mouths right after the shots and they are a big fan. No fussing at all.
When you are negotiating with your child, be clear that whether or not to get the shot is not one of the choices!
When you go in for the appointment it is helpful if your child is wearing short sleeves or clothes that will allow them easy access. Perhaps bring an ice pack with you and give yourself a bit more time for some icing in advance. The shot usually doesn’t hurt too much but an ice pack gives some kids a little boost of confidence.
You might also order a product called a Shot Blocker or the Buzzy Bee from Amazon and bring it with you. These little gizmos have helped a few of my ‘shot haters’ have an easier experience.
We have found that there is no age limit to people who are terrified of shots. Some parents are so upset by the sight of a needle that they can’t be in the room when their kids get vaccinated. If you are one of those, see if you have the option of having a partner be the adult on duty.
Wishing you all an influenza free year. Now go ahead and make an appointment!
For frequently asked questions, here are a couple great resources from the CDC.
Thank you to Nancy for weighing in. It is always a treat to have you collaborating with us!
Thank you Dr. Coby for being my model!
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