Q: I keep hearing this is going to be a bad winter for flu. Shouldn't my kids get flu shots? I don't want them to miss school.
A: Influenza appeared earlier than usual in some parts of the country this year. It may well be a bad flu year. Doctors have been making an extra effort to immunize people at high risk for complications if they become infected with the influenza virus.
Senior citizens, health-care workers and adults and children with chronic diseases (especially diseases that affect the lungs, heart or immune system) should be immunized. If your children have medical conditions that require frequent doctor's visits or daily medicine, they may be in the high-risk category. Ask your doctor.
Influenza vaccine is not usually recommended for completely healthy children. That's not because it wouldn't work or would harm. Healthy children are less likely than sick children or older people to have severe complications from influenza. So normal children are not high on the priority list for flu shots.
It would not be wrong for your children to get flu shots. If you feel strongly about it, ask their doctor to provide them. It would be particularly important if you have a frail adult in your household who might fare badly if your children bring flu home from school.
Of course, flu shots will not guarantee your children won't miss school this winter. The vaccine doesn't work perfectly.
And remember, if your children do get the flu, don't give them aspirin. Although it happens infrequently, influenza virus infection and aspirin seem to work together occasionally in children to cause a rare form of liver failure called Reye's syndrome. It can be fatal.
Dr. Wilson is director of general pediatrics at the Johns Hopkins Children's Center; Dr. Joffe is director of adolescent medicine.