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Q: How many doses of the flu vaccine does my child need, and how long should we wait between doses?

A: Children from 6 months to 8 years getting the flu vaccine for the first time need to get two doses in order to maximize having a good immune response. This year, because the composition of flu vaccine is the same as last year's, we are recommending that children who received one dose last year (instead of the recommended two) need only one this year, rather than the previously recommended two.

If it's your child's first time, she still needs two doses. Or if you don't know what your child got before --- if it's not documented anywhere -- [get] two doses.

This year, we also recommend that children who did not get at least one dose of the 2012-2013 vaccine receive two doses, even if they received two doses in some season prior to 2010-2011.

The doses should be at least four weeks apart.

Q: Is H1N1 (swine flu) still a concern?

A: Yes. We need to consider whether children get an adequate number of doses of the H1N1 pandemic strain to be protected from the 2009 H1N1 pandemic virus. It was in last year's vaccine and is also in this year's vaccine.

Your child will need two doses of this year's flu vaccine if she did not get at least one dose of the 2010-2011 flu vaccine, even if he or she received two doses in an earlier season.

Q: Which children are eligible for the nasal spray flu vaccine?

A: The nasal spray is an option for healthy children over age 2 who don't have asthma, chronic medical conditions, or other medical problems that might place them at increased risk for influenza complications.

Sometimes doctors' practices run out of it, or they're not able to stock it every year. But you can ask for it.

Q: How can a parent prepare a child for the flu shot, particularly if the child is afraid of injections?

A: For children who are fearful of an injection, the nasal spray flu vaccine is an option. Otherwise, it's just like any other vaccination, and it may help if the pediatrician has good distraction techniques.