“It’s not like the viruses are smart and sit back and say, 'How can I change this year?'” explains Stephen Aronoff, M.D., chair and professor of pediatrics at Temple University School of Medicine and Hospital. “We’re just talking about random mutational events and when you consider the infinite number of viral particles out there, it’s not surprising that you can get a mutation that just randomly imparts a competitive advantage to that virus.”

For scientists, figuring out which three influenza strains to vaccinate against each year is a bit of a guessing game. Get it wrong and that can mean empty classrooms and full emergency rooms or doctor’s offices. That’s why the Centers for Disease Control and Prevention expanded the recommendation list for those kids who should get flu shots.

Previously, the vaccine was only recommended for high-risk kids and preschool children with weaker immune systems, but after seeing the dramatic rise in cases, the CDC says there is enough reason for parents to protect healthy kids, too, ages six months to 18 years old.

“I think a lot of parents are concerned that this is one more shot their child needs to get,” says Aronoff. “They think influenza is just a cold. It’s not. It’s significantly different in kids and has been associated with pneumonia and brain infections. It is an essential shot because younger children are at greater risk for getting sick and seeing a doctor or requiring hospitalization.”

Aronoff also stresses that kids up to eight years old who have not been previously vaccinated need two flu shots, at least four weeks apart. He wants parents to remember to take their children back for that second injection; otherwise they aren’t truly protecting their children from the flu.

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