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Influenza and Children

Flu can be serious for kids — annual vaccination offers the best protection.

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Key Summary

  • What it is: Influenza (flu) is a contagious viral illness. Children often have the same symptoms as adults — fever, cough, sore throat, runny nose, headache, fatigue, and muscle aches — but may also get vomiting and diarrhoea.
  • How serious it is: Children under 5 are at higher risk of hospitalisation and complications. In 2024, over 2,300 children were hospitalised in Australia, almost half under 5 years old. Some required intensive care, and several deaths occur each year.
  • How it spreads: Flu spreads easily in schools and childcare centres; children can pass on the virus for up to 2 weeks, longer than adults.
  • Prevention:
    • Annual flu vaccination is the best protection — free under the National Immunisation Program for children aged 6 months to under 5 years.
    • Vaccination also recommended for all children over 5 years.
    • Good hygiene (handwashing, covering coughs/sneezes) helps but is harder for young children to follow.
  • Treatment: Rest, fluids, and fever relief at home for most cases. Antiviral medicines may reduce severity if given early — see a GP as soon as symptoms start.

Symptoms of influenza in children?

Children with influenza (commonly known as ‘the flu’) usually show many of the same symptoms as adults. Common flu symptoms include:

  • Fever (often with chills)
  • Cough
  • Sore throat
  • Sneezing and a stuffy or runny nose
  • Tiredness (fatigue)
  • Headache
  • Muscle aches and joint pains 1-3

These typical symptoms often come on suddenly and can make a child feel very unwell1-3​.

Additional Symptoms in Children

Children may also experience gastrointestinal symptoms that are less common in adults, such as nausea, vomiting, and diarrhoea1,3. These symptoms can contribute to dehydration and added discomfort, so it’s important for caregivers to monitor children carefully during illness.

How serious is seasonal influenza for children?

Influenza is a significant cause of illness and hospitalisation in young children in Australia. Infants and children aged under 5 years are at a higher risk of hospitalisation and complications compared to older children, regardless of whether they have pre-existing medical conditions4 – 8.

In 2024, children aged under 5 years had the highest influenza notification rate of any age group, with 50,000 laboratory-confirmed cases—a rate of 3,314 cases per 100,000 population9.

Influenza is one of the most common vaccine-preventable causes of hospitalisation in this age group. In fact, children under 5 years and adults aged 65 years and over experience the highest rates of influenza-related hospitalisation4, 10 – 12. 

In 20249:

  • 2,329 children aged 16 years or younger were hospitalised with influenza
  • The majority of these children were aged 6 months to 4 years (46%)
  • 4.6% of hospitalised children required direct admission to intensive care
  • Tragically, six children died due to influenza-related complications, a mortality rate consistent with previous years (approx 0.3%)

Children also play a substantial role in the transmission of influenza within the community. The virus is typically incubated for about 2 days (range 1–4 days), and children can shed the virus for up to 2 weeks – much longer than adults, who usually shed the virus for about 3–5 days after illness13. Their higher infection rates and close contact in settings like schools and childcare centres facilitate the spread of the virus to other age groups.

Importantly, Aboriginal and Torres Strait Islander people experience a greater burden of disease from influenza than non-Indigenous Australians across all age groups4.

How can you reduce a child’s risk of catching influenza?

Annual influenza vaccination is the most effective way to protect children against influenza and its complications

In Australia, the influenza vaccine is funded under the National Immunisation Program (NIP) for all children aged 6 months to under 5 years. Influenza vaccination is part of the government’s Childhood Immunisation Program and is especially recommended for this age group. Australia aims for 95% of children to receive all vaccines under the NIP Schedule. All of the immunisations are scheduled according to your child’s age and medical risk.

Despite the availability of free influenza vaccines for children aged six months to under five years through the NIP, vaccination uptake remains low. In 2024, only 27.6% of children in this age group received the influenza vaccine14. This low coverage leaves many young children unprotected against the virus.

Importantly, children of all ages benefit from annual influenza vaccination and not just those eligible for free vaccines under the NIP. Influenza can cause significant illness in older children as well, including high fever, fatigue, and complications such as pneumonia. The vaccine can be administered by your GP and, for children aged 5 years and older, it may also be available at community pharmacies.

From April through to June is the best time to vaccinate as this is during the early stages of the flu season15. However, it is never too late to get vaccinated and may well extend into September.

Hand washing and personal hygiene, such as trying not to touch your mouth or nose are also important preventative measures, however, these are less likely to be practised by children.

Where possible, avoid crowds when influenza is prevalent; again this is unlikely to be achieved with children attending day care, kindergarten or school.

Note: In controlled clinical trials remedies such as vitamin C and Echinacea have failed to show any benefit in preventing influenza.

Which children should be vaccinated against influenza?

Annual influenza vaccination is recommended for all individuals aged 6 months and older, including children, to reduce the risk of infection and serious complications.

Children at Higher Risk

While influenza vaccination is beneficial for all children, it is especially important for those at increased risk of severe illness or complications, including children with16:

  • Chronic heart conditions
  • Chronic respiratory conditions such as asthma or bronchopulmonary dysplasia
  • Type 1 or type 2 diabetes
  • Chronic kidney disease
  • Conditions that result in immunocompromise, whether due to disease or medical treatment
  • Neurological conditions, such as cerebral palsy or epilepsy
  • Children with disabilities, particularly those requiring frequent medical intervention or who are at risk of aspiration

Children with these conditions are eligible for a free annual influenza vaccine under the NIP.

Protecting Infants and Others

Influenza vaccination is strongly recommended during pregnancy, including in the first trimester. Vaccination during pregnancy not only protects the parent but also provides passive immunity to the newborn in the first months of life—when infants are too young to be vaccinated themselves17.

Close contacts of at-risk individuals, including parents, siblings, carers, and household members, are also encouraged to receive the influenza vaccine to help prevent transmission.

Healthy Children

Even if your child is healthy, influenza can still cause severe illness. Many hospitalisations occur in children with no underlying conditions4 – 8. Vaccination for healthy children aged 6 months and over is within current national guidelines and can be arranged through your GP, and for children aged 5 years and older, at participating pharmacies.

What can parents do if their child falls ill with influenza?

Influenza is highly contagious and children can spread the virus for up to 2 weeks – much longer than adults, who usually shed the virus for about 3–5 days after illness13.

Ways to avoid spreading influenza include:

  • Wash hands regularly
  • Cover nose and mouth when coughing or sneezing
  • Avoid physical contact with others
  • Avoid mixing with other people, particularly those in a high-risk category, while contagious
  • Don’t return children to child care early, as they could still be contagious

Antiviral medications (including paediatric formulations) that can limit the progression of influenza if they are taken early after onset of symptoms (within the first two days of the illness) are available on prescription. Take your child to your GP as soon as they start to display flu symptoms. 

References

  1. Australian Technical Advisory Group on Immunisation (ATAGI). Influenza (flu): Women who are pregnant or breastfeeding [Internet]. Canberra: Australian Government Department of Health and Aged Care; 2024 [cited 2025 May 8]. Available from: https://immunisationhandbook.health.gov.au/contents/vaccine-preventable-diseases/influenza-flu#women-who-are-pregnant-or-breastfeeding
  2. Healthdirect Australia. Flu (influenza) [Internet]. Canberra: Healthdirect; 2024 Apr [cited 2025 Mar 25]. Available from: https://www.healthdirect.gov.au/flu
  3. NSW Health. Influenza – information for families and young children [Internet]. Sydney: NSW Government; 2023 Jun 20 [cited 2025 Mar 25]. Available from: https://www.health.nsw.gov.au/Infectious/Influenza/Pages/families_and_individuals.aspx
  4. The Royal Children’s Hospital Melbourne. Influenza (the flu) – Kids Health Info [Internet]. Melbourne: RCH; 2024 May [cited 2025 Mar 25]. Available from: https://www.rch.org.au/kidsinfo/fact_sheets/influenza_the_flu/
  5. Li-Kim-Moy J, Yin JK, Blyth CC, et al. Influenza hospitalizations in Australian children. Epidemiology and Infection 2017;145:1451-60.
  6. Li-Kim-Moy J, Yin JK, Patel C, et al. Australian vaccine preventable disease epidemiological review series: influenza 2006 to 2015. Communicable Diseases Intelligence 2016;40:E482-95.
  7. Izurieta HS, Thompson WW, Kramarz P, et al. Influenza and the rates of hospitalization for respiratory disease among infants and young children. New England Journal of Medicine 2000;342:232-9.
  8. Coffin SE, Zaoutis TE, Rosenquist AB, et al. Incidence, complications, and risk factors for prolonged stay in children hospitalized with community-acquired influenza. Pediatrics 2007;119:740-8.
  9. Ampofo K, Gesteland PH, Bender J, et al. Epidemiology, complications, and cost of hospitalization in children with laboratory-confirmed influenza infection. Pediatrics 2006;118:2409-17.
  10. Australian Centre for Disease Control. 2024 Annual Australian Respiratory Surveillance Report. Canberra: Australian Government Department of Health and Aged Care; 2025. Available from: https://www.health.gov.au/resources/publications/annual-australian-respiratory-surveillance-report-2024
  11. Thompson WW, Shay DK, Weintraub E, et al. Influenza-associated hospitalizations in the United States. JAMA 2004;292:1333-40.
  12. Chiu C, Dey A, Wang H, et al. Vaccine preventable diseases in Australia, 2005 to 2007. Communicable Diseases Intelligence 2010;34 Suppl:ix-S167
  13. Poehling KA, Edwards KM, Weinberg GA, et al. The underrecognized burden of influenza in young children. New England Journal of Medicine 2006;355:31-40
  14. Bresee JS, Fry AM, Sambhara S, Cox NJ. Inactivated influenza vaccines. In: Plotkin SA, Orenstein WA, Offit PA, Edwards KM, eds. Plotkin’s vaccines. 7th ed. Philadelphia, PA: Elsevier; 2018.
  15. National Centre for Immunisation Research and Surveillance (NCIRS). All persons 2020–2025 YTD influenza vaccination coverage [Internet]. Sydney: NCIRS; 2025 [cited 2025 May 8]. Available from: https://ncirs.org.au/influenza-vaccination-coverage-data/all-persons-2020-2025-ytd-influenza-vaccination-coverage
  16. Victoria State Government – Department of Health. Seasonal influenza vaccine [Internet]. Melbourne: Victorian Government; 2024 [cited 2025 Feb 27]. Available from: https://www.health.vic.gov.au/immunisation/seasonal-influenza-vaccine
  17. Australian Technical Advisory Group on Immunisation (ATAGI). Influenza (flu): People with medical conditions that increase their risk of influenza [Internet]. Canberra: Australian Government Department of Health and Aged Care; 2024 [cited 2025 May 8]. Available from: https://immunisationhandbook.health.gov.au/contents/vaccine-preventable-diseases/influenza-flu#people-with-medical-conditions-that-increase-their-risk-of-influenza