Flu vaccine 2019-2020

flu vaccine 2019-2020

Excited for his Germ Fighters, this kiddo wears his “Vaccines save, bro” shirt for all of his pediatric office vaccine visits.

The US flu vaccine 2019-2020 is here!

Who should get it?

Unless medically contraindicated, all kids aged six months and older should get the flu vaccine. Your child’s pediatrician will ask you questions to be sure the flu vaccine is appropriate for your child.

Is the flu vaccine different this year from last year?

Yes, so even if your child received a flu vaccine last year, they should get another one this year.  The predicted flu strains change yearly so manufacturers make up a new batch of flu vaccines every year.

Which flu vaccine should they get- the shot or the-spray-in-the-nose kind?

All kids can get the shot. Kids two years and older without certain other medical conditions can get the nose spray. If your child is eligible for both, then the best type to get is the one that is available- they are both effective.

When should they get the flu vaccine?

The goal is to be completely immunized for this year’s flu season by Halloween- the end of October. When it comes to the flu vaccine, “better late than never” also holds true. It is impossible to predict precisely when the flu will hit and how long it will circulate. So even if it’s mid winter, get the vaccine if it is still available.

How many doses do they need?

If your child is under the age of nine years and never had a flu vaccine or had only one prior dose of flu vaccine before the date of June 30, 2019, then they need two doses separated by a minimum of four weeks. All other kids need one dose only every year.

What are the common side effects of the flu vaccine?

The injectable brands of flu vaccine, like all shots, can cause mild symptoms such as soreness or redness in the body area where a child gets the shot, fever, or fatigue. The nasal spray version can cause some nasal congestion, sore throat, fever, and muscle aches.

Can any flu vaccine cause the flu?


You can read a summary about the nasal spray form of the flu vaccine here and well as the injectable form of the flu vaccine here. Both of these Vaccine Information Statements expand on all of the above points.  

Still on the fence about flu vaccine 2019-2020?

Last year, 116 children in the US died from the flu, and almost half of these children were previously healthy kids. The average age of death was six years. Of those who died and COULD have received flu vaccine- meaning the ones that were older than 6 months of age, 70% did NOT receive the flu vaccine. So flu vaccine might have averted more than half of these flu deaths.

Additionally, of children last year in the hospital with flu, the majority did NOT receive flu vaccine. The flu killed thousands of adults last year.  School-aged children are the group most likely to spread the flu germs. Therefore, flu vaccine not only can protect your children and those too young or too ill to be vaccinated, but also protects your children’s grandparents.

Click here for an exhaustive review of the American Academy of Pediatrics recommendations for this year’s flu season. We hoped to provide you all with the most important highlights. You can read our flu vaccine myth-busters here.

Julie Kardos, MD and Naline Lai, MD
©2019 Two Peds in a Pod®


Treating fever: some like it hot!

fever in childrenWhile most of us enjoy back-to-school night, we do NOT enjoy back-to-school fever. Here is our guide for evaluating and treating fever in your child.

Julie Kardos, MD and Naline Lai, MD

©2019 Two Peds in a Pod®


School avoidance: Why won’t my child go to school?

prevent school avoidance

Happily hopping off to school — image by Sasin Tipchai from Pixabay

Do you recognize these school avoidance scenarios?

  • Your child feels sick every school-day morning, but not on weekends. 
  • Your kid outright refuses to get on the bus or into your car on school mornings. 
  • After witnessing another kid throwing up in school, your kid refuses to go back to school in fear that they might throw up in school. 
  • Beginning with the second or third day of school, your child says it doesn’t “feel right” to be away from mom or dad for the day. 
  • Your middle schooler or high schooler gets ready for school and then feels too tired to actually leave the house. They go back to sleep for several hours and that convinces you and them that they needed to stay home and rest. 

It can happen at any age, in any grade. School avoidance is the older kid version of daycare separation anxiety.

Before getting into the why’s of school avoidance, let’s jump to the most important part of how to treat school avoidance: While it may feel difficult for you and cause tears to flow, you need to get your school-avoiding child BACK TO SCHOOL!

All other treatment modalities and all other issues can be dealt with while your child continues to attend school. The longer you let your child stay home, the more difficult it will be for them to return to school.

Can there be legit reasons that your child avoids going to school? Of course! Think about the following factors that might come into play: Continue Reading


All cleaned up!

All cleaned up!

All cleaned up! Someone hacked into our blog and inserted links to ads without our knowledge and certainly without our endorsement.

We combed through ALL of our blog posts and removed all links to ads, and we added some security to our site. You will note that while we link to our own prior posts and to scholarly sources, we do not advertise on our blog and we do not insert links that endorse any particular products.

Thanks for your patience while we cleaned up !

Julie Kardos, MD and Naline Lai, MD
©2019 Two Peds in a Pod®



We really, really don’t like any type of virus

website hacked

We are cranky.

Oh no! Unfortunately, it looks like someone or some robot has inserted links into our old blog posts. Please be extra careful when reading a sentence which contains a link. We may not posting for a bit while we solve this problem.

This shows, yet again, how much we dislike viruses.

Thank you all for supporting us.

Julie Kardos, MD and Naline Lai, MD
©2019 Two Peds in a Pod®


Pack your child a healthy lunch

healthy lunchWondering how to pack your child a healthy lunch for school this year? Our friend and colleague, Dr. Roxanne Sukol, gives some wonderful suggestions in this post.

Julie Kardos, MD and Naline Lai, MD
©2019 Two Peds in a Pod®


Photo quiz: what causes brown spots on feet?

brown spots on feetWhat causes brown spots on feet? In the summer, we see kids with these spots on their feet or hands. Read on for the answer behind the mysterious spots.

Every child with a lemonade stand hopes for hot sunny days to drive in customers. But if your kids squeeze fresh lemons for their stand, make sure they wash their hands after squeezing the lemons. Otherwise, after a sunny day, your child’s hands may turn out looking like this kid’s feet. The juice of some fruits or plants will cause a dark discoloration of the skin if exposed to sunlight.

This reaction, called phytophotodermatitis, usually starts a day after the juice comes into contact with the skin. Redness and mild blistering eventually leads to a discoloration, like those brown spots on feet, which can that can last for months. Citrus fruits are the most common culprits, but wild parsnip, wild dill, wild parsley and buttercups also cause the photosensitivity. Often the initial redness and blistering is missed. The kid in the photo was walking in bare feet on leaves near an apple tree. So now you can tell your kids not to walk barefoot outside to prevent stepping on a bee, to prevent contracting poison ivy, and to prevent phytophotodermatitis!

Makes you think about holding off on fresh lemons and using powdered lemonade mix…almost.

Naline Lai, MD and Julie Kardos, MD
©2014, 2019 Two Peds in a Pod®


Holy Cannoli, Two Peds in a Pod® turns ten!


Two Peds in a Pod® turns 10 years old

This little ten-month-old wishes Two Peds in a Pod® a happy ten-YEAR-old birthday!

Let’s take a stroll back ten years to 2009. Ten years ago Facebook was just five years old. Back then there was no Instagram (2010), no Pinterest (2010), no Snapchat (2011).  People were mesmerized by virtual vegetable picking (FarmVille) and taking care of Zhu Zhu pets. Bulky video gaming consoles ruled. The “New” Super Mario Bros. Wii really was “new.” Apple’s “pile of poo” emoji had just arrived the year before. And ten years ago, Two Peds in a Pod® was born. The idea that doctors would write advice on the internet was so novel that even NPR thought the concept worthy of a story. Today we take a Happy Birthday look back at our first five posts:

Then and now

Our blog’s first five posts, from the summer of 2009, include the very same topics parents ask us about now in the summer of 2019. 

Back then parents wondered about infant sleep, or lack thereof. Please note that we began our infant sleep podcast with the reminder that newborns are not meant to sleep through the night. Fisher Price should have listened to our podcast, because now in 2019 we are writing about rock‘ n play recalls

Two posts tackled  Potty training and picky eating. Spoiler to both posts: you can lead a horse to water but you can’t make him drink!These days, we’re still talking about both topics in the office. But now, people also ask about the need for probiotics to regulate bowels and digestive health in their child. Unfortunately, in 2019 probiotics have not panned out to be the hoped-for panacea for all gastrointestinal ailments. But they are helpful in some types of diarrhea

In 2019 we talked about the tick borne illness Lyme disease and we’re still talking about ticks now. As for the  mystery object Dr. Lai found in a drawer, ten years later the models are kinder and sport a raised lip instead of a contraption that can break off. 

Blog writing a decade later

Internet traffic has grown exponentially. Possibly because of so many sources of misinformation, we see more and anxious parents who receive conflicting information about how to raise their kids. We depend on you to let your friends know about this site. We would rather spend more time on writing than on search engine optimization. Despite the congested writing climate, our mission (read our maiden voyage) remains the same, to bring you practical pediatric advice. What fuels us? Our intense and comprehensive pediatric training from Children’s Hospital of Philadelphia, our combined over forty years of practicing pediatrics, and our passion for helping children and their families, give us the experience and the motivation to continue to help all of you whether online or in our offices.

A last blast from the past

How many of you remember our initial logo penned by the combined efforts of Dr. Kardos’s brother and her sister-in-law? That’s an iPod dangling from Dr. Lai’s neck-remember those?

two peds in a pod original icon

It’s good to be ten.

Julie Kardos, MD and Naline Lai, MD
©2019 Two Peds in a Pod®