Logan Yates, 2, is comforted by his mother Jenny while getting a flu shot and a Hepatitis B shot. (Enquirer photo/Michael E. Keating)

Last year's outbreak came early and hit its youngest victims with particular force, causing 152 flu-related deaths among children, most under 5, according to the U.S. Centers for Disease Control and Prevention.

Seven of these deaths were in Ohio; Kentucky did not report any.

The new guidelines, issued this summer, might spark a frenzy of activity at Greater Cincinnati pediatric offices. October and November are the best times to get vaccinated. Children under age 9 receiving the flu vaccine for the first time will need two doses, one month apart.

Another decision for parents

But some parents might feel uncomfortable exposing their young children to a vaccine that is not part of the routine immunization schedule.

"I thought, gee, he's really young, and I don't know if he should be getting this or not. It sort of made me nervous," said Beth Noeth of Delhi Township, who had her 9-month-old son, Zachary, vaccinated last week.

"But I trusted my doctor's advice. I figured, why risk him (Zachary) getting the flu?"

Tuesday, U.S. health officials said there could be a significant flu shot shortage because British authorities suspended the license of Chiron Corp., maker of half of the vaccine supplied to the U.S. But priority will be given to children 6 to 23 months, along with those over 65, because they are at high risk for complications from the flu, officials said.

Zachary Noeth's pediatrician, Dr. Thomas Maloney at Group Health Associates' Western Hills Pediatric Practice, said he ordered his supply early and has 1,000 doses in stock.

Most of the parents he's spoken with agreed to have their young children get a flu shot. Some, though, have opted to go without because of misconceptions about the vaccine, he said, and its side effects, such as a low-grade fever and swelling where the shot was given.

"I just think getting the flu shot is a very reasonable thing to do," Maloney said. "Flu-related deaths in this young age group are rare, but they do occur."

Jenny Yates opted to have her 2-year-old son, Logan, vaccinated Tuesday, even though he's just out of the new "at risk" category.

"If he were to get the flu, I'd feel bad knowing that there was something I could have done to prevent it," said Yates, 32, of Miami Heights.

More than a nuisance

Dr. David Bernstein, an infectious-disease expert at Cincinnati Children's Hospital Medical Center, said too many parents - even some pediatricians - think of the flu as a type of cold or a "nuisance disease."

But influenza is a specific and serious disease, Bernstein said. Children 2 years of age and younger have hospitalization rates second only to people 65 years and older.

The flu season typically runs between November and February.

N.Ky. flu clinics

This month, the Northern Kentucky Health District began mass-mailing all of its 150 licensed child-care centers and in-home providers with information on upcoming flu clinics where workers and parents can get immunized.

The CDC began moving toward its new guidelines even before this summer. Two studies published in 2000 showed the same results: that otherwise healthy children under 2 years old were more likely to be hospitalized for serious influenza complications than older, healthy children.

Only 4.4 percent of children in the 6- to 23-month age range were fully vaccinated against influenza last year, the agency said. The flu shot is not approved for use in children younger than 6 months old.

20 cases last year

Last year, Cincinnati Children's had 20 children from Hamilton County ages 6 to 23 months hospitalized with the flu, spokesman Jim Feurer said.

There were more cases than that, but the medical center's flu surveillance system tracks Hamilton County children only, Feurer said.

In the next few years, experts say, flu vaccine recommendations might be expanded to include everyone.

"The movement for universal immunization is interesting because there's a lot of data suggesting that attack rates are high for school-age children, which is a major factor in bringing the flu home to mom, dad, grandma and grandpa," Bernstein said.

Flu primer

The U.S. Centers for Disease Control and Prevention recommends a flu shot for those at high risk for complications from the flu - people 65 and older, children 6 to 23 months of age, and adults and children who have weakened immune systems.

Still, many people go without, leading to illness, complications and an average of 36,000 U.S. deaths each year. In the last two decades, flu-related hospitalizations have increased from 114,000 to more than 200,000 annually.

What is influenza (flu)?

Influenza, commonly called "the flu," is caused by the influenza virus, which infects the respiratory tract (nose, throat, lungs). Unlike many other viral respiratory infections, such as the common cold, the flu causes severe illness and life-threatening complications in many people.

What are the symptoms of influenza?

Typical influenza disease is characterized by abrupt onset of fever, aching muscles, sore throat, and non-productive cough. Additional symptoms may include runny nose, headache, a burning sensation in the chest, eye pain and sensitivity to light.

Why do I need to get vaccinated against the flu every year?

Flu viruses change from year to year. The vaccine typically contains three inactive strains of influenza. This year, those included are Type A Fujian, Type A New Caledonia and Type B Shanghai.

What is the availability of this year's flu vaccine?

The CDC anticipated a record 100 million doses to be distributed in the United States, 13 million more than last year. But Tuesday, U.S. health officials warned of major flu shot shortages after British health officials abruptly pulled the license of the maker of half the U.S. vaccine. American vaccine experts suggested shots this year would likely be rationed.

When should I get a flu shot?

The best time is in the fall.

Where can I get a flu shot?

Contact your doctor's office. Walgreens pharmacies are now offering it. Public vaccination clinics in Greater Cincinnati and Northern Kentucky are expected to begin in late October. For additional clinics and more information, call (513) 931-SHOT.

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E-mail mleingang@enquirer.com