At Loma Linda University Children’s Hospital, pediatricians are bracing for what’s shaping up to be another intense respiratory season. Sabiha Kanchwala, MD, medical director of vaccines, says flu activity is already picking up, and families shouldn’t wait to protect their kids.
“It’s definitely the start of flu season,” she said. “We’re seeing children test positive, and with the holidays coming up, we want to make sure everyone who can get the flu vaccine gets it.”
This year, she added, feels familiar: “Every year I say it’s a really bad flu season, this year is no different. We’re just at the start of it.”
Flu, RSV, Rhinovirus, COVID, all circulating at once
In clinic, Kanchwala is seeing a broad mix of viruses.
“Rhinovirus is everywhere right now. We’re also seeing parainfluenza, non-COVID coronaviruses, and COVID, and we’re at the start of RSV season.”
For infants, LLUCH is offering nirsevimab, an antibody injection that protects babies 0 to 8 months old during RSV season, October through March. While it isn’t technically a vaccine, Kanchwala said it functions similarly by offering months of protection during a child’s first vulnerable winter.
Pregnant patients delivering during RSV season may also be eligible for a true RSV vaccine to protect both mother and baby.
Should kids receive multiple shots during the same visit?
Parents often worry about overwhelming their child with several shots at once. Kanchwala reassures them it’s okay.
“They can get everything at the same visit, routine immunizations, RSV, flu, and COVID,” she said. “The kids will cry whether they get one shot or four. It’s usually harder on the parents.”
A new flu strain is raising concern
One flu subtype, H3N2, is drawing attention after early reports suggested this year’s flu shot may not be a perfect match.
“The vaccine may not be an exact match, but you still get some protection. It’s not a complete loss,” said Kanchwala.
While both Flu A and Flu B can cause severe illness, early data suggest the circulating H3N2 variant may cause more severe symptoms in some children. The flu typically brings fever, body aches, cough, headache, and fatigue, and young children can also experience vomiting or diarrhea.
Her advice remains the same: “Still get the flu vaccine. It helps prevent severe illness.”
Why kids seem sick all winter
This time of year, many families worry that their child will move from one cold straight into another. Kanchwala says it’s not in their imagination.
“Cold and flu viruses are everywhere right now,” she said. “Sometimes a child is already at the start of a cold when they come in for a flu shot, and parents assume the vaccine caused it. It didn’t, it’s just timing.”
The injectable flu vaccine, she emphasized, cannot cause the flu.
“You might feel under the weather for a day or two, but that’s your immune system doing exactly what it should,” she said.
When to call the doctor
Parents can handle most cold and flu symptoms at home, but Kanchwala says a few red flags warrant medical attention:
- Fever lasting more than 3–5 days
- Symptoms getting worse instead of better
- Signs of dehydration
- Lethargy or difficulty waking a child
- Fewer wet diapers in infants
“If anything feels off, it’s always okay to check in with your pediatrician,” she said.
Protecting the youngest family members during the holidays
Thanksgiving and Christmas gatherings can sometimes bring sick relatives into close contact with newborns. For young infants, especially those too young for flu or COVID vaccines, Kanchwala says, “If you have a baby under six months, the best protection comes from vaccinated adults around them,” she said. “If someone isn’t feeling well, it might be best for them to stay home.”
Travelers should also be cautious. “Airports can increase exposure. Parents should be extra mindful if they’re traveling with very young babies.”
COVID vaccines for kids newly available
Kanchwala said the updated COVID-19 vaccine is available at Loma Linda University Children’s Hospital.
“It’s available for patients six months and up,” she said. “Families can talk with their pediatrician about whether their child should get it.”
Her overarching message: don’t wait.
“Flu, RSV, COVID, they’re all here,” Kanchwala said. “Vaccines won’t prevent every illness, but they make a huge difference in keeping kids out of the Emergency Department.”
Families can schedule flu, COVID-19, or RSV appointments through their child’s pediatrician at Loma Linda University Children’s Hospital.
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