Q. What are the recommendations this year for flu vaccines for kids?

A. "There are some updates for this year's flu season," says Dr. Roya Samuels of the division of general pediatrics at Cohen Children's Medical Center in New Hyde Park. Vaccination is still recommended for ages 6 months and older, and it's still recommended kids get the vaccine in early fall.

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But here are the changes:

The annual vaccine still protects against three strains of flu -- H1N1, known as swine flu, influenza A and influenza B. But the composition of the influenza A and B viruses has changed, and this year's vaccine protects against those mutations, Samuels says. "From year to year, we see changes in which strains are more prominent."

This year, the American Academy of Pediatrics is recommending two vaccines administered four to six weeks apart for kids ages 6 months to 8 years who haven't received a flu vaccine since July 1, 2010. That's because the H1N1 portion of the vaccine only started to be included after July 1, 2010, and research has shown a booster is needed to provide adequate H1N1 protection in that age group, Samuels says. If your child received the first vaccine after July 1, 2010, or is 9 or older, only one dose is needed.

There are still two versions of the vaccine, the shot or the nasal spray. Both are considered safe, but nasal spray isn't recommended for kids younger than 2 or kids with asthma or a weakened immune system, Samuels says.