It may still feel like summer for a few more weeks, but a warning has already been issued about the upcoming flu season.

This week, the American Academy of Pediatrics (AAP) released flu vaccine recommendations for the 2018-2019 flu season that advise all children ages six months and older receive a flu shot as soon as it becomes available, and no later than the end of October.

They also recommend the injectable flu vaccine be used as the first choice for children rather than the nasal spray vaccine, which has not provided consistent protection against all strains of the flu virus in past years, per the AAP. The nasal spray has limitations on who can use it, and due to unclear effectiveness, especially against influenza A, the injectable form is preferred.

“The very best defense against the flu is the annual flu vaccination, and the sooner your child is vaccinated, the sooner they will be protected,” says Dr. Shrinal Vyas, a pediatrician at Advocate Children’s Hospital.

Statistics from the Centers for Disease Control and Prevention (CDC) are a sad reminder of what can happen when children are not vaccinated. Last flu season, 180 children died of flu-related deaths, and thousands more were hospitalized. The CDC reports that about 80 percent of children who died had not been vaccinated.

“Vaccine side effects, like soreness, redness or swelling, far outweigh the risks,” explains Dr. Vyas. “The flu virus can cause serious complications in children, especially those who are younger than five or those with chronic conditions, like asthma or diabetes. Being immunized will protect kids from a serious illness that could lead to hospitalization or even death.”

The flu vaccine also protects others who are too young or too sick to receive a vaccine themselves, adds Dr. Vyas.

This year’s guidelines also include the following: