Flu vaccinations for children - everything you need to know

Flu can cause serious complications such as bronchitis and pneumonia. Children under the age of five are more likely to be admitted to hospital with flu than any other age group so it’s worth getting them vaccinated, however fit and healthy they are.

If you are the parent or carer of children aged between two and eight you should have received an invitation to have them vaccinated with the free flu nasal spray, either from their GP or from their school.

If your child hasn’t received theirs, ask at their GP surgery if they are aged two or three (born between 1 September 2013 and 31 August 2015). Children in reception class and up to primary year four should have received a permission slip from their school. If you have not been sent one please check with their school.

What are the symptoms of flu in children?

Children suffer from the same symptoms of flu as adults. And if you’ve had it, you’ll know it can be a miserable experience. Flu is not the same as a cold and can be quite debilitating. Signs of flu include:

a sudden fever – a temperature of 38C (100.4F) or above
a dry, chesty cough
a headache
tiredness and weakness
chills
aching muscles
limb or joint pain
diarrhoea or abdominal (tummy) pain
nausea and vomiting
a sore throat
a runny or blocked nose
sneezing
loss of appetite
difficulty sleeping

What is the children's flu vaccine and how is it administered?

Children aged two years and over are given a nasal spray flu vaccine called Fluenz Tetra – so no needles, just a quick spray up each nostril. It is easy, fast and painless and administered by a healthcare professional either at a GP surgery or in a primary school. The nasal spray is not licensed for use in children under two years old.

Some children who have certain health conditions are at higher risk of complications from flu and should be vaccinated from six months. If they are under two years old your GP will recommend the injected vaccine. You should always discuss this with your healthcare provider.

Should my child have the flu vaccine?

The choice of whether to have your child vaccinated is up to you. However, even healthy children can get flu and suffer from very unpleasant symptoms.

Children are big spreaders of flu – we all know how delightfully snotty they are, as well as how thrilled they are at the prospect of practising proper handwashing. So protecting your child against flu can also benefit the rest of your family. It can also help stop passing flu on to those babies who are too young to have the flu vaccine, but are at the highest risk of complications from flu and other vulnerable people like grandparents or people who may have a long term health condition.

Does the flu vaccine work?

Last winter’s nasal spray vaccine reduced influenza among eligible children by 65.8%. The flu vaccine will help prevent your child from getting flu. It won’t stop all flu viruses and the level of protection may vary. If your child does get flu despite having been vaccinated, then it will likely be milder and last for less time than it would have been without vaccination.

Can my child have the flu vaccine on the NHS?

Yes, all children aged two years to eight years are eligible for the free flu nasal spray vaccination. Children between six months and under two years who have certain health conditions can also have a free flu vaccination – just ask their GP.

In the autumn/winter of 2017-18, the vaccine will be available free on the NHS for eligible children, including:

children aged two and three on 31 August 2017 – that is, children born between 1 September 2013 and 31 August 2015
children in reception class and school years one, two, three and four
in some parts of the country, all primary school-aged children will be offered the vaccine (following a pilot in some areas)
all children (and adults) with a long-term health condition

If your child is four years old, but not yet in school, they are eligible to receive the flu vaccination at their GP if they were three on 31 August 2017. Four-year-old children who are home schooled or who will begin school in January are still eligible for the flu vaccination. The local healthcare team providing the service for school children is responsible for making alternative arrangements. These plans vary depending on the area, and you should contact your local Screening and Immunisation team, to find out the details. Over the next few years, the free flu vaccine programme will gradually be extended to include all primary school children. Find out more on the NHS website.

What if my child is ill when they are due to have the flu nasal spray?

If your child is due to have the nasal spray and they have a cold or blocked nose at the time, they may be recommended to have the spray when they have recovered. A cold can stop the vaccine from being absorbed properly and compromise its efficacy. But if your child has been wheezy in the week leading up to the vaccine, then the vaccine should be delayed until they’ve been wheeze-free for at least three days.

Are there any side effects from the flu vaccine?

As with any medicine, the flu nasal spray can cause side effects, particularly in the few days immediately after vaccination. Serious side effects are uncommon.

Children may develop a runny or blocked nose, headache, general tiredness and some loss of appetite. This may last a few days. The side effects are much less serious than developing flu or complications associated with flu. The vaccine is absorbed quickly in the nose so, even if your child sneezes immediately after having had the spray, there’s no need to worry that it hasn’t worked.

A full list of possible side effects and their likelihood is available on the NHS website.

Is the nasal spray vaccine suitable for my child?

The nasal spray vaccine is fine for most children unless they have:

A severely weakened immune system
A severe egg allergy (jump link to below section)
Severe asthma (those being treated with steroid tablets or high-dose inhaled steroids)
An allergy to any of the vaccine ingredients

If you have any concerns you should always ask your GP.

My child has a severe allergy to eggs – can they still have it?

Although the flu nasal spray vaccine is grown in fertilised hens' eggs, studies show that there is no significant risk to children who may have an allergy to eggs. However, you should always inform your healthcare provider if your child has an egg allergy and discuss this with them.

Does the flu vaccine have mercury in it?

All childhood vaccines are mercury-free, which includes the nasal flu vaccine. All ingredients in the flu vaccine are safe.

How many doses of the flu vaccine does my child need?

The NHS vaccination programme advises that healthy children only need one dose of the nasal spray (one dose is one spray in each nostril).

Two doses may be required if your child is aged from two to nine years AND:

They’re at increased risk of flu
They have an underlying medical condition
They’ve not been vaccinated against flu before

Is the flu vaccine thoroughly tested?

All vaccines go through a stringent testing process and the flu vaccine is no exception.

The vaccine is adjusted almost every year to protect against that years predicted strains and to optimise its effectiveness, without impacting the overall safety of the vaccine. Vaccine safety is monitored continuously; any potential problems would be rapidly assessed and prompt action taken to minimise any risks to people. Longer-term-onset side effects have not been reported from the flu vaccine. Fluenz Tetra has been used safely for over 10 years.

Any other questions?

If you need more information about the childhood flu vaccination programme go to the NHS website.

Are you pregnant?

There is good evidence that pregnant women have a higher chance of developing complications if they get flu, particularly in the later stages of pregnancy. The flu jab will help protect you and your baby.