Vaccinations

Flu vaccine for children

In the autumn/winter of 2014/15 the annual nasal spray flu vaccine will be available for children aged two, three and four years old as part of the NHS childhood vaccination programme.

The vaccine will be offered routinely to all children aged two, three and four on September 1 2014. That is, children with a date of birth on or after September 2 2009 and on or before September 1 2012.

In some parts of the country all primary school-aged children and secondary school-aged children in years seven and eight will also be offered the vaccine as part of a pilot programme.

Over time, as the programme rolls out, potentially all children between the ages of two and 16 will be offered vaccination against flu each year with the nasal spray.

The nasal spray flu vaccine

The flu vaccine for children is given as a single dose of nasal spray squirted up each nostril. Not only is it needle-free (a big advantage for children), the nasal spray works even better than the injected flu vaccine with fewer side effects.

It’s quick and painless and will mean your child is less likely to become ill if they come into contact with the flu virus. Its brand name is Fluenz Tetra.

The nasal spray flu vaccine is also for children aged two to 18 who are "at risk" from flu, such as children with long-term health conditions. Some of these children will be offered two doses of the vaccine.

The injectable flu vaccine will continue to be offered to those aged 65 and over, pregnant women, carers and adults and babies (aged six months to two years) with a long-term medical condition.

Read more about which children are eligible for flu vaccination.

Why children are being offered a flu vaccine

Flu can be very unpleasant for children. They have the same symptoms as adults – including fever, chills, aching muscles, headache, stuffy nose, dry cough and sore throat lasting up to a week.

Some children develop a very high fever or complications of flu such as bronchitis, pneumonia and painful middle ear infection. They may need hospital treatment, and very occasionally a child may die from flu.

For children with long-term health conditions such as diabetes, asthma, heart disease or lung disease, getting flu can be very serious as they are more at risk of developing serious complications.

Read more about flu and the complications of flu.

Stopping the spread of flu

The nasal spray flu vaccine will not only help to protect your child from getting flu, it also stops the disease spreading from them to their family, carers and the wider population. This is known as herd immunity.

Watch a video explaining herd immunity.

Children are good at spreading flu, because they tend to sneeze everywhere and don't use tissues properly or wash their hands. Vaccinating them may also protect others that are vulnerable to flu such as babies, older people, pregnant women and people with serious long-term illnesses.

Read more about how flu is spread.

The flu vaccine for children is expected eventually to prevent at least 2,000 deaths from flu in the general population and lead to 11,000 fewer hospitalisations.

Children with long-term health conditions

Children with long-term health conditions are at extra risk from flu and it's especially important that they are vaccinated against flu each year.

Children at risk of flu are already offered an annual flu injection. As the nasal spray is more effective than the injected vaccine, children aged from two to 17 with long-term health conditions are now being offered the annual flu nasal spray instead of the injection.

Those children with long-term health conditions aged between six months and two years will continue to be offered the annual injectable flu vaccine.

Neither the nasal spray or the injectable flu vaccine are suitable for babies under the age of six months.

Pork in the children's flu vaccine

The Fluenz Tetra nasal spray contains a highly processed form of gelatine derived from pigs. Although certified as acceptable by some faith groups, including representatives from Jewish and Muslim communities, there is considerable diversity in the Muslim community, and some scholars from the majority Hanafi community in England have stated that porcine gelatine is not permissible. Some parents may want to balance the constraints of their faith against the benefits of vaccination. Read more about Fluenz and gelatine.

Are there children who shouldn't have the flu vaccine?

There are a few children who should avoid the nasal spray flu vaccine.

It’s not suitable for children who have:

  • a severely weakened immune system
  • egg allergy
  • severe asthma (children with mild or moderate asthma are able to have the flu nasal spray)
  • active wheezing at the time of vaccination 

Children unable to have the nasal spray vaccine may be able to have the flu injection instead.

Read more about which children should not have the flu vaccination.

How does the flu vaccine for children work?

The nasal spray vaccine contains flu viruses that have been weakened to stop them causing flu. It will help your child build up immunity to flu in a similar way as natural infection (but without the symptoms).

Because the main flu viruses change each year, a new nasal spray vaccine has to be given each year, in the same way as the injectable flu vaccine.

Fluenz Tetra works well in children and gives them good protection against catching flu. In fact, the nasal spray is more effective than the injected flu vaccine, especially in young children, which is why children are being routinely offered the nasal spray rather than the flu jab.

As the vaccine is absorbed very quickly, it will still work even if your child has a runny nose, sneezes or blows their nose straight after being vaccinated.

How many doses of the flu vaccine do children need?

Most children only need a single dose of the nasal spray.

The patient information leaflet provided with Fluenz Tetra suggests children should be given two doses of this vaccine if they've not had flu vaccine before. However, the NHS vaccination programme has advised that healthy children need only a single dose of Fluenz Tetra because a second dose of the vaccine provides little additional protection.

Children aged two to nine years at risk of flu because of an underlying medical condition who have not received flu vaccine before should have two doses of Fluenz Tetra (given at least four weeks apart).

How safe is the flu vaccine for children?

The flu vaccine for children has a very good safety profile. It’s been widely used in the US for more than 10 years and no safety concerns have been raised so far.

The vaccine contains live, but weakened, forms of flu virus that do not cause flu in children who receive it.

What are the side effects of the flu vaccine for children?

The nasal spray flu vaccine has very few side effects, the main one being that vaccinated children may have a runny nose for a short time.

Read more about the side effects of the flu vaccine for children.

This leaflet tells you the common vaccination reactions (PDF, 64.4kb) that may happen in babies and young children up to five years of age.

How to get the flu vaccine for your child

You’ll be automatically contacted by your GP or your child’s school in September/October 2014 about getting your child vaccinated before the winter. If you don’t hear anything, or you want more information about when and how your child will be vaccinated against flu, talk to your GP, practice nurse or your child’s school nurse.

Read the answers to some of the common questions that parents have about the flu vaccine for children.

Page last reviewed: 06/08/2014

Next review due: 06/08/2015

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The 22 comments posted are personal views. Any information they give has not been checked and may not be accurate.

shezzle said on 28 November 2014

My 2.5 year old daughter had her first flu vaccine on Monday (nasal) she was ok for a few hours the first day but has deteriorated rapidly all week. She has got awful flu symptoms, hasn't eaten properly since Tuesday and aches all over. Her eyes are red and sore as is her nose and she is terribly unhappy in herself crying and wailing. I have been so worried. Normally she is a robust happy little girl who is never ill in any way. I am usually all for vaccinations but I wish we hadn't gone for this. It's been a horrible week and she still isn't better or sleeping. I didn't realise this would happen and was led to believe by the nurse my daughter may have a runny nose (I don't blame her but wish I had read up more as I normally do) The leaflet also seemed to focus on very mild symptoms with the others listed but as I read it wasn't usual. My daughter has been more ill this week than in her whole two years.

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Mertonmum said on 19 November 2014

Firstly my doctors surgery have no appointments for Flu Vaccinations until January!! Secondly they are refusing to accept that my daughter is eligable for it. She was born on 3rd September 2009, and according to this website children born on or after 2nd September 2009 are eligable to have the vaccination, but they will not give it to her because she is now 5 not 4!! I do not know what to do next as they point blank refuse to accept what it clearly states here. Any advice NHS Choices?

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googlemum said on 28 October 2014

Dear NHS, please advise:

1 In the normal course of things, how many children would be exposed to 4 different strains of flu virus in the space of one day?

2 Which of the 4 strains of GM flu virus in the 2014 vaccine retain the ability to replicate?

3 I refer to - "Due to the segmented nature of the viral RNA, the gene segments of one virus can reassort with those of another virus during replication in the infected host cell and form new pathogenic flu viruses. " (google it for source)
Which of the 4 strains of flu virus in the 2014 vaccine are able to replicate and reassort?

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Ilovemygarden said on 08 October 2014

We had a letter from our surgery offering the vaccine for our two boys age 2 and 4. The letter stated that they would be holding a clinic on Saturday 25th October. We rang them to book an appointment to be told sorry the clinic was full on that day and they couldn't offer any other dates.

Surely they must have sent out more letters to parents than they have the capacity to see in one day ?

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monkety89 said on 07 October 2014

Just phoned my GP practice to Book my 2 year old son in for his, Only to be told the cut off date is 1st Sept 2012. So my 2yr old son, Birthday 12th sept 2012 is not eligible. Therefore it's not All 2yr olds, I was hoping he could have it as I also have a baby in the house & wouldn't want him to get it.

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Rob NHS Choices said on 05 September 2014

Rangers80
Sorry to hear about your daughter's illness, I hope she has made a full & speedy recovery. Her illness was likely to be due to another infection from nursery.

The flu vaccine for children is expected to prevent 2000 or more deaths from flu in the general population and lead to 11000 fewer hospitalisations.

I'm not sure where your claim that Fluenz is 55% effective comes from, but it does not sound accurate. The only similar relevant figure we can find is that the nasal spray vaccine was, in 1 study, about 55% MORE effective than the injectable flu vaccine (see page 6 for details: http://ec.europa.eu/health/documents/community-register/2011/2011012793189/anx_93189_en.pdf).

You’re correct that it contains genetically modified organisms, which you can see from the link above. You are also correct that the vaccine contains pork gelatine, and you can read more in a statement from Public Health England https://www.gov.uk/government/news/vaccines-and-gelatine-phe-response.

The H1N1 swine flu virus is included as it is now circulating, and causing cases of flu and deaths. It is just one of several strains contained in the vaccine.

Mercury (thiomersal) is used in tiny amounts as a preservative in some vaccines, but in none of the vaccines currently given to children nor any influenza vaccines for the 2013/14 season contain as an added preservative. The WHO states that there is no health risk from mercury in vaccines http://www.who.int/vaccine_safety/committee/topics/thiomersal/statement_jul2006/en. Read more about vaccine ingredients here: http://www.nhs.uk/Conditions/vaccinations/Pages/vaccine-ingredients.aspx

Like all medicines, vaccines have possible side effects. But there is no association between autism & the flu vaccine, or the MMR vaccine. In the exceptionally rare cases where people are severely harmed by vaccines the UK has a vaccine damage payment scheme (see: https://www.gov.uk/vaccine-damage-payment/overview).

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Rangers80 said on 03 June 2014

My 3 year old daughter was offered this last year.
We refused after her being frought with complications from previous vaccines.
She attends a local nursery many of the other children did receive the flu nasal vaccs.
Over the nest 4-5 weeks almost every single child including my daughter developed extreme flu like symptoms.
The nursery were a little shocked and did not tie two and two together.
My daughter ended up from being a wild full of life 3 year to being unable to move off the couch for almost a week.
Was heart-breaking to watch.
Several other parents stated the same.
So what benefit does this really have ?
Considering it is only 55% successful?
Also why is there any need to have swine flu added and pork geletine?
It also contains GMO according to producers.
There is also conflicting evidence from manufacturers to what is stated here.
So thankful I have studied and referred to independent tests rather than the tests provided by the vaccine manufacturers and other parties with vested interest, when considering vaccs for our one year old.
Our own Doctor told me a certain vacc did not have mercury in it until he read the ingredients for himself!
So how can any responsible parent blindly accept what we are being told by Docs and NHS when even they don't have all the facts???
All I can do is compare the health of my vaccinated child against our unvaccinated child one is constantly poorly the other rarely.
Also is these are all so safe why is the Vaccinated related injury court in the UK which has paid out for Autism?
Why is this not common knowledge.

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Mummy_tee87 said on 22 December 2013

My son (3yrs today) had the flu nasal spray in October, and since then has caught almost every other bug going, and he is usually quite healthy and doesn't catch much of the viruses going round. So far he has had; chest infection, hand foot and mouth, general cold, conjunctivitis and an ear infection! But no flu, so it did serve it's purpose, but with a unwelcome effect.

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Weevon said on 03 December 2013

My older boy (15yrs) has been having the flu injection for years due to asthma, but this year he had the nasal spay. I'm glad to say he had almost no side effects at all apart from a slight headache immediately afterwards. My 2 year old also had the nasal vac this year for the first time, with absolutely no side effects at all. Having had the 'Actual Flu' myself (and not just a really bad cold, which most people think is flu). I would urge anyone to get their kids vaccinated against this deliberating and horrible illness. Even if my kids had suffered side effects like vomiting, diarrhoea, lethargy etc. I would still have them vaccinated again next year as I'd rather have a few days with sick kids than to go through the nightmare of Flu with them. I'm just a mum, and have absolutely no know medical knowledge at all, this is just my opinion.

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Harriet29 said on 26 November 2013

Hi. Quick for mumtotoddler
Just to say that fluenz vaccine has been given in the States for ten years ( as is often the case when " new "vaccines appear on the uk schedule) and is aimed to be offered to age groups 2-18 starting this winter. Aspirin is absolutely not given to children anyway and hasn't been for many years . Incidentally the pre school aged children ie. before aged 4 are to be done at the gp surgery but they are unable to stock supplies beyond that so aged 4-10 will be offered in school and eventually flu cover will be rolled out to the older children. Aren't we lucky that unlike many countries we can protect our children from a well known killer. Do consider it. But read up first as with all matters affecting your child. As yet there is no compulsory vaccine in this country!!

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touni said on 24 November 2013

Hello, my daughter has had her flu nasal vaccine yesterday,but unfortunately,this morning, she's not feeling well, she's vomiting a bit, and having diarrhea, can any one tell me please if this is a normal side effect of the jab, or it has nothing to do with it, thank you.

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Kathryn at NHS Choices said on 19 November 2013

Dear Ok faulks,

Yes, this year's children's flu vaccine does contain H1N1 (the swine flu virus) and no, it doesn't matter - any protection passed to the baby at birth from vaccination in pregnancy will have declined by the age of six months.

Best wishes,
Kathryn Bingham, NHS Choices editor

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Ok faulks said on 18 November 2013

I was vaccinated with the swine flu when I was pregnant. My child is due to be given the flu spray tomorrow can you tell me if it contains the h1n1 strain and if yes does that matter?

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Kathryn at NHS Choices said on 13 November 2013

Dear Ralphdavieswebb, strattonnewman, sangari and CherishMyBabies

Sorry to hear your children were unwell after receiving the vaccine. As with all vaccines, a few children will have side effects. However, when deciding whether to have the vaccination it’s important to remember that the nasal spray is very safe and effective and the vast majority of children won’t have any problems at all.

You can read more about the side effects of the children’s flu vaccine and what to do if you think your child is affected here:

http://www.nhs.uk/Conditions/vaccinations/Pages/child-flu-vaccine-side-effects.aspx

Best wishes,
Kathryn Bingham, NHS Choices editor

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Ralphdavieswebb said on 11 November 2013

My son has had the flu injection for the last 7 years & has not been affected. 4 days ago he had the nasal vaccine which has knocked him for six! He has a constant headache, temperature, loss of appetite, nausea, is lethargic & generally unwell. He had 2 sprays (1 up each nostril).
I have called the GP practice to inform them of his symptoms to help them build a bigger picture. I will not be consenting to this method of vaccination again-given that the injections have previously been fine. I would be very keen to find out how long symptoms persist for.

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strattonnewman said on 11 November 2013

My nearly 4 year old daughter had flu spray on Friday and by Sunday was very ill with flu like symptoms, Monday now and still very ill with fever/high temperature, hurts all over, lethargic, loss of appetite etc. Checked this website before making decision to take her and it suggests that although spray contains flu virus they are weakened forms of it that do not cause flu in children but it is a big coincidence that my daughter now seems to have the flu straight after receiving this spray. Think carefully before taking your child.

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sangari said on 04 November 2013

Hi my 2 and a half daughter had nasal flu shot, ever since she is suffering breathing difficulty, high temprature, vomiting, lost apeetite. I regret for giving this vaccine it is the first time... any suggestiion, pls post to me.

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CherishMyBabies said on 20 October 2013

My son and daughter had the flu nasal vaccine yesterday (19/10/2013) My son will be 8 in December and my daughter will be 5 in November. They both have asthma.
So far my son seems fine but my daughter has been really poorly all night. Her symptoms are as follows:
- Coughing
- Headache
- Fever/Temperature
- Loss of appetite
- Vomiting
I obviously am monitoring her and encouraging her to drink water in order to keep her fluids up but I am somewhat worried.
I just wanted to state her symptoms on here and also hope to hear from others to see if their little ones have had the same or similar symptoms?
As her mother and someone who was terribly ill with Swine Flu in 2010 - I would always choose for my children to be vaccinated and protected as the flu is so dangerous!
I would just prefer there to be no side effects as any parent hates seeing their precious babies poorly.

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Mumtotoddler said on 16 October 2013

I am trying to gather as much info as possible in order to make an informed choice but keep finding contradictions. Can I just clarify...

Fluenz is the same as Flumist (just branded differently for Europe)?

I have read on the Fluenz website itself that people who have been taking aspirin can't have the vaccine and recipients must not be given aspirin for 4 weeks after but you say below there is no advice to avoid it, which is true?

Thanks

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Kathryn at NHS Choices said on 09 October 2013

myquestions:

It's Fluenz that's used in the UK (Flumist in USA and Canada). Here's more info on Fluenz:

http://www.medicines.org.uk/emc/medicine/25084#PRODUCTINFO

Essentially, there's no advice to avoid aspirin after Fluenz. As it's a live virus, children should avoid relatives etc with severely weakened immune systems eg if on chemotherapy for a while after vaccination. Ask your GP if you think this may apply in your case.
There's no evidence that Fluenz causes wheezing - it's been shown safe in children with mild or moderate asthma. The reason children with severe asthma or wheezing on the day of vaccination are told not to have Fluenz, is that it's not been tested in these groups.
Hope this helps,

Kathryn Bingham (NHS Choices editor)

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myquestions said on 06 October 2013

Hello, You've asked my son to get the Flumist, he's 3 years old, so I have to make the decision for him, but I have questions that are not answered here:
1. Why does the Flumist company tell people not to take Aspirin for 20 days after having it, but the NHS hasn't mentioned this here, can you take aspirin, yes or no?
2. Which of the flumist brands, is it?
3. My wife has chronic fatigue (3 years suffering) very weak immune system, it says that the child should not go near anyone with immune weaknesses, would she be considered someone not to go near? What about grandad, who has cancer and pneumonia?
4. I read it was only 55% effective, is this correct?
5. I read it could make you get tired, muscle ache and runny nose for a few days, is this true? i.e you get a minor flu?
6. I read you will shed Flu virus to other people, for 10 days, i.e. Aunties and Uncles might get a reduced strength dose of some of the strains, is this true?
7. The vaccine was approved first in America and causes bronchial problems in 1 in 20 children, when they carried out tests? Is this why wheezing kids, cant have it? Does it cause wheezing?
You can see, from above I have many questions and mainly they are doubts, as I'm not going to really ask about things that aren't doubts. Sorry if this comes across like I'm a paranoid person. I am just weighing up the reason for having it, v's him potentially getting flu.
Furthermoe, If point 6 is true, then if only a few children get the vaccine then it will likely spread across the classroom anyway, which raises further social concerns as to;
8. how it can be contained from the rest of the population with immune system issues, if all children are contagious for 10 days after having it. That assumes point 6 is true.
Thanks and I look forward to you making me feel more comfortable. Yours, a nervous parent.

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kimTBO said on 28 September 2013

I went to get my flu vaccination today, then they gave me this, even though I was adamant that I didn't want anything put up my nose, I am a blind, type 1 diabetic, and I use the rest of my senses a lot. And I generally don't like things up my nose. So after insisting that they give me the injection that I have had numerous times before, they gave me the nasal vaccine. I am 16 and should have had the right to choose not to have it but to have the injection anyway, so now my face is aching, my eyes feel like the pressure has gone up, I'm sure that the pressure hasn't gone up but that is what it feels like. I am peeved and I came to this part of the website to find out if this was normal and found advice for if you are a four year old.

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Flu Heroes - Nasal flu spray for kids

The nasal flu vaccination programme is being piloted in primary schools across England. Find out more by visiting www.healthforkids.co.uk.

Media last reviewed: 18/09/2014

Next review due: 18/09/2016

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