Vaccinations

Flu vaccine for children

In the autumn/winter of 2014/2015 the annual nasal spray flu vaccine will be available for all children aged two, three and four years old as part of the NHS childhood vaccination programme.

In some parts of the country all primary school-aged children and secondary school-aged children in years 7 and 8 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.

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 spead.

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.

Which children can have the flu vaccination?

The nasal spray flu vaccine for 2014/15 will be offered routinely on the NHS to all children who were aged two, three and four on September 1st 2014. That is, children with a date of birth on or after September 2 2009 and on or before September 1 2012.

Read more about which children are eligible for flu vaccination.

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 between two and 18 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 many faith groups, including representatives from Jewish and Muslim communities, some parents may want to balance the constraints of their personal beliefs against the benefits of vaccination. Read more here .

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 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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Comments

The 15 comments posted are personal views. Any information they give has not been checked and may not be accurate.

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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