The children's nasal spray flu vaccine is safe and effective. It's offered every year to children to help protect them against flu.

This page is about flu vaccination for children. Find out about flu vaccination for adults.

Flu is caused by the influenza virus. It can be a very unpleasant illness for children. It can also lead to serious problems, such as bronchitis and pneumonia.

Children can catch and spread flu easily. Vaccinating them also protects others who are vulnerable to flu, such as babies and older people.

If you have any questions about vaccinations, you can:

ask your GP surgery or other healthcare professionals for advice
read more about why vaccination is safe and important

Who should have the nasal spray flu vaccine

The nasal spray flu vaccine is free on the NHS for:

children aged 2 or 3 years on 31 August 2023 (born between 1 September 2019 and 31 August 2021)
all primary school children (Reception to Year 6)
some secondary school aged children (Year 7 to Year 11)
children aged 2 to 17 years with certain long-term health conditions

If your child is aged between 6 months and 2 years and has a long-term health condition that makes them at higher risk from flu, they'll be offered a flu vaccine injection instead of the nasal spray.

This is because the nasal spray is not licensed for children under 2 years old.

The nasal spray vaccine offers the best protection for children aged 2 to 17 years. They'll be offered a flu vaccine injection if the nasal spray vaccine is not suitable for them. Injected flu vaccines are also safe and effective.

Children who should have the flu vaccine injection

Some children will be offered the injected flu vaccine if they have:

a severely weakened immune system
asthma that's being treated with long-term steroid tablets or has needed intensive care in hospital (unless the nasal spray is recommended by their asthma specialist)
a flare-up of asthma symptoms (such as they've been wheezy in the past 72 hours or are currently wheezy) and need to use a reliever inhaler more than usual
had an allergic reaction to a nasal spray flu vaccine in the past
a condition that needs salicylate therapy

Children will also be offered the injected flu vaccine if they live with somebody with a severely weakened immune system who requires isolation (for example, someone who has had a bone marrow transplant).

If you're not sure, check with the school aged immunisation service team, the nurse or GP at your surgery, or the specialist if your child has hospital care.

The nasal spray vaccine contains small traces of gelatine derived from pigs (porcine gelatine). If you do not accept the use of porcine gelatine in medical products, the injected vaccine is available as an alternative.

Injected flu vaccines are given into the muscle of the upper arm or the thigh for children under 1 year.

Children with long-term health conditions

Children with certain long-term health conditions, such as diabetes or heart problems, are at higher risk from flu.

It's important they're vaccinated.

Examples of long-term health conditions

Long-term health conditions that qualify for the NHS flu vaccine include:

serious breathing problems, such as having asthma that needs steroid inhaler or tablets, or having had a lung or airways infection in the past that needed hospital treatment
serious heart conditions
diabetes
kidney or liver disease
weakened immune system as a result of a condition or treatment with medicines such as steroid tablets or chemotherapy
problems with the spleen like sickle cell disease, or the spleen has been removed
learning disability
problems with the nervous system, such as cerebral palsy

If it's their first time being vaccinated against flu, children under 9 years old with certain long-term health conditions will usually be offered a 2nd dose of the flu vaccine from 4 weeks after the 1st dose. This helps them develop immunity against flu for that first season.

Where to have the flu vaccine

Where children can get the flu vaccine
Child's age	Where to have the flu vaccine
Child's age From 6 months until 2 years (with certain long-term health conditions)	Where to have the flu vaccine GP surgery
Child's age From 2 years until child starts primary school	Where to have the flu vaccine GP surgery
Child's age All children at primary school (Reception to Year 6)	Where to have the flu vaccine School
Child's age Secondary school aged children in eligible groups (Year 7 to Year 11)	Where to have the flu vaccine School
Child's age Children in eligible school groups (with certain long-term health conditions)	Where to have the flu vaccine School or GP surgery
Child's age Children who are home-schooled or not in mainstream education (same ages as those offered in eligible groups at schools)	Where to have the flu vaccine Community clinic

School aged children who miss the vaccination session at school will have other opportunities to get vaccinated. This will usually be at NHS community clinics.

Home-schooled children and children not in mainstream education should be invited for vaccination by the school aged immunisation service. If you do not hear from them, ask your Local Authority Education Department about arrangements.

School children with certain long-term health conditions

If you have a child with a certain long-term health condition, you can ask the GP surgery to give them the vaccine instead of them having it at school if you prefer.

If your child is not in one of the eligible school aged groups, ask the GP surgery to give the vaccine.

Important: What if my child is unwell on the day?

You may be asked to wait until your child is better before having the nasal spray flu vaccine if they have:

a very blocked or runny nose – these might stop the vaccine getting into their system
a high temperature

Sometimes an injected vaccine may be offered instead.

How the nasal spray flu vaccine is given

The vaccine is given as a spray squirted up each nostril. It's quick and painless.

The vaccine will still work even if your child gets a runny nose, sneezes or blows their nose.

How effective is the nasal spray flu vaccine?

The nasal spray flu vaccine gives children the best protection against flu. The injected flu vaccine is a good alternative if the nasal spray vaccine cannot be used.

It may take around 2 weeks for the flu vaccine to work.

Any child who catches flu after vaccination is less likely to be seriously ill or be admitted to hospital.

Side effects of the children's flu vaccine

Flu vaccines are very safe.

Side effects of the nasal spray flu vaccine are mild and do not last long. They include:

a runny or blocked nose
a headache
tiredness
loss of appetite

For the injected flu vaccine, most side effects are also mild and do not last long. They include:

a sore arm (or thigh) where the injection was given
a slightly raised temperature
aching muscles

These side effects usually last for 1 or 2 days.

Allergic reactions to the flu vaccine

It's rare for anyone to have a serious allergic reaction to the flu vaccine. If they do, it usually happens within minutes.

The person who vaccinates you or your child will be trained to deal with allergic reactions and treat them immediately.

Gelatine, neomycin and gentamicin allergies

Let your doctor or nurse know if your child has had severe allergic reactions to:

gelatine
the antibiotics neomycin and gentamicin

Egg allergies

The nasal spray flu vaccine has a low egg content and is safe to give in school or in a clinic to children who do not have a serious egg allergy.

Children who have previously needed treatment in intensive care for an egg allergy may be offered the nasal spray vaccine in hospital.

If you're not sure, check with the school aged immunisation service, the nurse or GP at your surgery, or a hospital specialist.

For more advice on what to expect after vaccinations and how to treat common side effects, read vaccination tips for parents.

What's in the nasal spray flu vaccine?

The nasal spray flu vaccine contains small amounts of weakened flu viruses. They do not cause flu in children.

As flu viruses change each year, a new nasal spray vaccine has to be given each year.

The brand of nasal spray flu vaccine available in the UK is called Fluenz Tetra.

The nasal spray vaccine contains small traces of gelatine derived from pigs (porcine gelatine). If this is not suitable because you do not accept the use of porcine gelatine in medical products, a flu vaccine injection is available that contains no gelatine.

Your child may be able to have an injected vaccine instead.

See the emc website for a full list of ingredients in the Fluenz Tetra nasal spray patient information leaflet

More information and other formats

GOV.UK: flu vaccination for children: leaflets and posters (including information in alternative languages and formats)
YouTube: protecting your child from flu British Sign Language (BSL) video

Page last reviewed: 9 August 2023
Next review due: 5 September 2025

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Children's flu vaccine