The children's flu vaccine is offered as a yearly nasal spray to young children to help protect them against flu.

Flu can be a very unpleasant illness for children, with potentially serious complications, including bronchitis and pneumonia.

At what age should children have the nasal spray flu vaccine?

In the autumn/winter of 2018/19, the vaccine will be available free on the NHS for eligible children, including:

• children aged 2 and 3 on August 31 2018 – that is, children born between September 1 2014 and August 31 2016
• children in reception class and school years 1, 2, 3, 4 and 5
• in some parts of the country, all primary school-aged children will be offered the vaccine (following a pilot in some areas) 
• children aged 2 to 17 with long-term health conditions

Who will give the children's flu vaccination?

Children aged 2 and 3 will be given the vaccination at their general practice, usually by the practice nurse.

Children who are 4 years old are also eligible for flu vaccination provided they were 3 on August 31 2018. These children should be offered the vaccination at their general practice.

Children in reception class and school years 1, 2, 3, 4 and 5 will be offered their vaccination in school. In a couple of areas it might be offered in primary care settings.

Children who are home educated will also be offered the vaccine, provided they are in an eligible age group. Parents can obtain information about arrangements from their local NHS England Public Health Commissioning team.

Children at higher risk from flu

Children aged 2 to 17 with long-term health conditions such as diabetes are at higher risk from flu.

It's especially important that they are vaccinated with the annual flu nasal spray instead of the annual flu jab, which they were previously given.

Children between the ages of 6 months and 2 years who are at high risk from flu are offered the annual flu jab, usually at their GP surgery.

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

The nasal spray flu vaccine has few side effects – most commonly getting a runny nose after vaccination for a few days.

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

How to get the flu vaccine for your child

Your child's GP or school should contact you about getting them vaccinated before the winter.

Talk to the GP, practice nurse or your child's school nurse if you want more information about when and how your child will be vaccinated against flu.

If you haven't heard from their GP by early November 2018, contact them directly to make an appointment.

How is the nasal spray flu vaccine given?

The vaccine is given as a single spray squirted up each nostril. Not only is it needle-free – a big advantage for children – the nasal spray is quick, painless, and works even better than the injected flu vaccine.

The vaccine is absorbed very quickly. It will still work even if, after the vaccination, your child develops a runny nose, sneezes or blows their nose.

Read the patient information leaflet for the nasal spray flu vaccine (PDF, 238kb).

Are there any children who should delay having the nasal spray flu vaccine?

Children should have their nasal spray flu vaccination delayed if they:

• are unwell with a fever
• are wheezy

If your child has a fever, the vaccination can be delayed until they feel better.

If a child is wheezy or has been wheezy in the past week, their vaccination should be postponed until they have been wheeze-free for at least 3 days.

If a child has a heavily blocked or runny nose, it might stop the vaccine getting into their system. In this case, their flu vaccination can be postponed until their nasal symptoms have cleared up.

Are there any children who should not have the nasal spray flu vaccine?

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

The vaccine is not recommended for children who have:

• a severely weakened immune system
• severe egg allergy
• severe asthma – that is, those being treated with steroid tablets or high-dose inhaled steroids
• an allergy to any of the vaccine ingredients, such as neomycin
• a condition that requires salicylate treatment

If your child is at high risk of flu due to one or more medical conditions or treatments, and can't have the nasal flu vaccine because of this, they should have the injected flu vaccine.

If you're unsure, check with the school immunisation team or the nurse or GP at your surgery.

Why children are offered flu vaccine

Flu is a very common infection in babies and children. It can be very unpleasant for them.

Children with flu have the same symptoms as adults – including fever, chills, aching muscles, headache, stuffy nose, dry cough and a sore throat lasting up to a week.

Some children develop a very high fever or complications of flu, such as bronchitis, pneumonia and a painful ear infection.

They may need hospital treatment, and very occasionally a child may die from flu.

In fact, healthy children under the age of 5 are more likely to have to be admitted to hospital with flu than any other age group.

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.

Learn more about protecting your child from flu

Read more about the complications of flu.

How safe is the flu vaccine for children?

The flu vaccine for children has a good safety record. In the UK, millions of children have been vaccinated safely and successfully.

How does the children's flu vaccine work?

The vaccine contains live but weakened flu viruses that do not cause flu in children. 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.

Stopping the spread of flu

The nasal spray flu vaccine will not only help protect your child against flu, the infection will also be less able to spread from them to their family, carers and the wider population.

Children spread flu because they generally don't use tissues properly or wash their hands.

Vaccinating children also protects others that are vulnerable to flu, such as babies, older people, pregnant women and people with serious long-term illnesses.

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 the nasal spray suggests children should be given 2 doses of this vaccine if they've not had flu vaccine before.

However, the NHS vaccination programme has advised that healthy children only need a single dose because a second dose of the vaccine provides little additional protection.

Children aged 2 to 9 years at risk of flu because of an underlying medical condition, who have not received flu vaccine before, should have 2 doses of the nasal spray given at least 4 weeks apart.

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