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

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

Important: Coronavirus (COVID-19) update

Routine vaccinations for babies, pre-school children and adults are continuing as normal.

It's important to go to your appointments unless you, your child or someone you live with has symptoms of COVID-19.

If your child has missed any of their other vaccinations, contact their GP surgery to book an appointment.

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 2021 – born between 1 September 2017 and 31 August 2019
all primary school children (reception to year 6)
all year 7 to year 11 children in secondary school
children aged 2 to 17 years with 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.

The nasal spray vaccine offers the best protection for children aged 2 to 17 years. They will be offered the flu vaccine injection if the nasal spray vaccine is not suitable for them.

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 steroid tablets or that has needed intensive care in hospital
a flare-up of asthma symptoms (such as 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 flu vaccine in the past
a condition that needs salicylate treatment

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

The injected flu vaccine is given as a single injection into the muscle of the upper arm, or the thigh for children under 1 year.

Children with long-term health conditions

Children with 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 conditions that qualify for the NHS flu vaccine include:

serious breathing problems, such as asthma needing steroid inhaler or tablets
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, for example, sickle cell disease, or the spleen has been removed
learning disability
problems with the nervous system, such as cerebral palsy

Where to have the flu vaccine

A table showing a child's age and where the flu vaccine is available on the NHS.
Child's age	Where to have the flu vaccine
From 6 months until 2 years (with long-term condition)	GP surgery
From 2 years until child starts primary school	GP surgery
All children at primary school	School
Year 7 to year 11 secondary school children	School
Children in reception to year 11 (with long-term condition)	School or GP surgery
Home-schooled children (same ages as reception to year 11)	Community clinic

Home-schooled children should be invited for vaccination by the local healthcare team. If you do not hear from them, ask your child's GP where they should go for vaccination.

Schoolchildren with a long-term health condition

You can ask the GP surgery to give the vaccine instead of having it at school if you prefer.

If your child is not in reception to year 11, 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

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.

Your child will be given 2 doses if they're under 9 years old and have:

a long-term health condition that means they're more at risk from flu
never had a flu vaccine before

These doses are given 4 weeks apart.

How effective is the nasal spray flu vaccine?

The nasal spray flu vaccine gives children the best protection against flu.

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

Any children who catch flu after vaccination are less likely to be seriously ill or be admitted to hospital.

Side effects of the children's flu vaccine

The nasal spray flu vaccine for children is very safe. Most side effects are mild and do not last long, such as:

a runny or blocked nose
a headache
tiredness
loss of appetite

If your child has the injected flu vaccine, side effects include:

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

These side effects usually last for a day or 2.

Allergic reactions to the nasal spray 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 intensive care in hospital for an egg allergy may be offered the nasal spray vaccine in hospital.

If you're not sure, check with the school immunisation team, 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 the main flu viruses can 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 pork gelatine. If this is not suitable, speak to your child's nurse or doctor about your options.

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

You can find a full list of ingredients in the Fluenz Tetra nasal spray patient information leaflet on the emc website.

Find out more about the injected flu vaccine

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: 24 August 2021
Next review due: 24 August 2022

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Children's flu vaccine