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.
Children can catch and spread flu easily. Vaccinating them also protects others who are vulnerable to flu, such as babies and older people.
Answering your vaccination questions
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 2022 (born between 1 September 2018 and 31 August 2020)
- all primary school children (Reception to Year 6)
- some secondary school aged children
- 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 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 steroid tablets or has needed intensive care in hospital
- 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 flu vaccine in the past
- a condition that needs salicylate treatment
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 pork gelatine. If you do not accept the use of pork 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 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
- 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 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
|Child's age||Where to have the flu vaccine|
|From 6 months until 2 years
(with a long-term condition)
|From 2 years until child
starts primary school
|All children at primary school||School|
|Some secondary school aged children in eligible groups||School|
|Children in eligible school groups
(with a long-term health condition)
|School or GP surgery|
|Children who are home-schooled or not in mainstream education
(same ages as those offered in eligible groups at schools)
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.
Vaccination will start in primary schools and then be rolled out later in the season to some secondary school aged children. This will depend on the availability of the vaccine.
Schoolchildren with a long-term health condition
If you have a child with a 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 primary school, ask the GP surgery to give the vaccine.
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
- 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:
- the antibiotics neomycin and gentamicin
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 pork gelatine. If this is not suitable, speak to your child's nurse or doctor, or the school aged immunisation service about your options.
Your child may be able to have an injected vaccine instead.
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: 5 September 2022
Next review due: 5 September 2025