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Protect your child against flu – information for parents and carers of children in primary school or pre-school

Updated 8 August 2024

Applies to England

This guide is for parents and carers of children eligible for the flu vaccine.

5 reasons to have the flu vaccine

1. Protect your child

The vaccine will help protect your child against flu and serious complications such as bronchitis and pneumonia.

2. Protect you, your family and friends

Vaccinating your child will help protect more vulnerable friends and family.

3. No injection needed

The nasal spray is painless and easy to have.

4. It’s better than having flu

The nasal spray helps protect against flu, has been given to millions of children worldwide and has an excellent safety record.

5. Avoid costs

If your child gets flu, you may have to take time off work or arrange alternative childcare.

Eligible children

The flu vaccine is offered free to:

• children aged 2 or 3 years old (on 31 August before flu vaccinations start in the autumn)
• some school-aged children
• children with a health condition that puts them at greater risk from flu

Further information on which children are eligible each year is available on NHS.UK.

Why your child should have the flu vaccine

Flu can be a very unpleasant illness in children causing fever, extreme tiredness, aching muscles and joints, stuffy nose, dry cough, and sore throat. Children usually begin to feel better within about a week.

Complications of flu include acute bronchitis, painful ear infections, and pneumonia. Some children may need to go to hospital for treatment, including intensive care.

Benefits of the vaccine

Having the vaccine will help protect your child from what can be a very nasty illness in children. Children under the age of 5 years have the highest rate of hospital admissions due to flu.

It will also reduce the chance of others in your family, who could be at greater risk from flu, such as grandparents or those with long term health conditions, getting flu from your child.

It can help you avoid having to take time off work, or other activities, to look after your sick child or if you become sick yourself.

Vaccine effectiveness

Flu vaccine is the best protection we have against this unpredictable virus. In the last few years, the protection that children get from vaccination has been consistently higher than for adults.

There are different strains of flu virus and the most likely strains that will cause flu are identified in advance of the flu season. Vaccines are then made to match them as closely as possible – they will usually give some protection even if the match isn’t perfect.

Flu viruses can change every year so the vaccine is usually updated each year. And protection from the vaccine may fade with time. For this reason, we recommend that your child is vaccinated against flu again this year, even if vaccinated last year.

Who will give your child their vaccination

Children aged 2 and 3 years old (age on 31 August before flu vaccinations start in the autumn) will be given the vaccination at their general practice, usually by the practice nurse.

School-aged children will mainly be offered the vaccination in school, with further opportunities to get vaccinated, potentially at NHS community clinics, for anyone who misses the session at school.

Children who are home educated will be offered the vaccine if they are in an eligible age group. Parents can obtain information about arrangements from their Local Authority Education Department.

How the vaccine will be given

For most children, it is given as a nasal spray. If the nasal spray is not suitable for a child, an injection can be given instead, usually into the muscle in the upper arm.

How the nasal spray works

The nasal spray contains viruses that have been weakened to prevent them from causing flu but will help your child to build up immunity. This means your child will be better able to fight off flu.

The vaccine is absorbed really quickly in the nose so, even if your child sneezes immediately after having had the spray, there’s no need to worry that it hasn’t worked.

Side effects

Children may develop a runny or blocked nose, headache, general tiredness and some loss of appetite. However, these are much milder than developing flu or complications associated with flu. Serious side-effects are uncommon.

Why the vaccine cannot cause flu

The vaccine cannot cause flu because the viruses in it have been weakened to prevent this from happening.

Children with a health condition

Children with certain health conditions, even if well managed, are at higher risk of severe complications if they get flu. It is especially important that these children are vaccinated.

These conditions include:

• serious lung problems, for example, asthma needing regular inhaled or oral steroids
• serious heart conditions
• kidney or liver disease
• diabetes
• immunosuppression due to disease or treatment, for example, chemotherapy or radiotherapy treatment for cancer or long term steroid use
• problems with the spleen, either because the spleen has been removed (asplenia) or doesn’t work properly, for example, because of sickle cell or coeliac disease
• your GP may also recommend that your child is vaccinated if they have a condition that affects the nervous system such as cerebral palsy

These children should have a flu vaccination every year from the age of 6 months onwards. Most will have the nasal spray vaccine but it is not recommended for children under the age of 2 years.

Children under 2, and those for whom the nasal spray is not suitable for medical reasons, will be offered a flu vaccine injection.

If your child has any health condition listed above but is not in one of the age groups being offered the vaccine in school, it is important that you contact your GP to arrange an appointment.

If you are not sure whether your child needs a flu vaccination or you need more advice, speak to your practice nurse, GP or health visitor.

When the vaccine will be given

For 2 and 3 year olds, you should receive an invitation for your child to have it at their GP surgery in the autumn or early winter. Alternatively, you can contact them directly to make an appointment.

For school-aged children a vaccination session will be held at school generally during the autumn term. The school aged immunisation team will contact you via the school.

If your child is in an eligible group offered vaccine at school and has a health condition that puts them at increased risk from flu, you can ask your child’s GP surgery to provide the vaccine if you don’t want to wait until the school vaccination session or if this is what you prefer.

Children who shouldn’t have the nasal vaccine

As children with pre-existing medical conditions may be more vulnerable to complications of flu it is especially important that they are vaccinated.

Children may not be able to have the nasal vaccine if they:

• are currently wheezy or have been wheezy in the past 72 hours, they should be offered an injected flu vaccine to avoid a delay in protection
• have needed intensive care due to
  • asthma
  • egg allergic anaphylaxis
    (children in these 2 groups are recommended to seek the advice of their specialist and may need to have the nasal vaccine in hospital)
    
• have a condition, or are on treatment, that severely weakens their immune system or have someone in their household who needs isolation because they are severely immunosuppressed
• are allergic to any other components of the vaccine (See the Patient Information Leaflet for a list of the ingredients of the vaccine)

If your child can’t have the nasal flu vaccine they should have the flu vaccine by injection.

If you are unsure whether your child should get the injected vaccine or the nasal vaccine please check with the school aged immunisation team or the nurse or GP at your surgery.

Children who have been vaccinated with the nasal spray should avoid household contact with people with very severely weakened immune systems (for example those who have just had a bone marrow transplant) for around 2 weeks following vaccination.

Flu vaccine and other vaccines

The flu vaccine can be given at the same time as all the other routine childhood vaccines.

The vaccination may be delayed if your child has a fever. Also, 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. Sometimes an injected vaccine may be offered instead.

The nasal vaccine and gelatine derived from pigs (porcine gelatine)

The nasal vaccine contains traces of a highly processed form of gelatine (porcine gelatine), which is used in a range of many essential medicines. The gelatine helps to keep the weakened vaccine viruses stable so the vaccine is able to work properly.

The nasal vaccine is easy to give and painless. Each child who has the nasal spray vaccine gets the best protection against flu. It is also considered to be the best at reducing the spread of flu. That way children protect one another and others who might be vulnerable to flu.

For those who may not accept the use of porcine gelatine in medical products, an injected flu vaccine is available as an alternative. You should discuss your options with your nurse, doctor, or school aged immunisation team.

Further information

Talk to your GP, practice nurse, your child’s school nurse or your health visitor if you have any further questions.

Further information is available on NHS.UK.

Order or download print copies

A PDF version of this leaflet and other resources are available to download.