Protecting your
child against flu
Flu immunisation in England
Information for
parents and carers
Helping to protect children, every winter
5 reasons
to get your child vaccinated
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
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Protect your child against flu
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 can be found at: www.nhs.uk/child-flu
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Information for parents and carers
Why should my child 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.
What are the 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.
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Protect your child against flu
How effective is the vaccine?
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 my 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.
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Information for parents and carers
How will the vaccine 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 does the nasal spray work?
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.
Are there any side-effects of
the vaccine?
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.
Can the vaccine cause flu?
No, the vaccine cannot cause flu because the
viruses in it have been weakened to prevent
this from happening.
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Protect your child against flu
What if my child has 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
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Information for parents and carers
These children should have a flu vaccination
every year from the age of six 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 on
page 8 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 will the vaccine 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 (see page 8),
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.
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Protect your child against flu
Are there any 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 or
– 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*
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.
*See the website at www.medicines.org.uk/emc/
product/3296/pil for a list of the ingredients of the vaccine
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Information for parents and carers
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.
Can the flu vaccine be given to my child
at the same time as other vaccines?
Yes. 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.
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Protect your child against flu
Does the nasal vaccine contain gelatine
derived from pigs (porcine gelatine)?
Yes. 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.
Where can I get more information?
Visit www.nhs.uk/child-flu for more
information. Talk to your GP, practice nurse,
your child’s school nurse or your health
visitor if you have any further questions.
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