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Flu immunisations

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Flu is an unpleasant and occasionally serious illness which can lead to children spending days in bed rather than being at school and participating in everyday family life.

For the last two years, the flu vaccine has being offered to all children in special schools and some children in primary school. This year, from October to January 2019, children in Reception and in years one, two, three, four and five will be offered the flu vaccine at school. The vaccine sessions will be organised and delivered by the school nursing service.

The vaccine is provided to children as a nasal spray: find out more about this method.

Local area information

We generally send parents vaccination consent forms and letters with more information around September each year: please fill in as much detail as you can, as this will help us determine if the nasal application of the vaccine is suitable for your child.

You can find details about the clinic locations and times here.

Please see below for a list of commonly asked questions, or email us. Or you can call your local school health nurse: see our list of named nurses in your area for contact details.

See also the flu vaccination form.

Frequently asked questions

What is flu like for children?

Children and adults get the same flu symptoms. These symptoms are worse than a normal cold and include:
  • Fever
  • chills
  • aching muscles and joints
  • headaches
  • extreme tiredness.

Symptoms can also include a stuffy nose, dry cough and sore throat.

Symptoms can last between two and seven days. Some children have a very high temperature, sometimes without other obvious symptoms, and need to go to hospital for treatment.

Complications from flu can include:

  • bronchitis
  • pneumonia
  • painful middle ear infection
  • vomiting
  • diarrhoea.

For children with specific long-term medical conditions (chronic respiratory, heart, kidney, liver or neurological disease; diabetes; immunosuppression; or no fully working spleen) getting flu can be even more serious as it’s likely to make their medical condition much worse.
In severe cases (which are very rare), flu can lead to disability and even death.

How does flu spread?

The flu virus spreads through the air when people cough and sneeze without covering their nose and mouth. Other people then breathe in the virus directly, or pick it up by touching surfaces where it has landed, and touch their eyes, nose and mouth.

Because young children don’t always cover their mouths when coughing or sneezing, flu is passed on very quickly among this age group. Anyone who is in close contact with a young child should ensure good personal hygiene, such as washing their hands.

Why do we need to protect children and adults from flu?

Children who get flu usually pass it on to family members: the flu virus spreads quickly, and it infects adults and children very easily. It causes an unpleasant illness which can be serious, and it may lead to days spent ill in bed rather than being at school or participating in family life.

Who is being offered the vaccine?

The vaccine is offered  to children who on 1st September 2018 will be in reception, years 1, 2, 3, 4 and 5 classes. Children educated at home in these age groups are also eligible for the vaccine: please contact the school nurse base nearest your home address.

Children aged two, three and four years who are not yet in primary school will be offered the vaccine by their GP practice.

Children in secondary school are not currently included in the programme. The programme may be extended to include more children in the future.  However, children of all ages with a long-term medical condition will still be offered the flu vaccine from 6 months of age by their GP Practice.

Where and when will my child get the vaccine?

  • Flu vaccines are administered from October to January each year
  • Children aged 2-4 years and not yet in primary school, will be offered the flu vaccine at the GP practice
  • All children in school years Reception and Years 1, 2, 3 4 and 5 will be offered the flu vaccine at a school session

Children at high risk are offered the flu vaccine each year from their GP and you can choose if you would like your child to be vaccinated in school or at the GPs.

How is the vaccine given?

For most children, the flu vaccine is given via the nose, through a spray into each nostril: it is not an injection, and the process is quick and painless. There’s no need to sniff or inhale the vaccine: only a tiny amount is sprayed into each nostril.

An alternative form of the flu vaccine may be suitable for children who cannot have the nasal spray. These children will be offered a flu vaccine as an injection in the upper arm.

What if my child is ill on the day?

If your child is very unwell (they have a fever, diarrhoea or vomiting, for example), or if your child’s asthma has worsened (with more wheezing or increased use of their inhalers three days before their immunisation), they should not have the vaccine.

If you have any concerns, please speak to your school nurse team. Otherwise there is no reason to delay.

What if my child misses their immunisation?

If your child is in primary school and misses their immunisation at school, please contact school health nurse (on the number in the letter that was sent you with the leaflet) or find out about upcoming catch up clinics here. You can also email us with any queries.

I've heard that the vaccine is live. Does this mean that my child will get flu?

No, the virus in the vaccine has been weakened so that it doesn’t cause flu. It helps your child build up immunity to flu, in the same way as a natural infection (but without the severe symptoms). Flu viruses are constantly changing – the strains may be different each year and are selected to offer the best protection each flu season. The flu vaccine should start to protect most children about 10 to 14 days after they receive their immunisation.

Does my child need a second dose?

Almost all children will only need one dose of the nasal spray vaccine. However, if your child is under 9 years old, has a long-term medical condition and is getting the flu vaccine for the first time, they will need a second dose (4 weeks after the first) to make sure their immunity has fully built up. So the next time your child comes into contact with the flu virus they should be protected and will not get seriously ill.

If your child is aged 2-4 years and not yet in school, your GP will advise you. If your child is in primary school, please contact your local school health nurse (on the number in the letter that was sent to you with the leaflet) to find out about local arrangements.

Are there any reasons why my child shouldn't have the nasal (nose) spray vaccine?

There are very few children who cannot have the nasal spray vaccine, and these children will be offered an injection in the upper arm.

Children who are severely immunosuppressed (unable to fight off most infections) should not have the nasal spray vaccine. Children who are severely immunosuppressed include those:

  • whose immune system is suppressed because they are undergoing treatment for a serious condition such as a transplant or cancer
  • who have any condition which affects the immune system, such as severe primary immunodeficiency
  • who are taking regular high doses of oral steroids

Also, children should not have the nasal spray vaccine if:

  • They have had a severe reaction to a previous dose of the vaccine, or any ingredients in it
  • They are undergoing salicylate treatment (taking aspirin).

Egg allergy
Children with an egg allergy can safely have the nasal spray vaccine, unless they have had a life-threatening reaction to eggs (or products containing eggs) that required intensive care.

The nasal spray vaccine may not be suitable for some children with severe asthma who are taking high doses of inhaled steroids, or if they have recently been prescribed oral steroids. Your GP will advise you about this.

Pork gelatine
The nasal spray vaccine contains a small trace of pork gelatine. Gelatine is a common and essential ingredient in many medicines, including some vaccines. Many faith groups, including Muslim and Jewish communities have approved the use of gelatine-containing vaccines. It is, however, an individual choice whether or not to receive the nasal spray vaccine and we recognise that there will be different opinions within different communities. The nasal spray is a much more effective vaccine than the injection in children. There is no suitable alternative flu vaccine available for otherwise healthy children.

Will there be side-effects of the vaccine?

As with all medicines, side effects to the flu vaccine are possible but usually mild and may include a headache and muscle aches.

Some, but not all, children may experience a runny or blocked nose following the nasal spray. Less common side effects include a nosebleed after the nasal spray.

The vaccine is absorbed very quickly so, even if your child gets a runny nose or sneezes immediately after the spray, there’s no need to worry that it hasn’t worked.

For more information on the side effects of the vaccine please read the patient information leaflet (external link).

Is the vaccine safe?

Before they are allowed to be used, all medicines (including vaccines) are tested for safety and effectiveness. Once they are in use, the safety of vaccines continues to be monitored.

The nasal spray flu vaccine has been used successfully and safely for several years in the USA and has been given safely to hundreds of thousands of children in the UK.

Will the vaccine interfere with my child's natural immune system?

No, the vaccine helps children to build up immunity in the same way as a natural infection with flu, but without the severe symptoms.

Will my child be protected for life when they've had this vaccine?

No. Flu viruses are constantly changing and a different vaccine has to be made as time goes on to continue to protect against the new viruses. So next year’s vaccine may protect against different viruses from this year’s vaccine. This is why the flu vaccine is offered every year during autumn/winter.

How effective is the vaccine?

During the last 10 years, the flu vaccine has generally been a good match for the circulating strains of flu, even though it is not possible to predict exactly which strains will circulate each year. Being immunised is the best protection available against an unpredictable virus that can cause severe illness.

What if I change my mind?

If you change your mind and your child is aged 2–5 and not yet at school, please contact your GP.
If you change your mind and your child is at primary school, please telephone your local school health nurse on the number given in the letter you were sent with the leaflet. If you want to withdraw consent, you will need to follow this up in writing. If you want to give consent to your child’s immunisation again, you will need to fill in a new consent form.

Where can I find more information?

You can talk to the school health nurse (see ‘local information’ above) or GP, or go to the NHS website.

Where can I report suspected side effects?

You can report any suspected side effects of vaccines and medicines through the Yellow Card Scheme.
This can be done online by visiting the Yellow Card website, or by calling the Yellow Card hotline on 0808 100 3352 (available Monday to Friday, 10am to 2pm).

Last updated: 12 September, 2019