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Intranasal Vaccination

Flu vaccination for children aged two, three and four years

All children aged two, three and four years old on 31 August 2015 are being offered an annual flu vaccination as part of a programme to extend flu immunisation to children. The flu vaccine provides protection against the strains that are predicted to circulate each year. These strains may be different from last year which is why we recommend vaccination every year.

For most children, the vaccine is given as a simple nasal spray – no injections are involved. This vaccination programme is designed to protect your child against flu which can be an unpleasant illness and, although rarely, sometimes cause serious complications. By having the flu vaccination, children are also less likely to pass the virus on to friends and family, some of whom may be at greater risk from flu if they are, an infant, an older person or someone with an underlying health condition.

Please note that if your four-year-old child will be in reception year at school (born on or after 1 September 2011) there is a possibility they may be offered their flu vaccination in school. If you decide to have your child vaccinated at the practice, please write this on the consent form that you are sent from the school.


Why should children have the flu vaccine?

Flu can be a very unpleasant illness in children causing fever, stuffy nose, dry cough, sore throat, aching muscles and joints, and extreme tiredness. This can often last several days. Some children can get a very high fever, sometimes without the usual flu symptoms, and may need to go to hospital for treatment. Serious complications of flu include a painful ear infection, bronchitis, and pneumonia.

What are the benefits of the vaccine?

Having the vaccine will help protect your child from what can be a very nasty illness. It may also reduce the chance of others in your family getting it from your child. It can help you avoid having to take time off work or other activities because you are ill or need to look after your sick child.

Over the past two years the programme has been tested in a number of areas in school-aged children. In those areas less flu has been detected in all age groups of the population. This suggests that as well as protecting the vaccinated children other people benefited too.

How will the vaccine be given?

For most children, it is given as a nasal spray.

Who will give my child their flu vaccination?

In general practice, the vaccine is usually given by the practice nurse. If given at school, specially trained healthcare staff will give your child the flu vaccination.

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. When your child comes into contact with the flu virus they will be less likely to get ill.

Are there any side effects of the vaccine?

Serious side effects are uncommon. Children may commonly develop a runny or blocked nose, headache, general tiredness and some loss of appetite. This may last a few days. The vaccine is absorbed 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 children who shouldn’t have the nasal vaccine?

Children should not have the nasal vaccine if they:

  • are currently wheezy or have been wheezy in the past three days (vaccination should be delayed until at least three days after the wheezing has stopped)
  • are severely asthmatic, ie being treated with oral steroids or high dose inhaled steroids
  • have a condition that severely weakens their immune system or have someone in their household who needs isolation
  • have severe egg allergy. Most children with egg allergy can be safely immunised with nasal flu vaccine. However, children with a history of severe egg allergy should seek specialist advice. Please check with your GP
  • are allergic to any other components of the vaccine*

If your child is at high risk from flu due to one or more medical conditions or treatments and can’t have the nasal flu vaccine, they should have the flu vaccine by injection.

Children who have been vaccinated with the nasal spray should avoid household contact with people with very severely weakened immune systems for around two weeks following vaccination.

* See the website at and enter Fluenz Tetra in the search box for a list of the ingredients of the vaccine.

How effective is the vaccine?

Because the flu virus can change from year to year there is always a risk that the vaccine does not match the circulating virus. During the last ten years the vaccine has generally been a good match for the circulating strains although last year it was less so.

Has the nasal vaccine been used in other countries?

Yes; it has been used safely in America for many years and it was used in the previous two flu seasons in the UK where hundreds of thousands of children were successfully vaccinated.

My child had the flu vaccination last year. Do they need another one this year?

Yes; the flu vaccine for each winter helps provide protection against strains of flu that may be different from last year. For this reason we recommend that even if vaccinated last year, your child should be vaccinated again this year.

Does the nasal vaccine contain gelatine derived from pigs (porcine gelatine)?

Yes. The nasal vaccine contains a highly processed form of gelatine (porcine gelatine), which is used in a range of many essential medicines. The gelatine helps to keep the vaccine viruses stable so that the vaccine provides the best protection against flu.

Can’t my child have the injected vaccine that doesn’t contain gelatine?

The nasal vaccine provides the best protection against flu, particularly in young children. It also reduces the risk to, for example, a baby brother or sister who is too young to be vaccinated, as well as other family members (for example, grandparents) who may be more vulnerable to the complications of flu. The injected vaccine is not thought to reduce spread so effectively and so is not being offered to healthy children as part of this programme. However, if your child is at high risk from flu due to one or more medical conditions or treatments and can’t have the nasal flu vaccine they should have the flu vaccine by injection.

Some faith groups accept the use of porcine gelatine in medical products – the decision is, of course, up to you. For further information about porcine gelatine and the nasal flu vaccine, see

Why Porcine Gelatine Is Used In Vaccines - Download (.pdf)

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