NHS Choices

Flu vaccine (children)

In the autumn/winter of 2016/17 the annual nasal spray flu vaccine will be available for children aged two and three years old plus children in reception class, years one, two and three in school as part of the NHS Wales routine childhood vaccination programme.

The vaccine will be offered routinely to all children aged two and three (age on August 31 2016) at their general practice.

Children in reception class, year one, year two and year 3 will be offered flu vaccination in school. Children aged 4-8 years old (date of birth from 1st September 2008 to 31st August 2012) who do not attend a school where flu vaccine is offered should contact their GP to obtain their nasal spray flu vaccine.

Over time, as the routine children's flu programme rolls out, it is expected that all children between the ages of two and 16 will be offered vaccination against flu each year with the nasal spray.

The nasal spray flu vaccine

The flu vaccine for children is given as a nasal spray squirted up each nostril. Not only is it needle-free (a big advantage for children), the nasal spray works even better for children than the injected flu vaccine.

It’s quick and painless and will mean your child is less likely to become ill if they come into contact with the flu virus. Its brand name is Fluenz® Tetra.

The nasal spray flu vaccine is also for children aged two to 16 who are "at risk" from flu, such as children with long-term health conditions. Children under 9 years of age with a long-term health conditions who have never had a flu vaccine before will be offered two doses of the vaccine, one month apart.

Why children are being offered a flu vaccine

Flu can be very unpleasant for children. They have the same symptoms as adults – including fever, chills, aching muscles, headache, stuffy nose, dry cough and sore throat lasting up to a week.

Some children develop a very high fever or complications of flu such as bronchitis, pneumonia and painful middle ear infection. They may need hospital treatment, and very occasionally a child may die from flu.

For children with long-term health conditions such as diabetes, asthma, heart disease or lung disease, getting flu can be very serious as they are more at risk of developing serious complications.

Read more about flu and the complications of flu.

Stopping the spread of flu

The nasal spray flu vaccine will not only help to protect your child from getting flu, it also stops the disease spreading from them to their family, carers and the wider population. This is known as herd immunity.

Children are good at spreading flu, because they tend to sneeze everywhere and don't use tissues properly or wash their hands. Vaccinating them may also protect others that are vulnerable to flu such as babies, older people, pregnant women and people with serious long-term illnesses.

The flu vaccine for children is expected eventually to prevent at least 2,000 deaths from flu in the general population and lead to 11,000 fewer hospitalisations.

Children with long-term health conditions

Children with long-term health conditions are at extra risk from flu and it's especially important that they are vaccinated against flu each year.

Children at increased risk of flu are already offered an annual flu vaccine. For most this will be the nasal spray as it is more effective than the injected vaccine for children, children aged from two to 17 with long-term health conditions are also being offered the annual flu nasal spray instead of the injection.

Those children with long-term health conditions aged from six months to less than two years will continue to be offered the annual injectable flu vaccine as the nasal spray vaccine isn't suitable for children under two years old.

Are there children who shouldn't have the flu vaccine?

Neither the nasal spray or the injectable flu vaccine are suitable for babies under the age of six months.

There are a few children who should avoid the nasal spray flu vaccine.

It’s not suitable for children who have:

  • a severely weakened immune system
  • severe egg allergy which has previously required intensive care
  • severe asthma (children with mild or moderate asthma are able to have the flu nasal spray)
  • active wheezing at the time of vaccination or in the previous 72 hours

Children unable to have the nasal spray vaccine may be able to have the flu injection instead.

How does the flu vaccine for children work?

The nasal spray vaccine contains flu viruses that have been weakened to stop them causing flu. It will help your child build up immunity to flu in a similar way as natural infection (but without the symptoms).

Because the main flu viruses change each year, a new nasal spray vaccine has to be given each year, in the same way as the injectable flu vaccine.

Fluenz® Tetra works well in children and gives them good protection against catching flu. In fact, the nasal spray is more effective than the injected flu vaccine, in children which is why they are being routinely offered the nasal spray rather than the flu jab.

As the vaccine is absorbed very quickly, it will still work even if your child has a runny nose, sneezes or blows their nose straight after being vaccinated.

How many doses of the flu vaccine do children need?

Most children only need a single dose of the nasal spray.

The patient information leaflet provided with Fluenz® Tetra suggests children should be given two doses of this vaccine if they've not had flu vaccine before. However, the NHS vaccination programme has advised that healthy children need only a single dose of Fluenz® Tetra because a second dose of the vaccine provides little additional protection.

Children aged two to nine years at risk of flu because of an underlying medical condition who have not received flu vaccine before should have two doses of Fluenz Tetra (given at least four weeks apart).

How safe is the flu vaccine for children?

The nasal spray flu vaccine for children has a very good safety profile. It’s been widely used in the US for more than 10 years and no safety concerns have been raised so far.

The vaccine contains live, but weakened, forms of flu virus that do not cause flu in children who receive it.

What are the side effects of the flu vaccine for children?

The nasal spray flu vaccine has very few side effects, the main one being that vaccinated children may have a runny nose for a short time.

Read more about the side effects of the flu vaccine for children.

How to get the flu vaccine for your child

You’ll be automatically contacted by your GP or your child’s school in September/October 2016 with information about getting your child vaccinated before the winter. If you don’t hear anything, or you want more information about when and how your child will be vaccinated against flu, talk to your GP, practice nurse or your child’s school nurse.


Click here to see all vaccination leaflets.

Last Updated: 01/04/2017 09:00:00