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Immunising preschool children against flu

This information is about the annual flu vaccination programme for pre-school children. It is for those working in the early years sector to inform them about the programme and how they can support it. It is for nursery and preschool managers and staff, and childminders delivering the Early Years Foundation Stage Framework and those who provide informal childcare, such as nannies.

Background to the programme

Flu is a common infection in babies and children and can be very unpleasant for them. Children under the age of 5 have the highest hospital admission rates for flu compared to other age groups.

All children aged 2 and 3 years old on 31 August 2021 are eligible for a free flu vaccination in the form of a nasal spray. However, not all parents are aware of this or take up the offer. Not only does the flu vaccine help to protect the children themselves, but by reducing the spread of flu it will also help protect family members, and others in the local community.

What is flu?

Flu in children can cause 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 painful ear infections, acute bronchitis, and pneumonia.

Flu is different from the common cold. It is caused by a different group of viruses and the symptoms tend to start more suddenly, be more severe and last longer.

The purpose of the programme

Annual immunisation helps provide protection to individual children and reduces the spread of flu to their families, younger siblings, grandparents and the wider community, protecting others who are at increased risk of becoming seriously ill from flu.

For many years the flu vaccine has been offered to those who are most at risk of severe illness from flu. This includes pregnant women, those aged 65 and over, and those with long term health conditions, including children.

To further extend protection, the vaccination programme has been extended to 50 to 64 year olds this year. Helping to protect them against flu is particularly important this year with coronavirus (COVID-19) in circulation because people at risk from flu are also vulnerable to the complications of COVID-19. Research also shows that if you get both flu and COVID-19 at the same time you may be more seriously ill.

Where children can get the vaccine

All children who are aged 2 and 3 years old (on the 31 August 2021) can get the vaccine at their general practice. This is usually administered by the practice nurse and for most children is a quick and painless nasal spray.

There are some children for whom the nasal spray is not suitable. GP practices will check suitability before offering the vaccine.

When the vaccinations need to be given

To be effective, vaccinations need to be given in the autumn or early winter before flu starts to circulate. Flu viruses can change year on year. Consequently, vaccines are made each year to provide protection against the flu viruses that are predicted to circulate, and therefore the vaccine needs to be given on an annual basis.

Can parents refuse to have their child vaccinated?

Yes. The vaccination is not mandatory. Parents will need to give their informed consent for the vaccination. The nasal flu vaccine contains a highly processed form of gelatine (derived from pigs). For those who may not accept the use of porcine gelatine in medical products, an alternative injectable vaccine is available this year. Parents should discuss their options with their nurse or doctor.

The role of the early years sector

What staff in the early years sector can do to support the programme

Staff working in the early years sector can help raise awareness of the programme amongst parents. Resources adapted by Public Health Isle of Man with kind permission from Public Health England can be downloaded or ordered for free.

As well as protecting children and the wider community, promoting the flu vaccine promotes a healthy working environment in nurseries and childcare settings by reducing the risk of spread of flu to others including staff.

Can staff have the vaccine?

Not as part of this programme. The nasal flu vaccine used in this programme is not licensed for adults. Some early years providers, however, may choose to provide an injectable vaccine for their staff through their own occupational health services.

Staff with certain medical conditions that put them more at risk of flu, or who are pregnant, are entitled to free flu vaccination (injectable vaccine) through Manx Care. Eligible staff should contact their GP practice. Some local pharmacies also provide this service. For more information visit

Other children who are offered flu vaccination

Older children are being offered flu vaccination in schools

All children in primary school and those in year 7 to 11 of secondary school will be offered flu vaccination this autumn. Most vaccination sessions will take place in school.

Children with long-term health conditions

Children less than 2 years old, but over 6 months of age, with a long term health condition that puts them at increased risk of flu should also have annual flu vaccination.

This includes children with serious breathing problems (such as some children with asthma), serious heart conditions, severe kidney or liver disease, diabetes, immunosuppression or problems with the spleen. Children under the age of 2 will be offered an injected vaccine as the nasal spray is not licensed for them.

Preventing the spread of flu

You can help stop yourself from catching flu or spreading it to others with good hygiene measures. The young children that you care for should also be encouraged to do the same:

  • wash hands regularly with soap and warm water
  • use tissues to cover the mouth and nose when coughing or sneezing
  • put used tissues in a bin as soon as possible

Regularly cleaning surfaces such as tables, telephone and door handles can also help to get rid of germs.

Anyone with flu should avoid unnecessary contact with other people until they are fully recovered.


Public Health Isle of Man has adapted the following resources with kind permission from Public Health England. They can be downloaded from

  • protecting your child against flu leaflet – this provides information for parents and carers of preschool and primary school aged children on the flu vaccine, including how it works and contraindications
  • 5 reasons to vaccinate your child against flu poster – this sets out key messages for parents about the flu vaccine

Visit to download copies or contact the Manx Care childhood flu administration team on or ring +44 1624 686709 to order printed copies.

This page has been adapted with kind permission from Public Health England © Crown copyright 2021 Immunising preschool children against flu – GOV.UK 

Updated 22 July 2021

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