Protect your child against flu

This page is for parents and carers of preschool and primary school-aged children on how to protect them from the flu. Further information on eligible children can be found at gov.im/flu

5 reasons to have the flu vaccine

  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.

The flu vaccine is offered free to:

  • children aged 2 or 3 years old (on 31 August of current flu season)
  • all primary school-aged children
  • all year 7 to year 11 secondary school-aged young people
  • children with a health condition that puts them at greater risk from flu

Why should your child 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 last several days or more.

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, acute bronchitis and pneumonia.

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 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.

This year, helping to protect them against flu is particularly important if COVID-19 is still circulating because people at risk from flu are also vulnerable to the complications of COVID-19.

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.

Vaccine effectiveness

Flu vaccine is the best protection we have against this unpredictable virus. The effectiveness of the vaccine will vary from year to year, depending on the match between the strain of flu in circulation and that contained in the vaccine.

In the UK the vaccine offered to children has usually provided good protection against flu since its introduction.

Why are so many children being offered the vaccine?

As well as helping to protect children who are vaccinated, the infection is then less able to spread, and so it helps to protect other family members and friends.

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

Yes – flu viruses change every year so the vaccine may be updated. For this reason, we recommend that your child is vaccinated against flu again this year, even if vaccinated last year.

Who will give your child their vaccination?

Children aged 2 and 3 years old will be given the vaccination at their general practice usually by the practice nurse. [Footnote 1]

Nearly all school-aged children will be offered the vaccination in school.

Children who are home educated will be offered the vaccine, provided they are in an eligible age group. Parents can obtain information about arrangements from their local childhood flu administration team.

How will the vaccine be given?

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

Can the vaccine cause flu?

No, the vaccine cannot cause flu because the viruses in it have been weakened to prevent this from happening.

How the nasal spray works

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 these flu viruses, it helps the immune system to fight off the infection. 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.

Side effects

Children may develop a runny or blocked nose, headache, general tiredness and some loss of appetite. However, these are much less serious than developing flu or complications associated with flu. Serious side-effects are uncommon.

Children with 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 breathing problems, for example, some children with asthma needing steroid inhaler or tablets
  • serious heart conditions needing steroid inhaler or tablets
  • kidney or liver disease
  • diabetes
  • a learning disability
  • 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

These children should have a flu vaccination every year from the age of 6 months onwards. Most will have the nasal spray vaccine but it should not be given to children under the age of 2 years.

These children, and those for whom the nasal spray is not suitable for medical reasons, will be offered an injectable flu vaccine.

If your child has any health condition listed above but is not offered the vaccine in school, it is important that you contact your GP surgery 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 before the winter. Alternatively, you can contact them directly to make an appointment.

For primary school-aged children a vaccination session will be held at school generally during the autumn term. Your local healthcare 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, 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.

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 a suitable injected flu vaccine to avoid a delay in protection)
  • have needed intensive care due to
    • asthma
    • 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 [footnote 2]
  • have a condition that needs salicylate treatment

If your child is at high risk from flu due to 1 or more medical conditions or treatments and can’t have the nasal flu vaccine they should have the injected flu vaccine.

If you are unsure whether your child should get the injected vaccine or the nasal vaccine please check with the childhood flu administration team or the nurse or GP at your surgery.

Children who have been vaccinated with the nasal spray should avoid household contact with people with very severely weakened immune systems for around 2 weeks following vaccination.

Flu vaccine and other vaccines

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.

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.

The nasal vaccine is offered to children as it is more effective in the programme than the injected vaccine. This is because it is easier to administer and considered better at reducing the spread of flu to others, who may be more vulnerable to the complications of flu.

However, if your child is at high risk from flu due to 1 or more medical conditions or treatments and can’t have the nasal flu vaccine you should have the flu vaccine by injection.

For those who may not accept the use of porcine gelatine in medical products, an alternative injectable vaccine is available this year. You should discuss your options with your nurse or doctor.

Further information

Talk to the childhood flu administration team, your GP, or practice nurse if you have any further questions.

Further information is available on gov.im/flu

  • [Footnote 1]: Your child will be eligible provided they were aged 2 or 3 years old on 31 August of the current flu season 
  • [Footnote 2]: See the Patient Information Leaflet for a list of the ingredients of the vaccine 



This page has been adapted with kind permission from Public Health England © Crown copyright 2021 Protect yourself against flu – information for parents and carers of preschool and primary school-aged children – GOV.UK 

Updated: 18 August 2021