Child flu vaccine

The flu vaccine helps protect your child against flu and reduces the chance of them spreading the virus to others.

The vaccine doesn’t cause flu.

Who's being offered the vaccine?

The flu vaccine's offered to all:

• children in Scotland aged 2-5 years (and not yet in school) at their GP practice (children must be aged 2 years or above on 1 September 2019 to be eligible)
• primary school children at school

Children in secondary school aren't currently included in the programme. However, children of all ages with a health condition will still be offered the flu vaccine from 6 months of age.

Why get your child immunised

Flu's very infectious and can be serious. Flu can lead to complications that may result in hospitalisation or even death.

Even healthy children can become seriously ill from flu and can spread it to family, friends and others. Every year in Scotland, children are hospitalised for the treatment of flu or its complications.

In some cases flu can lead to complications. These can include:

• bronchitis
• pneumonia
• painful middle ear infection
• vomiting

For children with health conditions getting flu can be even more serious. Health conditions that make children more vulnerable include:

• asthma
• bronchitis
• heart disease
• kidney disease
• liver disease
• morbid obesity (defined as BMI of 40 and above)
• neurological disease
• diabetes
• immunosuppression
• no fully working spleen

A tiny amount of the flu vaccine is given as a nasal (nose) spray into each nostril. It isn't an injection.

It’s quick and painless and there’s no need to sniff or inhale the vaccine.

Children who can't have the nasal spray vaccine may be offered a flu vaccine as an injection in the upper arm.

The nasal spray flu vaccine has been used successfully and safely for several years and millions of doses of the vaccine have been given to children in the last 5 years in the UK.

What vaccine's used?

The Fluenz Tetra nasal spray suspension Influenza vaccine (live attenuated, nasal) is routinely used in Scotland.

Can the flu vaccine give my child flu?

No, the flu vaccine can’t give your child flu. The virus in the vaccine has been weakened so 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).

The flu vaccine should start to protect most children about 10 to 14 days after they receive their immunisation.

Can my child get the flu from viral shedding?

Children who don’t get the vaccine are also not at risk of becoming seriously ill with flu from the vaccine, either by being at school during immunisation days or by being in contact with a child who has recently had the vaccine.

It is therefore not necessary to keep children off school during the period when the vaccine is being given or in the following weeks. The only exception to this would be children who have a severely weakened immune system (immunocompromised).

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

Very few children can't have the nasal spray vaccine. This includes children who:

• have their immune system suppressed because they're getting treatment for serious conditions such as cancer or had a transplant
• have a serious condition which affects the immune system, such as severe primary immunodeficiency
• are taking regular high doses of oral steroids
• have had a severe reaction to a previous dose of the vaccine
• are undergoing salicylate treatment (taking aspirin)

Children with an egg allergy can safely have the nasal spray vaccine, unless they've had a life-threatening reaction to eggs that required intensive care.

An egg-free injectable vaccine which can be used in those from 9 years of age has become available this year. If you're affected, please speak to your GP practice for advice.

The nasal spray vaccine may not be suitable for some children with severe asthma who regularly need oral steroids or asthma control. If you’re affected, please speak to your GP practice for advice.

If your child is at school, please make sure you list all of your child’s medications on the consent form. All consent forms will be checked by the school health team before the immunisation session to make sure your child can have the nasal spray.

More information about the consent form and its completion and return.

Is there pork gelatine in the nasal spray vaccine?

The nasal vaccine contains a highly processed form of pork gelatine as one of its additives; it's used in many essential medicines.

The gelatine helps keep the vaccine virus stable to provide the best protection against flu.

Many faith groups, including Muslim and Jewish communities, have approved the use of gelatine-containing vaccines. However, it's your choice whether or not you want your child to get the nasal spray vaccine. The nasal spray's much more effective for children than the flu vaccine injection, but those who choose not to have it for religious reasons can ask for the injection.

If your child is aged 2-5 years and not yet at school, please discuss this with your GP or practice nurse.

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 isn't possible to predict exactly which strains will circulate each year.

How do we know the vaccine's safe?

All medicines (including vaccines) are tested for safety and effectiveness by the Medicines and Healthcare Products Regulatory Agency (MHRA). The vaccine meets the high safety standards required for it to be used in the UK and other European countries. The vaccine has been given to millions of children worldwide.

Once they're in use, the safety of vaccines continues to be monitored by the MHRA.

All children aged 2–5 years as of 1 September 2019 and not yet in school will be offered the nasal vaccine from October onwards.

The vaccine takes 10 days to work, so the earlier your child can get the vaccine, the better.

You'll be sent a leaflet and letter about contacting your GP practice to arrange an appointment for your child or find out about local flu clinic arrangements.

What if my child's ill on the day?

If your child has a minor illness without a fever, like a cold, they can still attend their flu immunisation appointment as scheduled.

Please phone your GP practice to reschedule your child's appointment if they're very unwell - for example with a fever, diarrhoea or vomiting.

If your child’s asthma is worse than usual in the three days before their vaccination, meaning they are wheezing more or have had to use their inhaler more than they normally do, tell the healthcare worker at their appointment.

There is no need to delay their immunisation, and they should be offered an alternative injectable form of the vaccine.

What if my child misses their immunisation?

If your child misses their appointment, contact your GP to reschedule.

Does my child need a second dose?

Almost all children will only need one dose of the vaccine.

However, if your child is under 9 years old they'll need a second dose (4 weeks after the first) if they:

• have a health condition and this was their first time getting the flu vaccine - this will make sure their immunity has fully built up
• were given the injectable vaccine and this was their first time getting the flu vaccine - even if they don't have a health condition

Your GP will advise you if your child needs a second dose.

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

No, your child will need to get the flu vaccine every year. Flu viruses are constantly changing and a different vaccine has to be made every year to ensure the best protection against flu. This is why the flu vaccine is offered every year during autumn/winter.

Improving how vaccines are offered in Scotland

To improve how vaccinations are offered to you or your child, you may notice:

• you're invited to a new location to receive your immunisations instead of your GP practice
• the health professional giving your immunisations changes

You'll still receive clear information about the location, date and time of your appointment.

All primary school children are being offered the nasal vaccine in school between October and December. If your child has a health condition they're also offered the vaccine in school and no longer need to get it from your GP.

Your child will be sent home with a letter, leaflet and consent form. Please complete this consent form and send it back to school with your child. Your child can only get the nasal vaccine if you have sent back a completed and signed consent form.

You can view consent form guidance for full instructions on how to complete the consent form.

What if my child's ill on the day?

If your child has a minor illness without a fever, like a cold, they can still attend their flu immunisation appointment as scheduled.

Please phone your GP practice to reschedule your child's appointment if they're very unwell - for example with a fever, diarrhoea or vomiting.

If your child’s asthma is worse than usual in the three days before their vaccination, meaning they are wheezing more or have had to use their inhaler more than they normally do, tell the healthcare worker at their appointment.

There is no need to delay their immunisation, and they should be offered an alternative injectable form of the vaccine.

What if my child misses their immunisation?

If your child misses their immunisation in school, contact your local NHS Board to find out about other arrangements. You can find the number for your local NHS Board:

• on the invitation letter that was sent to you
• by phoning our health information team

Does my child need a second dose?

Almost all children will only need one dose of the vaccine.

However, if your child is under 9 years old they'll need a second dose (4 weeks after the first) if they:

• have a health condition and this was their first time getting the flu vaccine - this will make sure their immunity has fully built up
• were given the injectable vaccine and this was their first time getting the flu vaccine - even if they don't have a health condition

Please phone your local NHS Board using the number on the letter that was sent to you to find out about local arrangements.

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

No, your child will need to get the flu vaccine every year. Flu viruses are constantly changing and a different vaccine has to be made every year to ensure the best protection against flu. This is why the flu vaccine is offered every year during autumn/winter.

What if I change my mind?

If you change your mind, phone your local NHS Board using the number on the letter that was sent to you.

To withdraw consent, you'll need to confirm this in writing. To give consent, you'll need to fill in a new consent form.

Improving how vaccines are offered in Scotland

To improve how vaccinations are offered to you or your child, you may notice:

• you're invited to a new location to receive your immunisations instead of your GP practice
• the health professional giving your immunisations changes

You'll still receive clear information about the location, date and time of your appointment.

As with all medicines, side effects of the nasal spray 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 vaccine.

Less common side effects include a nosebleed after the nasal spray vaccine.

More information on the possible side effects of the vaccine is available in the Fluenz Tetra nasal spray suspension Influenza vaccine (live attenuated, nasal) Patient Information Leaflet (PIL).

Infant paracetamol

Vaccines protect your baby against the risk of very serious infections and should not be delayed.

Fever can be expected after any vaccination.  Fevers are usually mild, so you only need to give a dose of infant paracetamol if your child isn’t comfortable or is unwell.  Read the instructions on the bottle very carefully. 

Fever is more common when the MenB vaccine is given with the other routine vaccines at 8 and 16 weeks.  Infant paracetamol should be given to babies after each of these immunisation appointments.

Public Health Scotland’s booklet What to expect after immunisations: Babies and children up to 5 years has more information.

In infants who do develop a fever after vaccination, the fever tends to peak around 6 hours after vaccination and is nearly always gone completely within 2 days. 

Ibuprofen can be used to treat a fever and other post-vaccination reactions.  Giving ibuprofen at the time of vaccination to prevent a fever is not effective.

Remember, never give medicines that contain aspirin to children under 16.

Information about treating a fever in children.

If an infant still has a fever 48 hours after vaccination or if parents are concerned about their infant’s health at any time, they should seek advice from their GP or NHS 111. 

The diseases vaccines protect against are very serious and therefore vaccination should not be delayed because of concerns about post-vaccination fever.

If you're worried about your child, trust your instincts. Speak to your GP or phone the 111 service.

Where can I report suspected side effects?

You can report suspected side effects of vaccines and medicines through the Yellow Card Scheme.

This can be done by:

• visiting the Yellow Card Scheme website
• phoning the free Yellow Card hotline on 0808 100 3352 (available Monday to Friday, 10.00am to 2.00pm)

If you’re unsure about anything, or have any questions about the child flu vaccine, phone:

• your GP practice
• the NHS inform helpline

Immunisation leaflets

NHS Health Scotland has produced leaflets explaining the child flu vaccination in Scotland, why it's offered and when it's given.

These leaflets are also available in Easy Read English and other languages - including Polish, Mandarin (Simplified Chinese) and Arabic.

Childhood flu immunisation children aged 2-5 and not yet in primary school leaflets (Scotland)

Childhood flu immunisation primary school leaflets (Scotland)

Childhood flu immunisation 'What to expect after the flu vaccine' leaflets (Scotland)

Childhood flu consent form guidance

Childhood flu immunisation BSL video leaflets

Childhood flu immunisation audio leaflets

Protecting your child

Protect your child against serious diseases (Leaflet)

Protect your child against serious diseases (Audio)

Protect your child against serious diseases (BSL)

After immunisation

What to expect after immunisations in babies and young children (Audio)

What to expect after immunisation: Babies and young children (Leaflet)

What to expect after immunisation: Babies and young children (BSL)