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 2018 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 are:

• asthma
• heart disease
• kidney disease
• liver disease
• neurological disease
• diabetes
• immunosuppression
• no fully working spleen

A tiny amount of the flu vaccine's 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's been used successfully and safely for several years and millions of doses of the vaccine have been given to children in the last 4 years in the UK.

What vaccine's used?

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

I’ve heard the vaccine's live. Does this mean my child will get flu?

No, the virus in the vaccine's been weakened so that 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 didn’t get the vaccine aren't at risk of becoming seriously ill with flu from the vaccine, either through being in the same room where the flu vaccine has been given or by being in contact with a recently vaccinated child. The amount of virus shed is normally below the levels needed to pass on infection to others and the virus doesn't survive for long outside of the body.

You don't need to keep children off school during the period when the vaccine's being offered, or in the following weeks. The only exception to this would be children who are extremely immunocompromised (have a weakened immune system).

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 a transplant or cancer
• 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.

The nasal spray vaccine may not be suitable for some children with severe asthma who're taking high doses of inhaled steroids, or if they've recently been prescribed oral steroids.

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 spray vaccine contains a small trace of pork gelatine. 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 2018 and not yet in school will be offered the nasal vaccine between October and December.

You'll be sent a letter about contacting your GP practice to arrange an appointment for your child.

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.

You should reschedule your child's appointment if:

• they're very unwell - for example with a fever, diarrhoea or vomiting
• their asthma has worsened - with more wheezing or increased use of their inhalers 3 days before their immunisation

Please phone your GP practice to arrange another appointment.

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.

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 receive their flu immunisation at school as scheduled.

You should reschedule your child's immunisation if:

• they're very unwell - for example with a fever, diarrhoea or vomiting
• their asthma has worsened - with more wheezing or increased use of their inhalers 3 days before their immunisation

Please speak to your school health team if you've any concerns.

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.

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

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, Simplified Chinese and Urdu.

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

Audio leaflets

British Sign Language (BSL) leaflet