Nasal flu vaccine for children

Influenza (flu) is a very infectious illness caused by the flu virus. Flu spreads easily and infects both children and adults.

Children are twice as likely to get the flu than adults. Children are also more likely than adults to get severe complications of flu.

Children who are sick with flu miss days in crèche, childcare and school. They also miss out on their usual activities such as hobbies and sports.

The flu vaccine will help protect your child against flu and reduce the spread of flu to others. For example their brothers and sisters, parents and grandparents.

Children and young people aged 2 to 17 can get the nasal flu vaccine for free.

The flu vaccine for children has been given to children in the US since 2003 and in the UK since 2013.

Complications of flu

Most children who get the flu have mild symptoms. But every winter some children can get complications of flu.

Complications of flu include:

  • pneumonia
  • bronchitis
  • inflammation of the brain (encephalitis) - this is rare

Children with these complications may need hospital treatment. Some may need intensive care.

Children with chronic health conditions are at risk of serious complications from flu.

In the last 10 years, almost 5000 children were admitted to hospital with complications of flu.  Almost 200 children had to have treatment in intensive care and 40 children died.

Read more about symptoms of flu

How the vaccine is given

The vaccine is given as a single spray in each nostril of your child's nose.

Your child can breathe normally while getting the vaccine. There is no need to take a deep breath or sniff.

The vaccine is not painful and is absorbed quickly. It will work even if your child has a runny nose, sneezes or blows their nose after the vaccination.

Most children need only 1 dose of the vaccine each year. Some children aged 2 - 8 years with chronic health conditions like chronic heart or lung conditions may need 2 doses if they have never had a flu vaccine. The doses are given 4 weeks apart.

Where to get the vaccine

Your child can get the vaccine at your GP or pharmacy from October until the middle of February 2022.

Who should not get the nasal flu vaccine

Your child should not get the vaccine if they:

  • have had a severe allergic reaction to a previous dose of the flu vaccine or any of its ingredients
  • have severe asthma or if they have been wheezy or needed their inhaler more than usual in the 3 days before the vaccination
  • are taking medicines called salicylates, which include aspirin
  • have taken influenza antiviral medication within the previous 48 hours
  • have a severely weakened immune system because of certain medical conditions or treatments
  • are living with someone who has a severely weakened immune system  - for example, a person who has to live in insolation in the months following a bone marrow transplant
  • have a condition which means they have a leak of the CSF (the fluid that surrounds the brain and spinal cord)
  • have severe neutropoenia (low levels of a type of white blood cell) 
  • are on combination checkpoint inhibitors (e.g. ipilumumab plus nivolumab) which are used to treat cancer
  • are pregnant

Your child may not be able to have the nasal flu vaccine if they have had a cochlear implant. The advice of the specialist looking after your child will be needed to see if your child can have the nasal flu vaccine.

Seek specialist advice if your child needs regular oral steroids or they have previously required ICU care for asthma.

If your child cannot have the nasal flu vaccine, you should speak to your GP or pharmacist about getting the vaccine as an injection.

If your child is 6 months to 2 years of age and is in a high-risk group for flu, they'll be offered a flu vaccine injection. This is because the nasal spray is not licensed for children under the age of 2.

Delaying your vaccination

You should delay your child's vaccination if they are not well and have a high temperature.

The vaccination can be delayed until they feel better.

If your child has a very blocked or runny nose, it might stop the vaccine from getting into their system. In this case, delay the vaccine until their nose is clear.

Side effects of the nasal flu vaccine

The most common side effects are mild and include:

  • a runny or blocked nose
  • headache
  • muscle aches
  • tiredness
  • loss of appetite 

Some children get a fever (temperature) after the vaccine. It is usually mild and goes away on its own.

If your child has a fever or a headache, you can give them paracetamol or ibuprofen.

Aspirin, or any medicines that contain aspirin, should never be given to children unless prescribed by a doctor.

This is especially important in the 4 weeks after getting the flu vaccine.

Serious side effects such as a severe allergic reaction are rare.

In very rare cases Guillain-Barré syndrome (GBS) has been reported (Guillain- Barré Syndrome is a condition that affects the nerves in the body. It causes nerve inflammation and can result in pain, numbness, muscle weakness and difficulty walking). However, the risk of GBS following flu is significantly greater than that following the flu vaccine.

There is no evidence that you can catch flu from the nasal flu spray.

Be aware that anti-vaccine stories are spread online through social media. They may not be based on scientific evidence and could put your child at risk of a serious illness.

Vaccine safety

All vaccines are thoroughly tested to make sure they will not harm you or your child.

The flu vaccine for children has a good safety record. Millions of children in the US and the UK have been vaccinated safely and successfully.

Read more about the Nasal Flu Vaccine

COVID-19 vaccines and the nasal flu vaccine

The flu vaccine doesn’t protect against COVID-19.

For children aged 12 to 17 years, they can get the flu vaccine at the same time as the COVID-19 vaccine if they have not yet received it.

It is important to get both the flu vaccine and the COVID-19 vaccine. This is because Flu and COVID-19 are caused by different viruses.

Flu and COVID-19 can both cause serious illness and if your child gets them, they might need to be admitted to hospital. It may be difficult to tell the symptoms of flu apart from the symptoms of COVID-19.

If your child has had the COVID-19 vaccine, they should still get the flu vaccine.

Vaccine Ingredients

There is no thiomersal, aluminum or mercury in the flu vaccine used in the 2021/2022 campaign.

There is a very small amount of Gelatin in the nasal flu vaccine. Gelatin is used as a preservative in the vaccine.

Read more on the use of gelatin in the vaccine from the Irish Council of Imams (PDF, 83K B, 2 pages)

Read more about the vaccine (Fluenz Tetra) and its ingredients in the Health Products Regulatory Authority patient information leaflet (PDF 340KB, 7 pages) and summary of product characteristics

More information

This page was last updated on 15 October 2021