Child flu

The flu vaccine is 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 2017 to be eligible). It is also offered to all primary school children at school.

Primary school children - Look out for the consent form in your child's school bag. Please make sure you answer all the questions on the consent form and return it to school as soon as possible. Consent form guidance is available to help you complete the form.


Questions and answers:

Facts about flu

  • Flu is very infectious and can be serious
  • Even healthy children can become seriously ill from flu and can spread it to family, friends and others
  • Flu can lead to complications that may result in hospitalisation or even death
  • Every year in Scotland, children are hospitalised for the treatment of flu or its complications
  • 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.

What is flu like for children? 

Flu is a virus; it spreads quickly and can infect children and adults very easily. It causes an unpleasant illness which can be serious. It may lead to days spent ill in bed rather than being at school or doing day-to-day activities. 

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What are the symptoms of flu?

Children get the same flu symptoms as adults. These symptoms are worse than a normal cold and include:

  • stuffy nose, dry cough and sore throat
  • fever and chills
  • aching muscles and joints
  • headaches
  • extreme tiredness.

These symptoms can last between two and seven days. Some children have a very high temperature, sometimes without other obvious symptoms, and need to go to hospital for treatment.

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Why do we need to protect children and adults from flu?

Flu can be very serious. In some cases flu can lead to complications. These can include: 

  • bronchitis
  • pneumonia
  • painful middle ear infection
  • vomiting
  • diarrhoea.

For children with health conditions (for example asthma, heart, kidney, liver, neurological disease, diabetes, immunosuppression or no fully working spleen) getting flu can be even more serious. In the worst cases, flu can lead to disability and even death.

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How does flu spread?

The flu virus spreads through the air when people cough and sneeze without covering their nose and mouth. Other people then breathe in the virus directly or pick it up by touching surfaces where it has landed and touch their eyes, nose and mouth. Because young children don’t always cover their noses or mouths when coughing or sneezing, the virus can spread very quickly from them. Anyone who is in close contact with a young child should ensure good personal hygiene, for example, washing their hands.

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Who is being offered the vaccine?

The vaccine is offered to all primary school children, as well as children aged 2–5 years who are not yet in primary school. Children in secondary school are not 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.

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Where and when will my child get the vaccine?

Children aged 2-5 years and not yet in primary school

All children aged 2–5 years and not yet in primary school will be offered the vaccine between October and December. You will be sent a letter about contacting your GP practice to arrange an appointment for your child.

Primary school children 

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

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How is the vaccine given?

A tiny amount of the flu vaccine is given as a nasal (nose) spray into each nostril. It is not an injection. It’s quick and painless and there’s no need to sniff or inhale the vaccine.

Watch our short film, explaining how the vaccine is given in school.

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

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

Very few children cannot have the nasal spray vaccine. 

This includes children who:

  • have their immune system suppressed because they are 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 have 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 are taking high doses of inhaled steroids, or if they have 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. 

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 is your choice whether or not you want your child to get the nasal spray vaccine. The nasal spray vaccine is a much more effective vaccine than the injection in children.

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

If your child is in primary school, please tick the box on the consent form if you wish to request the injectable alternative for religious reasons. You will be sent a consent form for your child every year of primary school (you child will not automatically be offered the injectable alternative – you will need to tick the box every year).

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What if my child is ill on the day?

If your child is very unwell (for example, with a fever, diarrhoea or vomiting), or if your child’s asthma has worsened (with more wheezing or increased use of their inhalers three days before their immunisation) they should not have the vaccine.

If your child is aged 2-5 years and not yet at school, please phone your GP practice to arrange another appointment.

If your child is in primary school, please speak to your school health team if you have any concerns. 

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What if my child misses their immunisation? 

If your child is aged 2–5 years and not yet in school, contact your GP. If your child misses their immunisation in school, please contact your local NHS Board (on the number in the letter enclosed) to find out about other arrangements.

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

No, the virus in the vaccine has 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. 

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Can my child get the flu from viral shedding?

Children who didn’t get the vaccine are not at risk of catching flu from the vaccine, either through being in the same room where 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 does not survive for long outside of the body. Excluding children from school during the period when the vaccine is being offered, or in the following weeks, is therefore not considered necessary. The only exception to this would be children who are extremely immunocompromised (have a weakened immune system).

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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 AND has a health condition AND is getting the flu vaccine for the first time, they will need a second dose (4 weeks after the first) to make sure their immunity has fully built up.

They will also require a second dose if your child is under 9 years old, was given the injectable vaccine AND this was their first ever flu vaccine, even if they do not have a health condition.

If your child is aged 2-5 years and not yet in school, your GP will advise you. If your child is at school, please contact your local NHS Board (on the number in the letter enclosed) to find out about local arrangements.

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Will there be any side effects of the vaccine?

As with all medicines, side effects to 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. 

For more information on the side effects of the vaccine please read the patient information leaflet (external link).

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Is the vaccine safe?

Before they are allowed to be used, all medicines (including vaccines) are tested for safety and effectiveness. Once they are in use, the safety of vaccines continues to be monitored.

The nasal spray flu vaccine has been used successfully and safely for several years in the USA and was given safely to hundreds of thousands of children in the last three years in the UK.

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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. 

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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 is not possible to predict exactly which strains will circulate each year.

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What if I change my mind?

If you change your mind and your child is aged 2–5 and not yet at school, please contact your GP. 

If you change your mind, please telephone your local NHS Board on the number given in the letter enclosed. To withdraw consent, you will need to confirm this in writing. To give consent, you will need to fill in a new consent form.

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Where can I report suspected side effects?

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

This can be done online by visiting the Yellowcard website or by calling the Yellow Card hotline on 0808 100 3352 (available Monday to Friday, 10am to 2pm).

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Last reviewed on 31 August 2017

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