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Flu vaccine

Flu is unpredictable and the levels of flu activity vary each year. Some years are much worse than others. For instance, in 2014 to 2015, a bad flu year, there were 28,000 deaths. There are several strains of the flu virus that cause flu and virus mutations also occur.

Vaccinations are generally given in the autumn term before flu tends to circulate. As the flu virus can change each year, vaccination is required on an annual basis. 

Flu can be a serious illness that leads to complications like bronchitis and pneumonia, and painful ear infections in children. Children under the age of 5 years old have the highest rate of hospital admission of any age group.

The main purpose of the programme is to help protect children themselves and to stop them spreading flu to their families and the wider community, given the role that children have in transmission of the flu virus. Those most at risk from the complications of flu (such as pregnant women, older people, and those with underlying health conditions) are also offered flu vaccination, and it is also free for anyone aged 50 years old and over this year. 

This Autumn term (2023-2024) the School-aged immunisation team will be returning to all primary schools to offer the flu vaccine to children in years Reception to year 6. If your child does not currently attend school, they will be invited to an alternative local community venue. 

All children who are aged 2 and 3 years old on 31 August 2023 will be offered flu vaccination through general practice. 

Any young person who is not in one of the eligible year groups for flu vaccination, but has an underlying health condition that puts them more at risk of flu, is eligible for a free flu vaccine from their GP practice or pharmacy.

Children are offered a nasal spray. It’s quick, painless and more effective in the programme than an injected vaccine. This is because it’s easier to administer and is considered better at reducing the spread of flu to others.

There will be a small number of children in your school not able to have the nasal spray vaccine because of pre-existing medical conditions or treatments. They will be offered an injected vaccine (either at school or through their GP practice).

The programme is delivered by an NHS commissioned school age immunisation provider team which may include nurses, healthcare support workers, administrative staff, and other associated professionals who specialise in the delivery of school age vaccinations. The team administer the vaccination according to nationally set standards. Staff have appropriate qualifications and training, including safeguarding training. Depending on the advice that is current at the time, staff administering the vaccine may need to be wearing personal protective equipment.  

All questions about vaccine suitability, and whether the child or young person can have it on the day if unwell, should be directed to the school age immunisation provider team. 

If your child was absent or unwell you will receive an email confirming that they did not receive a flu vaccine with instructions and link explaining how to book a clinic appointment online. You can also amend and cancel via this link.

If you were unable to complete a consent form in time and you would like your child to receive a flu vaccine please return to our consent system at least 24 hours after the planned session date and complete a consent form. You will receive an email with further instructions on how to book following the consent form being completed.

A consent form and information leaflet provided by the school age immunisation provider team will be used to seek parental consent. Parents will also be provided with a contact number for the school age immunisation provider team in case of any queries. Forms should be returned by the deadline agreed with the team. You may be asked to collect these forms from parents on behalf of the school age immunisation provider team or it may be done electronically.

Does GDPR change how consent needs to be obtained?

The General Data Protection Regulation (GDPR) became UK law on 25 May 2018. No change is required to the way in which parental agreement is obtained. Schools should continue to work with the school age immunisation provider teams providing vaccinations in schools, who will provide information resources and parental consent forms. 

How will the school age immunisation provider team identify the children to be vaccinated?

The team will have a list of all children for whom consent has been received. They may ask the class teacher or assistant to confirm the identity of younger children in primary schools. 

Who decides whether a child receives the vaccination?

Parents or guardians with parental responsibility make this decision. In primary schools, only children for whom consent has been received will be vaccinated. It is therefore worth reminding parents of the importance of completing the consent form they are sent ahead of the scheduled vaccination sessions.

In secondary schools, some older children may be sufficiently mature to provide their own consent if their parents have not returned a consent form and they express a wish to have a vaccine on the day of the session. The team will speak to the child and will be responsible for assessing the appropriateness of administering the vaccine. This will include making every effort to contact the parent to seek their verbal consent and/or an assessment of the individual child’s capacity to self-consent, where appropriate. 

Can parents refuse to have their child vaccinated?

Yes. The vaccination is not mandatory. Parents will be asked to give their informed consent for the vaccination. Older children may express a wish to have the vaccine and have the capacity to provide informed consent themselves. Parents of older children should be encouraged to speak to their children ahead of time so that there is agreement on consent in advance of the vaccination session. 

Will it be a bad flu winter this year?

We don’t know whether it will be a bad flu winter this coming year, but we need to be prepared. The winter that we just had saw very low levels of flu activity, with measures in place to reduce COVID-19 (such as hand washing, mask wearing, social distancing and reduced international travel) helping to reduce flu transmission.

It’s hard to predict what will happen this coming winter but there may be a rebound in flu. If some of the measures to reduce COVID-19 remain in place, this will help reduce flu transmission too, as will uptake of flu vaccination which was at record high levels last year. However, there is also a risk that because we saw so little flu this last year, that there could be high levels of flu activity this coming winter because people will be mixing more and will also be more susceptible. 


What if the vaccination session at my school is quite late in the autumn or winter?

For children who are at risk because they have an underlying health condition, it is very important that they get the flu vaccine for their own protection. Parents can ask their child’s GP to vaccinate them rather than wait for the school session if this is what they prefer.

See NHS.UK for further information. 

Can unvaccinated contacts catch flu from the nasal spray droplets or from vaccinated individuals ‘shedding’ the virus?

The nasal spray vaccine has a good safety record and unvaccinated contacts are not at risk of catching 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 individual. Although vaccinated children are known to shed virus for a few days after vaccination, it is less able to spread from person to person than the natural infection. 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. This is in contrast to natural flu infection, which spreads easily during the flu season.

Excluding children from school during the period when the vaccine is being offered, or in the following weeks, is not necessary. The only exception to this would be the tiny number of children who are extremely immunocompromised (for example those who have just had a bone marrow transplant). These children are normally advised not to attend school anyway because of the much higher risk of being in contact with other infections, including natural flu infection, that spread in schools.  

Is there porcine gelatine in the nasal spray?

The nasal spray contains very small amounts of porcine gelatine, which is used as a stabiliser in the vaccine. Some people may not accept the use of porcine gelatine in medical products. For these children, there is an alternative injectable vaccine available this year and parents should discuss the options with the school age immunisation provider team.  

What should be done if a child becomes unwell in school after receiving the vaccination?

If the school age immunisation provider team is still on site, seek advice directly from them. If the school age immunisation provider team has left the site, manage the situation according to existing policies for pupil sickness in school and contact the school age immunisation provider team to ensure they are aware and can report any event related to the timing of administration of the vaccine.