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Children's flu vaccine

Children's annual flu vaccine

In the autumn/winter of 2023/24 the annual nasal spray flu vaccine will be available for children aged two and three years old (age on 31 August 2023) plus all children in primary school (from reception class to school year 6) and secondary school years 7 to 11, as part of the NHS Wales routine childhood vaccination programme.

We expect to see flu and COVID-19 both circulating this winter, so we all need to do what we can to protect ourselves and our families. Making sure your child has a flu vaccine if they are eligible is an important part of that protection. 

The nasal spray vaccine will be offered routinely to all children aged two and three (age on 31 August 2023) at their general practice, or in nursery in some parts of Wales.

Children and young people in school will generally be offered their flu vaccination in school. Children who do not attend a school where the flu vaccine is offered should contact their GP surgery to obtain their nasal spray flu vaccine.

Children from the age of 6 months with a long-term health condition should have an annual flu injection, as they are at increased risk of becoming very ill if they catch flu.

The nasal spray flu vaccine

The flu vaccine for most children is given as a nasal spray, which is squirted up each nostril. Not only is it needle-free (a big advantage), the nasal spray also works better for children than a flu vaccine injection.

It’s quick and painless and will mean your child is less likely to become ill if they come into contact with the flu virus. The brand name of the nasal spray flu vaccine is Fluenz® Tetra.

The nasal spray flu vaccine is also the best flu vaccine for children aged two to 17 who are at increased risk from complications of flu, such as children with long-term health conditions. Children aged six months to less than two years who are “at risk” of complications from flu due to a long-term health condition are given a flu vaccine injection, as the nasal spray isn’t suitable for this age group.

Why are children offered the flu vaccine?

Flu can be very unpleasant for children. They can have the same symptoms as adults – including fever, chills, aching muscles, headache, stuffy nose, dry cough and sore throat lasting up to a week.

Some children develop a very high fever or complications of flu such as bronchitis, pneumonia or a painful middle ear infection. They may need hospital treatment, and very occasionally a child may die from flu.

For children with long-term health conditions such as diabetes, asthma, heart disease or lung disease, getting flu can be very serious as they are more at risk of developing serious complications.

Stopping the spread of flu

Having a flu vaccine will not only help to protect your child from getting flu, it also helps stop them spreading it to their family, friends and the wider population, which is extra important this winter as we expect to see both flu and COVID-19 circulating.

Children are good at spreading flu, because they tend to sneeze everywhere and often don't use tissues properly or wash their hands enough. Vaccinating them may also protect others that are vulnerable to flu such as babies, older people, pregnant women and people with long-term illnesses.

Children with long-term health conditions

Children with a long-term health condition are at extra risk from complications of flu and it's especially important that they are vaccinated against flu each year for best protection.

For most children aged two years and over, the vaccine will be the nasal spray, as it is more effective for children.

Those children with long-term health conditions aged from six months to less than two years will continue to be offered the annual injectable flu vaccine, as the nasal spray vaccine isn't suitable for children under two years old.

Are there children who shouldn't have the flu vaccine?

Information on which children the flu vaccine is not suitable for is provided on the Who shouldn’t have the flu vaccine? page.

How does the flu vaccine for children work?

The nasal spray vaccine contains flu viruses that have been weakened to stop them causing flu. It will help your child build up immunity to flu in a similar way as natural infection (but without the symptoms).

Because the main flu viruses change each year, a new nasal spray vaccine has to be given each year, in the same way as the injectable flu vaccine.

Fluenz® Tetra works well in children and gives them good protection against catching flu. The nasal spray is more effective than an injected flu vaccine in children.

As the nasal spray flu vaccine is absorbed very quickly, it will still work even if your child has a runny nose, sneezes or blows their nose straight after being vaccinated.

How many doses of the flu vaccine do children need?

Most eligible children only need a single dose of the nasal spray vaccine each autumn/winter.

Children aged two to under nine years at risk of complications of flu because of a health condition who have not received a flu vaccine before should have two doses of Fluenz® Tetra (given at least four weeks apart).

How safe is the flu vaccine for children?

The nasal spray flu vaccine for children has a very good safety profile. It’s been widely used in the UK since 2013.

The vaccine contains live, but weakened, forms of flu virus that do not cause flu in children who receive it.

What are the side effects of the flu vaccine for children?

The nasal spray flu vaccine has very few side effects, the main one being that vaccinated children may have a runny nose for a short time.

Read more about the side effects of the flu vaccine for children.

A mild fever following a flu vaccine is a common and expected reaction. Any fever after vaccination should be monitored and if you are concerned about your health at any time please seek advice from your GP or NHS 111 Wales.

How to get the flu vaccine for your child

You should be contacted by your GP or your child’s school in September/October with information about getting your child vaccinated before the winter. If you don’t hear anything by the end of October, or you want more information about when and how your child will be vaccinated against flu, talk to your GP surgery, practice nurse or your child’s school nurse.

For more information visit


Flu vaccination leaflets and accessible information resources are available at Leaflets and accessible vaccination information.

Last Updated: 03/10/2023 10:34:33
The information on this page has been adapted by NHS Wales from original content supplied by NHS UK NHS website