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Which children can have the flu vaccine?

Which children can have a flu vaccine?

Annual nasal spray flu vaccine will be offered to all children aged two and three years (age on 31st August 2023), plus all children in primary school (reception class to school year 6), and secondary school years 7 to 11, as part of the routine NHS childhood vaccination programme.

Children with long-term health conditions

The nasal spray flu vaccine is also recommended for all children aged two to 17 who are at increased risk of complications of flu because they have a long-term health condition, such as diabetes, heart or lung disease.

Children at risk from the complications of flu between the ages of six months and under two years due to a long term-health condition will continue to receive a flu injection. 

Are there any children who should delay having the nasal spray flu vaccine?

If a child is wheezy or has been wheezy in the past three days, the nasal spray flu vaccination should be delayed until they have been free from wheezing for at least three days.

For children with asthma who have increased the use of their asthma inhaler in the past three days, the child’s doctor or nurse may decide to give these children a flu vaccine injection rather than delay their protection.

Children who are unwell with a temperature should delay the vaccination until they are better, but if they have a cold or other minor illness there is no reason to delay the vaccine. If your child has a cough or fever follow the current COVID-19 guidelines available at

If a child has a heavily blocked or runny nose at the time of vaccination, it might stop the vaccine getting into their system, so it’s best to postpone the flu vaccination until their nasal symptoms have cleared up.

Which children should NOT have the nasal spray flu vaccine?

The nasal spray flu vaccine is not recommended for children who have:

  • a severely weakened immune system
  • active wheezing at the time of vaccination or in the previous 72 hours
  • increased the use of their asthma inhalers in the previous 3 days
  • had a severe life threatening allergic reaction to a flu vaccine (or any ingredient in the vaccine)

Or children:

  • under the age of two years
  • on long term aspirin (salicylate) treatment
  • taking high dose steroid tablets.


Where children who are in close contact with someone who has a very severely weakened immune system and is being nursed in isolation in a protected environment (such as after a bone marrow transplant), there's a very small chance that the flu nasal spray vaccine virus may be passed to the very severely immunosuppressed person in the two weeks after a child is vaccinated. Where close contact with a very severely immunosuppressed person is likely or unavoidable, appropriate alternative inactivated influenza vaccines should be considered.

Children unable to have the nasal spray vaccine may be able to have the injectable flu vaccine instead. If you are unsure speak to their school nurse or GP or practice nurse.

Children with asthma who take regular oral steroids or have needed intensive-care treatment for their asthma should be referred to a specialist for advice to receive the nasal spray vaccine. They may need to receive an injectable flu vaccine instead.  

Children should not have the nasal spray flu vaccine if they have had a confirmed life-threatening allergic reaction (anaphylaxis) to a previous dose of flu vaccine, or any of the vaccine components, for example those with a severe egg allergy.

Children with a severe egg allergy which has previously required intensive care treatment cannot receive the nasal spray vaccine and will need to receive an egg free injectable flu vaccine instead.

There are traces of highly purified porcine gelatine in the flu nasal spray vaccine. If the parent of an eligible child declines the nasal spray vaccine due to its gelatine content, they may request a flu vaccine injection at their child’s GP surgery for them instead.

For more information visit


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

Last Updated: 03/10/2023 11:01:19
The information on this page has been adapted by NHS Wales from original content supplied by NHS UK NHS website