Health November 2014

flu nasal spray vaccine for kids

New four-strain type available

With winter approaching, it is time to consider having yourself and your family vaccinated against the flu.

Many Brits living in Japan are surprised to find that the flu vaccination is offered routinely here to healthy children. While guidelines vary somewhat, more countries are adopting this approach.

In the UK, all healthy children aged between two and four years will be offered the flu vaccination this winter. The aim is to gradually make it available, over the coming years, to all children up to the age of 16.

Young children are more susceptible to serious flu complications, such as pneumonia, bronchitis and ear infections. Vaccinating children who have chronic underlying medical conditions, such as diabetes or asthma, is especially important since they face a higher risk than healthy children of developing complications.

Another reason for vaccinating small children is that they tend to spread the flu to the wider population through poor use of tissues when coughing and sneezing, as well as by not washing their hands well.

Thus, by vaccinating children, other members of the community who are vulnerable to flu—such as babies under six months old, who are too young to be vaccinated—may also have increased protection.

This winter in the UK, the National Health Service is offering all two-, three-, and four-year-old children the flu vaccination as part of the childhood vaccination programme. The vaccine is given as a nasal spray, rather than as an injection, which is a definite selling point for children.

Moreover, this year, the nasal vaccination is in a new form that protects against four strains of flu (two type A and two type B). For years, the flu vaccine has protected only against two type A strains and one type B strain of flu. The new vaccine provides broader protection.

The four-strain nasal vaccine is approved for people aged between two and 49, and in some countries, an injectable quadrivalent vaccine is available for people outside this age range.

In contrast to the traditional flu shot, the nasal spray contains live forms of the flu virus, which have been weakened, and are thus not virulent. Although the vaccination cannot cause the flu, minor side effects, such as a runny nose, headaches, muscle aches, vomiting or mild fever may occur.

In young children, the nasal spray appears to be more effective than the flu injection, with some studies showing that the spray has prevented up to 50% more cases of flu. For this reason, children in the UK are offered the nasal spray rather than the injection.

In the US, the Centers for Disease Control and Prevention recommend use of the nasal spray vaccine for healthy children between the ages of two and eight, providing the child has no contraindications to the vaccine.

Children need to have either one or two doses of the vaccine, the number of doses being determined by the child’s age and flu vaccination history. If two doses are recommended, there must be a minimum of four weeks between doses.

The nasal vaccine is not suitable for some children. They include those with a severely weakened immune system, certain types of allergy, asthma or wheezing episodes. However, children aged two or over who are unable to have the nasal flu vaccination, may be able to receive the injected form. Where the nasal spray is not immediately available, the regular flu jab should be given instead.

Unlike the UK, some countries recommend universal flu vaccination for all children, from the age of six months. Six-month-old babies and children up to two years of age always need to be given the injection, rather than the nasal spray.

Generally speaking, the nasal spray is preferred for children between two and eight years of age, while for those over the age of eight, either form is recommended.