Parveen has just come out of the consultation room after an MUR when her new counter assistant, Heidi, asks if she can have a word...

“I’ve got myself into a complete muddle over these flu jabs,” says Heidi. “A lady asked why one of her children had had the nasal spray and the other received the injection. Can you help me get it straight in my head before she comes back?”

Answer

This winter, the annual flu nasal vaccine is being offered to all two, three and four-year-old children in England and Wales. In Scotland, the vaccine is also available to five-year-olds and in Northern Ireland it is being offered to all pre-school and primary school children. Some areas are piloting vaccination of other age groups as well. The eventual plan is for all children aged between two and 16 years to be offered an annual flu vaccine in nasal spray form.

Research has shown the nasal spray vaccine to be better at preventing illness caused by the influenza virus than injected vaccines in children, except in those aged under two years. For this reason, this formulation has become the flu vaccine of choice for children aged two to 18 years, such as those eligible as stated above and individuals who are considered at risk of complications if they catch flu.

Children aged between six months and two years who would benefit from being immunised against flu are given the vaccine in injectable form, as are those for whom the nasal spray is not suitable (e.g. children with severe asthma, and Jewish and Muslim children whose parents object to the gelatine component of the nasal vaccine).

The bigger picture

Although the nasal form of the flu vaccine is relatively new to the UK, it has been used for several years in America. So far, no serious concerns have been raised and the product has proved to have a very good safety profile.

Most children only require one dose of the nasal flu vaccine, but those aged between two and nine years who have not previously been vaccinated against the illness and who are considered at risk of complications because of an underlying condition should have two doses given at least four weeks apart.

Another vaccination that is available this winter is the varicella vaccine for people aged 70, 78 or 79 years. It is suitable for those who have had shingles in the past, as well as those who haven’t. The pneumococcal vaccine is recommended for adults aged 65 years and over, as well as individuals with longterm conditions that increase their risk of problems if they suffer from a pneumococcal infection (kidney or heart problems). Both the pneumococcal and varicella vaccines are one-off injections and do not need to be repeated annually as the seasonal flu vaccine does.

Extend your learning

• The pneumococcal vaccine given to adults is very different to the vaccine given as part of the childhood immunisation programme. Find out more about the schedule of routine vaccinations that are given free of charge to all babies and children in the UK at: www.nhs.uk/Conditions/vaccinations/Pages/childhood-vaccinationschedule.aspx.