Flu Vac 2018/19 - Childhood flu vaccination program
How is the vaccine administered?
Administration of the vaccine is via a nasal applicator which delivers just 0.1ml (around 1/50th of a teaspoon) of fluid into each nostril. Clear diagrams showing administration are provided in the SPC and NHS Education for Scotland has made a video for health professionals on how to administer the vaccine.
Can other people present be at risk of catching the vaccine as it is ‘sprayed’?
There is not a ‘mist’ of vaccine virus in the air when children are being vaccinated and therefore others in the room should not be at risk of “catching” the vaccine virus. The room or school in which administration of nasal influenza vaccine has taken place does not require any special cleaning afterwards.
Health care workers who are immunocompromised and those who are pregnant can safely administer the vaccine. As a precautionary measure, however, very severely immunocompromised healthcare workers should not administer LAIV
What are the types of vaccines available for children?
There are two types of vaccine available for children in 2018/19
- Live nasal vaccine
- Inactivated injectable flu vaccine
What is the age range for those children receiving the flu vaccination?
In England, flu vaccine should be offered to:
- all children who are aged two to nine years old (but not ten years or older) on 31 August 2018 and
- to children aged from 2 years up to 18 years in clinical risk groups.
LAIV should be offered unless contraindicated. For further information about the childhood flu immunisation programme 2018/19, please refer to the annual flu letter from DH/PHE/NHS England: Childhood flu vaccination programme
How many vaccine doses are required?
Children who have not previously been vaccinated against seasonal flu will require a second dose after an interval of at least four weeks.
Egg Allergies – Children
- Children with an egg allergy can be safely vaccinated with the LAIV in any setting, this includes primary care and schools
- Those with egg allergy and clinical risk factors that contraindicate LAIV such as immunosuppression, should be offered an inactivated flu vaccine with a very low ovalbumin content (less than 0.12 µg/ml)*
- Children with a history of severe anaphylaxis to egg that has previously required intensive care, should be referred to specialists for immunisation in hospital
- LAIV is not otherwise contraindicated in children with egg allergy. Egg-allergic children with asthma can receive LAIV in their asthma is well controlled (click here on severe asthma)
* Children in a clinical risk group and aged under nine years who have never previously received influenza vaccine will require a second dose, one month after the first dose, whether given LAIV or inactivated vaccine
What about those children who are not in a clinical risk group?
They should be offered a single dose of LAIV.
The Joint Committee on Vaccinations & Immunisations JCVI has considered this issue and has recommended that as a second dose of the vaccine provides only modest additional protection,
What about children who are in the clinical risk group?
Children aged two years to less than nine years who are in a clinical risk group and who have not received flu vaccine before should:
- receive two doses of LAIV.
- the second dose should be given at least four weeks after the first.
Please refer to your local PGD and Public Health guidelines on the administration, contraindications and precautions when administering a flu vaccine to children.
Do you have to defer the vaccination due to acute illness?
If the child has an acute severe febrile illness, LAIV administration should be deferred until recovered. Minor illnesses without fever or systemic upset are not valid reasons to postpone vaccination.
What if the child has a blocked or runny nose?
There is no data on the effectiveness of LAIV when given to children with a heavily blocked or runny nose (rhinitis) caused by infection or allergy. As heavy nasal congestion might impede delivery of the vaccine to the nasopharyngeal mucosa, deferral of administration until resolution of the nasal congestion or use of an appropriate alternative intramuscularly administered flu vaccine should be considered
What if you think you have administered an incomplete dose of the vaccine?
It is not necessary to repeat the dose of vaccine if at least 0.1ml of the vaccine has been given intranasally as each half dose (0.1ml) contains enough viral particles to induce an immune response.
If the vaccine is accidentally squirted into the child’s eye, it may cause some slight irritation to the eye and eyewash/normal saline should be used to wash out the eye. The child/parent should be advised to seek medical advice if any irritation occurs and persists beyond what might reasonably be expected.
What to do if the child refuses the second half of the vaccine dose after the first half has been given?
As each half dose (0.1ml) contains enough viral particles to induce an immune response, it is not necessary to offer an inactivated vaccine or a repeat live vaccine on another occasion as each half dose (0.1ml) contains enough viral particles to induce an immune response
What if you inadvertently give LAIV to a child who is aged less than 24 months or a child who is immunosuppressed?
Please refer to the Childhood Flu Vaccine pg. 21.