This year the fight against flu takes on a public health perspective. Up till now, flu vaccination has been offered on an individual basis to protect those most at risk. Offering flu vaccine to all healthy children, starting with the two- and three-year-olds this year, means that not only will children be protected, but we will be reducing the spread of the virus and helping to protect the rest of the community. You only have to watch a child with a runny nose to see how easily they can spread flu in a family or playgroup.
We also believe it may affect the numbers of young children admitted to hospital each year because of a high fever, as we believe many of these admissions may be caused by the flu virus. It is not good for them and may also have the advantage of easing the workload of the hospital.
So what is new about the flu programme for children? Well for starters, the vaccine is easier to give; the vaccine is in the form a liquid that is squirted up each nostril. Some of the work in the pilots has shown that older children are able to self-administer the vaccine. This means the programme can be done more quickly, cause less disruption in the school and the sore arm that people sometimes get with the jab is a thing of the past.
Since the new vaccine is a weakened form of the flu virus the response of the immune system is wider ranging than that to the inactivated vaccine. This results in protection that is longer lasting, more effective and works against a wider range of different flu strains.
However, a Google news search for “Flu Nasal Spray” might suggest that many people have a concern about Fluenz other than its efficacy compared to other flu vaccines. An important component of the Fluenz vaccine is refined gelatine of porcine (pig) origin, which has been a potential concern to vegans and some faith groups. However, this is used after an exhaustive study to find the most suitable gelatine and because this component forms part of the licensed product it would not be possible to change this without going through the whole licensing process again (a process that can take some considerable time). Our guidance about the presence of porcine gelatine is available here.
As with any vaccine, the decision to use Fluenz is ultimately a personal choice and parents will need to give their consent for the vaccination. However, I thought it was a bit of a shame that the media focus has been on this issue rather than the benefits described above. We need to be clear that the nasal spray vaccine is considered superior to the inactivated jabs in terms of effectiveness, duration of protection, and risk of side effects. This is why we're recommending that the flu jab should only be offered for those where the nasal spray is contraindicated.
While this marks the first time the vaccine has been used in the UK (outside of a 2012 pilot in Northern Ireland) the vaccine itself is not new. The vaccine has a good safety profile and has been used in the United States for over ten years.