Why the UK is still strongly recommending that children get the nasal flu vaccine

The Joint Committee on Vaccination and Immunisation (JCVI) , the body that advises the UK government on vaccination issues, recently issued a statement recommending that the UK should continue to use the nasal flu vaccine. The nasal flu vaccine is sprayed into the nose rather than injected, and was introduced into the UK in Autumn 2013. From Autumn 2016, the vaccine will be offered to all children aged 2, 3 or 4, and all those in school years 1, 2 and 3, as well as children up to 18 years of age who are at risk from complications of flu.

The JCVI’s statement follows the US government’s announcement in June 2016 that it would not recommend the use of the nasal flu vaccine in the 2016-17 flu season. The nasal flu vaccine used in the US is the same as the one used in the UK, but marketed under a different trade name (FluMist rather than Fluenz). The US is recommending that all children get the inactivated flu vaccine instead.

The US decision was made on the basis of research carried out by the US Centers for Disease Control and Prevention (CDC), which showed that the nasal flu vaccine was less than 3% effective in 2015-16. However, these findings are contradicted by research from the UK, Finland and Canada, which shows that the nasal flu vaccine in children gives a similar level of protection to the inactivated flu vaccine in adults. Research published by Public Health England from the 2014-15 and 2015-16 seasons shows that the vaccine prevented flu in more than half of the children who were given it. It also shows a reduction in flu cases in the population more widely, suggesting that vaccinating young children against flu also helps to protect others in the community.

It is not known why there is such a big difference between the US research and the UK research. JCVI will continue to monitor research into the effectiveness of the nasal flu vaccine, and keep the childhood flu programme under close review. In the meantime, however, the nasal flu vaccine is still recommended in the UK, on the basis of strong evidence that it helps to protect the health of both children and the wider population.

Read the full JCVI statement

Update (August 2018): For 2018-19 the vaccine manufacturers have used a different version of the influenza A(H1N1) strain in the vaccine. This is expected to be more effective against influenza A(H1N1), and the US is now once again recommending the nasal flu spray for use in children in the 2018-19 flu season .