GPs concerned about low uptake of free children’s flu vaccine

General practitioners across Ireland are concerned about the low uptake of the children's flu vaccine which is available free to all healthy children aged between two and 12.

By mid-November, only one in three healthy children have been given the vaccine, according to anecdotal evidence gathered by the Irish College of General Practitioners (ICGP). “Parents aren’t ringing us up looking for appointments to vaccinate their children. A lot of them haven’t heard of it or thought about getting their children vaccinated. But now is the ideal time for children to be vaccinated against the flu before we have cases of the flu,” says Dr Nuala O’Connor, ICGP lead on Covid-19 and antibiotic resistance.

She says that with a potential shortage of the adult flu vaccine – due to a much higher demand this year during the Covid-19 pandemic – giving children the flu vaccine will also protect older adults. “We know that influenza circulates among children rather than adults and if we can interrupt the spread of flu in this age group, we will protect younger children and older adults from getting the flu this season,” says Dr O’Connor.

Pharmacists have also noticed a slow uptake of the children's flu vaccine which is also administered by pharmacists for free. "Research carried out by the Irish Pharmacy Union [IPU] at the start of this flu season found that just more than half of parents were even aware that vaccinating children against the flu is recommended by the Health Service Executive [HSE] and the World Health Organisation and only a third of parents were aware that children are entitled to a free flu vaccination at their local pharmacy," says an IPU spokesperson.

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The children's flu vaccine – which is sprayed into the nostrils rather than given by injection – was rolled out by the HSE this year for the first time, although it has been used in other countries including Canada and the UK for several years. "It's a new programme for Ireland but it's not a new vaccine. It has been licensed since 2003. It's very effective and there is good safety data. Influenza is a preventable disease that we have a vaccine for," says Dr O'Connor.

Hospitalisation

Over the last 10 years in Ireland, 4,750 children have been admitted to hospital with the flu, 183 of these had to go to intensive care and sadly 41 children died. “People forget that flu can be a serious illness for young children,” says Dr O’Connor.

Adrian and Nora O'Hare's daughter, Aralynn, got the flu in February 2018 when she was four years old. An active, healthy child, she spent a month in the intensive care unit at Crumlin children's hospital after developing a bacterial infection on her lungs as a complication of the flu. "Our whole family will get the flu vaccine this year and I would encourage everyone to get their children vaccinated against the flu. If it can save one family from going through what we went through, it will be worth it," says Nora O'Hare.

An evaluation of the impact of administering the children’s flu vaccine in the UK found that there was a 93 per cent reduction in children being admitted to hospital with the flu and a 59 per cent reduction in adults presenting with flu symptoms.

The HSE purchased 600,000 doses of the nasal flu vaccine for children in 2020. GPs and pharmacists began administering the vaccine in mid-October with many GPs holding Saturday vaccination clinics. According to the HSE, at least 115,000 doses had been given by November 13th but this figure is likely to be higher due to a time lag between vaccination and GPs sending in their immunisation records.

It takes 10-14 days from getting the vaccine to being protected from catching the flu. The children’s flu vaccine, which is administered free by GPs and pharmacists, is available for all healthy children aged two to 12.

Dr Chantal Migone, specialist in public health medicine with the HSE's National Immunisation Office, says that the vaccine is absorbed very quickly and is pain-free. "Your GP or pharmacist will spray once in each nostril. There is no need to take a deep breath or sniff. If your child sneezes or gets a runny nose after the vaccine, there is no need to repeat the dose or worry that it won't work," says Dr Migone.

The most common side effects of having a flu vaccine are a runny or blocked nose, headache or muscle aches. “Some children get a fever after the vaccine but it is usually mild and goes away on its own,” says Dr Migone.

Children with severe asthma or who have had a severe allergic reaction to a previous dose of the flu vaccine or any of its ingredients should not have the nasal flu vaccine. Children with a severely weakened immune system or who are living with someone with a severely weakened immune system shouldn’t be given the nasal flu vaccine. The adult flu vaccine will be administered to these children instead.

Given the low uptake rates of the nasal flu vaccine amongst children – and that early batches of the vaccine will start expiring in January, the HSE is also considering making the nasal flu vaccine available to teenagers.