Flu vaccine
Flu (influenza) is a serious illness that can make your child extremely unwell. It can also be extremely serious in pregnant women and the elderly.
Why should you have your child vaccinated?
The children's nasal spray flu vaccine is safe and effective. It's offered every year to children to help protect them against flu.
Flu is caused by the influenza virus. It can be a very unpleasant illness for children. It can also lead to serious problems, such as bronchitis and pneumonia.
Children can catch and spread flu easily. Vaccinating them also protects others who are vulnerable to flu, such as babies and older people.
There are other groups of children with long-term health conditions that should have the flu vaccine every year. This includes children with weakened immune systems (including those on steroids or with problems with their spleen), chronic heart or lung problems, diabetes, asthma, chronic kidney or liver disease. It is especially important that these children are vaccinated because they have the greatest risk of becoming very unwell if they get flu. Children aged from 6 months to 2 years who are at risk from complications of flu should be given the inactivated (injected) flu vaccine rather than the intranasal vaccine.
Common myths about flu and the flu vaccine
'Flu isn't serious, so my child doesn't need a flu vaccine' and 'My children never get ill, so they don't need the vaccine'
It is tempting to think that flu is no worse than a bad cold, but in fact it is a serious disease which can infect anyone and can cause serious complications. For people at risk of complications e.g. grandparents or other vulnerable household members, flu can lead to hospitalisation or even death. Flu leads to hundreds of thousands of GP visits and tens of thousands of hospital stays a year.
'Last year my children had the flu vaccine but they got ill anyway, so it doesn't work'
No vaccine is 100% effective, including the flu vaccine. However, the vaccine usually prevents about half of all flu cases. For people who get flu after being vaccinated, the disease is often less severe than it would have been. It is important to remember that the flu vaccine only protects against flu, but there are other illnesses which have flu-like symptoms which you can still catch after getting the flu vaccine. It takes up to two weeks for the vaccine to take effect, so you could still catch flu if you are exposed to the virus during this time. Getting vaccinated as early as possible in the season can help to prevent this.
Use this video to explain to your child why they are having the flu vaccine
Why should pregnant women get vaccinated?
Flu is more severe in pregnant women than in non-pregnant women. It has the ability to cause:
Worsening of pre-existing health conditions, such as asthma, bronchitis, pneumonia, sepsis (blood poisoning), hospitalisation, death (rarely).
Your risk of is higher if you also have one or more other known risk factors such as asthma or diabetes.
Will my baby benefit from me having the flu vaccine?
Yes.
If you receive the flu vaccine, you are less likely to catch flu and develop some of the associated complications. If you reduce your chance of catching flu, you also reduce the chance of miscarriage, stillbirth, premature labour and the risk of having a poorly grown baby as a result of flu.
Flu can be really a serious illness in new-born babies and the only way to protect them is to get vaccinated yourself when you are pregnant. Following vaccination, your baby will directly receive some of your newly made antibodies through the placenta which will offer them protection against the same four flu strains for at least the first 8 weeks of their life following birth. Some studies show babies can even be protected from flu for up to 6 months.
There is also another level of protection. By protecting yourself against flu, you are reducing the chance of catching flu and therefore reducing the chance of passing it on to your new-born baby.
When can I receive the flu vaccine?
Pregnant women should aim to have the flu vaccine as soon as possible in pregnancy from the beginning of September until the end of March. This may be right at the beginning of pregnancy, if you find out you are pregnant in the winter months, or towards the end of your pregnancy if you fell pregnant in the spring/summer months.
Sometimes you may be offered two flu vaccines in your pregnancy, if you have fallen pregnant at the end of one flu season and are still pregnant in September when the next flu season begins. This will cover you for both seasons of flu.
Is the flu vaccine safe in pregnancy?
It is not uncommon to worry about the decision to have vaccinations in pregnancy and health professionals understand that you need to have as much information before you make a decision to have a vaccination while pregnant.
Pregnant women have been included in the flu vaccination programme since 2010 following a flu epidemic that caused an increased in the number of deaths. Since its introduction, the flu vaccine has been given to millions of pregnant women across the UK.
Data from over 11 million women who have received the flu vaccine in pregnancy show that, apart from mild pain at the site of the injection, there is no evidence of an increased risk of birth defects or stillbirths.
Although possible, the risk of a severe allergic reaction (also known as anaphylaxis) is extremely low. All medicines and food ingested, injected or applied to the skin have a risk of causing this type of allergic reaction. Anaphylaxis is different from less severe allergic reactions because it causes life-threatening breathing and/or circulation problems. It is always extremely serious but all health care workers providing vaccines know how to treat this should it occur. The risk of a severe allergic reaction following an immunisation is around 1 in 900,000.
There is no risk of catching flu from receiving the flu vaccine. The vaccination provided has been deactivated (killed). Your immune system is likely to be very slightly weaker for 1-2 weeks while your body builds the protection against flu, so you are slightly more susceptible to picking up other bacterial/viral infections in this time should you come in contact with them.
Does the flu vaccine work in pregnancy?
The flu vaccine is the best way of protecting yourself against the virus during pregnancy. Currently the vaccine is thought to be around 60-70% effective for pregnant women and near 90% effective for babies born from vaccinated mothers.
Women vaccinated in pregnancy more than halve the risk of developing flu in pregnancy.
The flu vaccine reduces the risk of women having a premature baby by more than two thirds.
The flu vaccination, if given to pregnant women, has been shown to reduce the chance of babies being admitted to hospital with flu.
What side effects may I experience?
It is important to know that you cannot catch flu from having the flu vaccine. Most people do not even feel any side effects following a vaccine however for those that do you could expect the following:
Common – Discomfort, swelling or redness to site of injection
Unlikely – Headaches, shivering, mild fever or slight muscle aches
Extremely Rare – severe allergic reaction
If the side effects are bothering you, paracetamol should help relieve some of the symptoms.
When should you worry?
12-18 months
12-18 MONTHS
Contact your health visitor or GP if your baby is 12-18 months and they…
- Have lost skills which they could do before
- Feel very stiff, for example:
- Hold their arms and legs in the same position, such as always pulling their arm to their chest, or always crossing their legs
- Find it difficult to change their position on their own
- You find it difficult to move your baby’s arms or legs, making it tricky to change their nappy or clothes
- Feel very floppy when they are awake
- Move their arms or legs in repetitive, jerky, or strange ways
- Use one side of their body more than the other, for example:
- Lean to the side when they sit
- Drag their leg or foot when crawling or walking
- Use one arm to pull to stand more than the other
- Rarely use one of their arms to pick up toys, or eat and drink
- Finds it hard to stand or walk, for example:
- Can’t pull to stand
- Fall over a lot when standing still
- Doesn’t cruise (walk while holding on to furniture)
- Walk on their tiptoes a lot
18-24 months
18-24 MONTHS
Contact your health visitor or GP if your baby is 18-24 months and they…
- Have lost skills which they could do before
- Feel very stiff, for example:
- Hold their arms and legs in the same position, such as always pulling their arm to their chest, or always crossing their legs
- Find it difficult to change their position on their own
- You find it difficult to move your baby’s arms or legs, making it tricky to change their nappy or clothes
- Feel very floppy when they are awake
- Move their arms or legs in repetitive, jerky, or strange ways
- Use one side of their body more than the other, for example:
- Lean to the side when they sit
- Drag their leg or foot when crawling or walking
- Use one arm to pull to stand more than the other
- Rarely use one of their arms to pick up toys, or eat and drink
- Find it hard to balance when standing still, or fall over a lot
- Can’t walk by themselves
- Walk on their tiptoes a lot
- Are suddenly unsteady when walking
2 years
2 YEARS
Contact your health visitor or GP if your baby is 2 years and they…
- Have lost skills which they could do before
- Feel very stiff, for example:
- Hold their arms and legs in the same position, such as always pulling their arm to their chest, or always crossing their legs
- Find it difficult to change their position on their own
- You find it difficult to move your child’s arms or legs, making it tricky to change their nappy or clothes
- Feel very floppy when awake
- Move their arms or legs in repetitive, jerky, or strange ways
- Use one side of their body more than the other, for example:
- Lean to the side when they sit
- Drag one leg or foot behind them when crawling or walking
- Rarely use one of their arms to play, eat and drink
- Find it hard to balance when standing still or fall over a lot
- Can’t walk by themselves
- Mostly walk on their tiptoes
- Are suddenly unsteady when walking
- Haven’t started to run
- Move from laying down or sitting to standing by using their hands to push off the ground, and “walk” their hands up their legs until they are standing
3 years
3 YEARS
Contact your health visitor or GP if your baby is 3 years and they…
- Have lost skills which they could do before
- Feel very stiff, for example:
- Hold their arms and legs in the same position, such as always pulling their arm to their chest, or always crossing their legs
- Find it difficult to change their position on their own
- You find it difficult to move your child’s arms or legs, making it tricky to change their clothes
- Feel very floppy when awake
- Move their arms or legs in repetitive, jerky, or strange ways
- Use one side of their body more than the other, for example:
- Lean to the side when they sit
- Drag one leg or foot behind them when walking
- Rarely uses one of their arms to play, eat and drink
- Find it hard to balance when standing still or fall over a lot
- Can’t walk by themselves
- Mostly walk on their tiptoes
- Are suddenly unsteady when walking
- Have not started to jump or run
- Move from laying down or sitting to standing by using their hands to push off the ground, and “walk” their hands up their legs until they are standing
4 years
4 YEARS
Contact your health visitor or GP if your baby is 4 years and they…
- Have lost skills which they could do before
- Feel very stiff, for example:
- Hold their arms and legs in the same position, such as always pulling their arm to their chest, or always crossing their legs
- Find it difficult to change their position on their own
- Find it tricky to change their clothes
- Feel very floppy when awake
- Move their arms or legs in repetitive, jerky, or strange ways
- Use one side of their body more than the other, for example:
- Lean to the side when they sit
- Drag one leg or foot behind them when walking
- Rarely use one of their arms to play, eat and drink
- Find it hard to balance when standing still
- Suddenly become unsteady when walking
- Find it hard going upstairs or uphill
- Trip or fall a lot
- Walk on tiptoes most of the time
- Feel pain in their arms or legs
- Move from laying down or sitting on the floor to standing by using their hands to push off the ground, and “walk” their hands up their legs until they are standing.
5 years
5 YEARS
Contact your health visitor or GP if your baby is 5 years and they…
- Have lost skills which they could do before
- Feel very stiff, for example:
- Hold their arms and legs in the same position, such as always pulling their arm to their chest, or always crossing their legs
- Find it difficult to change their position on their own
- Find it tricky to change their clothes
- Feel very floppy when awake
- Move their arms or legs in repetitive, jerky, or strange ways
- Use one side of their body more than the other, for example:
- Lean to the side when they sit
- Drag one leg or foot behind them when walking
- Rarely uses one of their arms to play, eat and drink
- Find it hard to balance, or trip or fall a lot
- Persistently walk on tiptoes
- Suddenly become unsteady when walking
- Feel pain in their arms or legs
- Move from laying or sitting on the floor to standing by using their hands to push off the ground, and “walk” their hands up their legs until they are standing.
15 months
Your Child By Fifteen Months
Social/Emotional Milestones
- Copies other children while playing, like taking toys out of a container when another child does
- Shows you an object she likes
- Claps when excited
- Hugs stuffed doll or other toy
- Shows you affection (hugs, cuddles, or kisses you)
Language/Communication Milestones
- Tries to say one or two words besides “mama” or “dada,” like “ba” for ball or “da” for dog
- Looks at a familiar object when you name it
- Follows directions given with both a gesture and words. For example, he gives you a toy when you hold out your hand and say, “Give me the toy.”
- Points to ask for something or to get help
Cognitive Milestones (learning, thinking, problem-solving)
- Tries to use things the right way, like a phone, cup, or book
- Stacks at least two small objects, like blocks
Movement/Physical Development Milestones
- Takes a few steps on his own
- Uses fingers to feed herself some food
18 months
Your Child By Eighteen Months
Social/Emotional Milestones
- Moves away from you, but looks to make sure you are close by
- Points to show you something interesting
- Puts hands out for you to wash them
- Looks at a few pages in a book with you
- Helps you dress him by pushing arm through sleeve or lifting up foot
Language/Communication Milestones
- Tries to say three or more words besides “mama” or “dada”
- Follows one-step directions without any gestures, like giving you the toy when you say, “Give it to me.”
Cognitive Milestones (learning, thinking, problem-solving)
- Copies you doing chores, like sweeping with a broom
- Plays with toys in a simple way, like pushing a toy car
Movement/Physical Development Milestones
- Walks without holding on to anyone or anything
- Scribbles
- Drinks from a cup without a lid and may spill sometimes
- Feeds himself with his fingers
- Tries to use a spoon
- Climbs on and off a couch or chair without help
2 years
Your Child By Two Years
Social/Emotional Milestones
- Notices when others are hurt or upset, like pausing or looking sad when someone is crying
- Looks at your face to see how to react in a new situation
Language/Communication Milestones
- Points to things in a book when you ask, like “Where is the bear?”
- Says at least two words together, like “More milk.”
- Points to at least two body parts when you ask him to show you
- Uses more gestures than just waving and pointing, like blowing a kiss or nodding yes
Cognitive Milestones (learning, thinking, problem-solving)
- Holds something in one hand while using the other hand; for example, holding a container and taking the lid off
- Tries to use switches, knobs, or buttons on a toy
- Plays with more than one toy at the same time, like putting toy food on a toy plate
Movement/Physical Development Milestones
- Kicks a ball
- Runs
- Walks (not climbs) up a few stairs with or without help
- Eats with a spoon
2.5 years
Your Child By Thirty Months
Social/Emotional Milestones
- Plays next to other children and sometimes plays with them
- Shows you what she can do by saying, “Look at me!”
- Follows simple routines when told, like helping to pick up toys when you say, “It’s clean-up time.”
Language/Communication Milestones
- Says about 50 words
- Says two or more words together, with one action word, like “Doggie run”
- Names things in a book when you point and ask, “What is this?”
- Says words like “I,” “me,” or “we”
Cognitive Milestones (learning, thinking, problem-solving)
- Uses things to pretend, like feeding a block to a doll as if it were food
- Shows simple problem-solving skills, like standing on a small stool to reach something
- Follows two-step instructions like “Put the toy down and close the door.”
- Shows he knows at least one color, like pointing to a red crayon when you ask, “Which one is red?”
Movement/Physical Development Milestones
- Uses hands to twist things, like turning doorknobs or unscrewing lids
- Takes some clothes off by himself, like loose pants or an open jacket
- Jumps off the ground with both feet
- Turns book pages, one at a time, when you read to her
3 years
Your Child By Three Years
Social/Emotional Milestones
- Calms down within 10 minutes after you leave her, like at a childcare drop off
- Notices other children and joins them to play
Language/Communication Milestones
- Talks with you in conversation using at least two back-and-forth exchanges
- Asks “who,” “what,” “where,” or “why” questions, like “Where is mommy/daddy?”
- Says what action is happening in a picture or book when asked, like “running,” “eating,” or “playing”
- Says first name, when asked
- Talks well enough for others to understand, most of the time
Cognitive Milestones (learning, thinking, problem-solving)
- Draws a circle, when you show him how
- Avoids touching hot objects, like a stove, when you warn her
Movement/Physical Development Milestones
- Strings items together, like large beads or macaroni
- Puts on some clothes by himself, like loose pants or a jacket
- Uses a fork
4 years
Your Child By Four Years
Social/Emotional Milestones
- Pretends to be something else during play (teacher, superhero, dog)
- Asks to go play with children if none are around, like “Can I play with Alex?”
- Comforts others who are hurt or sad, like hugging a crying friend
- Avoids danger, like not jumping from tall heights at the playground
- Likes to be a “helper”
- Changes behavior based on where she is (place of worship, library, playground)
Language/Communication Milestones
- Says sentences with four or more words
- Says some words from a song, story, or nursery rhyme
- Talks about at least one thing that happened during her day, like “I played soccer.”
- Answers simple questions like “What is a coat for?” or “What is a crayon for?”
Cognitive Milestones (learning, thinking, problem-solving)
- Names a few colors of items
- Tells what comes next in a well-known story
- Draws a person with three or more body parts
Movement/Physical Development Milestones
- Catches a large ball most of the time
- Serves herself food or pours water, with adult supervision
- Unbuttons some buttons
- Holds crayon or pencil between fingers and thumb (not a fist)
5 years
Your Child By Five Years
Social/Emotional Milestones
- Follows rules or takes turns when playing games with other children
- Sings, dances, or acts for you
- Does simple chores at home, like matching socks or clearing the table after eating
Language/Communication Milestones
- Tells a story she heard or made up with at least two events. For example, a cat was stuck in a tree and a firefighter saved it
- Answers simple questions about a book or story after you read or tell it to him
- Keeps a conversation going with more than three back-and-forth exchanges
- Uses or recognizes simple rhymes (bat-cat, ball-tall)
Cognitive Milestones (learning, thinking, problem-solving)
- Counts to 10
- Names some numbers between 1 and 5 when you point to them
- Uses words about time, like “yesterday,” “tomorrow,” “morning,” or “night”
- Pays attention for 5 to 10 minutes during activities. For example, during story time or making arts and crafts (screen time does not count)
- Writes some letters in her name
- Names some letters when you point to them
Movement/Physical Development Milestones
- Buttons some buttons
- Hops on one foot
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