When is a flu jab not a jab? When it's a child

Most GPs have only one thought as October rolls around. Whatever other work is going on, we know we're going to be inundated with patients attending for flu vaccines - or telling us they don't want them. A national flu vaccination programme was introduced in the UK in the late 1960s, and extended to all over-65s in 2000.

In 2010, pregnant women were added to the 'at-risk' list after a few tragic deaths made it clear that pregnant women with influenza could become very seriously ill with frightening speed. Until this year, everyone who's over 65 or has one of a wide range of long-term medical conditions has been invited for a flu vaccination every year. Numbers have been going up year on year, and the Department of Health is working towards getting 70% of people under 65 in clinical at-risk groups, and 75% of over-65s, covered. This is good news from a public health perspective - the vaccine is estimated to give 70-80% protection against catching flu and is targeted at people most likely to get severe complications such as pneumonia.

There are always some people convinced the vaccine 'gave them flu last time', or that it didn't work because they still got colds. I'm resigned to having conversations about there being 'no such thing as a touch of flu' until the day I retire. But I will keep having these conversations, because I believe firmly that lives can be saved.

I wrote last year about plans to introduce flu immunisation for healthy children in the UK for the first time. From September 1st 2013, all healthy two and three-year-olds will be offered immunisation against flu as well. Immunising all healthy children will be a mammoth undertaking, and this year only this cohort of children will be invited, apart from some areas where pilots to immunise four to 10-year-olds will be run. The vaccine that's being used, Fluenz®, isn't given by injection, but as a nasal spray. Children will be offered a single dose unless they also have certain medical conditions, in which case they'll be offered two doses at least four weeks apart.

Fluenz® has been found to be more effective than other versions of the flu vaccine given by injection and was first introduced in other countries 10 years ago. Since then over 64 million doses have been given. The Department of Health has obviously looked carefully at its safety record and has said there is no evidence of any safety concerns. Side effects like runny nose, fever and tiredness are common after the vaccine, but they aren't in the same league as 'the real thing'. Yet another vaccine? I've looked at the evidence, and I'd say this one is well worth it.

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