Seasonal influenza still accounts for a significant morbidity and mortality in the UK each winter, with the influenza season typically starting in the middle of November. This may vary year from year so it is recommended that vaccination occurs between September and early November. There are three types of influenza virus; A, B and C. Types A and B account for the majority of clinical disease.

Prior to 2013 flu vaccination was only offered to the elderly and at risk groups.

Remember that the type of vaccine given routinely to children and the one given to the elderly and at risk groups is different (live vs. inactivated) - this explains the different contraindications

Children

A new NHS influenza vaccination programme for children was announced in 2013. There are three key things to remember about the children's vaccine:

• it is given intranasally
• the first dose is given at 2-3 years, then annually after that
• it is a live vaccine

Contraindications

• immunocompromised
• aged < 2 years
• current febrile illness or blocked nose/rhinorrhoea
• current wheeze (e.g. ongoing viral-induced wheeze/asthma) or history of severe asthma (BTS step 4)
• egg allergy
• pregnancy/breastfeeding
• if the child is taking aspirin (e.g. for Kawasaki disease) due to a risk of Reye's syndrome

Side-effects