The Health Department is seeking to reassure parents about the safety of the nasal flu spray for children following reports that the vaccine programme has been halted in some schools in the UK. Elaine Walker spoke to Dr Linda Diggle, head of healthcare programmes
JERSEY has seen a shortage of nasal flu vaccines for children due to some batches not meeting the correct medical criteria, the JEP has learned.
The flu vaccination programme has been put on hold in 11 primary schools in England after supplier AstraZeneca told the NHS that some batches of the nasal spray involved did not meet licensing specifications.
The nasal flu vaccine was introduced to schoolchildren in reception classes in Jersey for the first time last year.
Now, this winter, the nasal flu vaccine is being offered to children aged two to seven years old.
It is provided to pre-school children aged two, three and four years old free through their GP surgery.
Children aged four to seven years receive it through their school.
Dr Linda Diggle, head of healthcare programmes, said: ‘We have seen a slight knock-on effect due to UK authorities being unable to approve the release of some batches of nasal flu vaccine, which caused a shortage of supply in the UK.
‘In turn, this meant we didn’t receive the vaccine as early as we had expected and supply to us is still being limited.’
Dr Diggle confirmed that the UK Department of Health supplies the Island with childhood vaccines.
‘This ensures we only receive vaccines that have passed all of the UK’s rigorous quality control measures,’ she said.
Asked if the Health Department were confident that all batches of the nasal flu spray have been thoroughly tested, Dr Diggle said:
‘Yes, in fact, by purchasing the same vaccine as is used in the NHS, we can be absolutely sure of only getting vaccine that has been thoroughly tested and approved by the UK’s medicines control laboratory that performs tests independently of the manufacturer.
Because of the supply problems, the programme has been delayed slightly in some GP surgeries.
Dr Diggle said that there was a lot of confusion about how the vaccine works and has today moved to reassure parents about the safety of the spray.
‘There appears to be a misunderstanding about how the nasal flu vaccine works which has led a small number of parents, who don’t want their child to be protected, to incorrectly believe their child will be inadvertently immunised when others receive the vaccine in school.
‘The truth is, there is no evidence that the nasal vaccine poses a risk to unimmunised children.
‘Although the nasal flu vaccine is referred to as a spray, it is not administered as an aerosol into the classroom.
‘Nor is the vaccine ‘airborne’.
‘Once the nasal vaccine is gently administered into a child’s nose, it binds very quickly to the lining of the cells inside the nostril.
‘Even if a child sneezes, the vaccine is destabilised in air and cannot inadvertently immunise other children.
‘In short, there is absolutely no evidence of a risk of children getting inadvertently immunised.’
The flu vaccine that wont give kids the needle
THE nasal flu spray was introduced in Jersey’s primary schools last year and over 70 per cent of children in reception classes were immunised with the new vaccine.
The Health department said that although it was too early to know if there had been a decline in the number of flu cases in children in Jersey, the UK had already seen a decrease in the virus since they rolled out the programme the year before.
As a result of this Jersey is now extending the offer of the nasal flu vaccine to schoolchildren in Years 1 and 2.
Dr Linda Diggle, head of healthcare programmes, said that there had been a supply shortage in the UK due to some batches of the nasal spray not meeting licensing specifications. However, she stressed that all batches of the vaccines sent to Jersey were thoroughly tested and safe to use.
‘The UK started their programme a year before us,’ she said, ‘and coverage about it in the news meant we received calls from parents asking when the nasal flu vaccine was going to be available in the Island, as there’s no needle involved.
‘Parents were clearly telling us they preferred this instead of their child getting an injection.
‘As a health service, we consider it very important to offer children in Jersey the same opportunities to be protected against infectious diseases as are available to children in the UK, and although the nasal flu vaccine is more expensive than the flu injection, it is more effective for protecting children.
‘It is very safe and there’s no needle.
‘Because we started the introduction of this vaccine slowly last year, it was too early to see a significant impact on disease cases locally.
‘However, in the specific UK areas where all pupils in primary schools are being offered the nasal vaccine, they’ve seen large decreases in the number of flu cases amongst children.
‘This evidence is why, this year, we’re extending the offer of nasal flu vaccine to children in school Years 1 and 2, as well as to those in reception classes.’
Last year the nasal flu vaccine was offered to 1,035 reception children aged four to five across 31 schools.
In total 725 of those children received the nasal flu vaccine.
Dr Diggle added: ‘As with all childhood immunisation, having a vaccine is voluntary.
‘Our job is to protect children in Jersey from paediatric infectious diseases and we aim, where possible, to offer children at least the same level of protection against diseases that their parents would expect were they a family living in the UK.
‘As parents and grandparents ourselves, we want only the best for the children of Jersey.
‘As experts in immunisation, we know that only good can come out of protecting children with the nasal flu vaccine.’
How many children were admitted to the General Hospital last year as a result of flu?
‘Around 20 children are admitted to our hospital each year with symptoms of flu.
‘Doctors don’t routinely test children for the flu virus, as we look for and treat the characteristic symptoms of flu-like illness; therefore quoted numbers are estimates.’
Did any of these children suffer serious complications as a result of flu?
‘Yes, though thankfully there were no deaths among children in Jersey from flu last year.
‘The main problems we saw due to flu were among babies who developed chest infections requiring days or weeks in hospital so we could support their breathing and feeding, reduce their temperature and ensure they didn’t get a secondary infection.
‘Although babies are too young to receive the nasal flu vaccine, we expect them to benefit indirectly by our extending the vaccination programme – that is, by protecting children aged two to seven against flu.
‘This should also prevent them spreading flu to their younger baby and toddler siblings.’
Why would a child need to be admitted to hospital with flu and how are they treated?
‘When children catch flu, some will develop a very high fever, sometimes leading to febrile seizures or complications such as bronchitis, pneumonia and painful middle-ear infection requiring hospital treatment.
‘Very occasionally a child may die from flu.
‘Treatment will involve use of antipyretic medicines to lower the high temperature and may involve providing hydration through intravenous fluids and we may need to give antibiotics to treat any secondary infection.
‘In severe cases, antiviral medication may be given.’
How does the nasal flu spray vaccine work?
‘In short, it helps your child build up immunity to flu in a similar way as natural infection (but without the symptoms).
‘In detail, the nasal flu vaccine applicator is placed directly up your child’s nose.
‘A gentle squirt is given into each nostril.
‘The nasal vaccine contains live, but weakened, forms of flu virus, which do not cause flu, but binds immediately to the lining of the cells inside the child’s nose.
‘This stimulates your child’s immune system to make specific antibodies against flu.
‘These antibodies will protect your child from becoming ill should they come into contact with flu during the winter months.’
Who is the nasal flu vaccine offered to?
‘This winter, the nasal flu vaccine is being offered to children aged two to seven years old. That is, to pre-school children aged two, three and four years old via their GP surgery and school-age children aged four to seven years old via school.’
Does the vaccine give children flu symptoms?
‘No. The most common side effect of the nasal vaccination is a runny nose for a short time.’
Why should children get immunised against flu?
‘Vaccination is an important step in protecting your child against serious infectious diseases.
‘Once your child has been vaccinated against a disease, their body can fight it more effectively.
‘The nasal flu vaccine is quick, safe and extremely effective.
‘Not only is the nasal flu vaccine needle-free (a big advantage for children), the nasal spray works even better than the injected flu vaccine.
‘Flu can be very unpleasant for children.
‘They have the same symptoms as adults – including fever, chills, aching muscles, headache, stuffy nose, dry cough and sore throat lasting up to a week, causing distress for your child and for you as their parent.
‘Some children develop a very high fever, leading to febrile seizures or complications of flu such as bronchitis, pneumonia and painful middle-ear infection and they may need hospital treatment.
‘If your child has a long-term health condition such as diabetes, asthma, heart disease or lung disease, getting flu can be very serious, as they are more at risk of developing serious complications.
‘Very occasionally a child may die from flu.’
Are there any side-effects with the flu spray?
‘The nasal flu vaccine has very few side-effects.
‘The most common is a runny nose for a short time.
‘Other possible side-effects include a high temperature, headache, feeling slightly unwell, loss of appetite – if they happen, these effects are generally mild.
‘Serious side-effects are very rare.
‘We had no reports of side-effects from last year’s Fluenz programme, despite all parents being given our telephone contact details and a named contact.’
Can the flu vaccine cause the flu?
‘No.’
How safe is the nasal flu vaccine for children?
‘We know the nasal flu vaccine has a very good safety record from its use over the past decade in other countries, with over 90 million doses having been used worldwide (the vaccine is named under different brand names in other countries).
‘For example, it’s been in use for over ten years in the USA, where millions of doses have been given and it’s also been used in Canada since 2010, with Canadian health authorities reporting that millions of vaccine doses have been given to protect their children and no serious problems have been identified.’
If a child is healthy should they have the vaccine?
‘Yes, the vaccine is being provided for healthy children to help them stay healthy.’
What is the difference between a common cold and the flu?
‘Unfortunately the term flu can often be used rather loosely when people are feeling unwell, when the reality is that what we’re really experiencing is a cold.
‘In fact, I have a cold now but I’m still able to work.
‘In contrast, when I was aged 19, I woke up after three days in a hospital bed not knowing what had happened to me and was told I’d had flu.
‘While not everyone with flu ends up in hospital, you can appreciate the difference between flu and a cold – that is, if you get flu, you really cannot get on with your normal daily activities.
‘There’s even a saying – if you have flu and see a £50 note on the floor, you wouldn’t be bothered to pick it up.
‘The chances are you can’t even get out of your bed, nor even lift your head off the pillow’.
If a child gets the flu what should a parent do?
Some of the main symptoms of flu include: a high temperature (fever) of 38°C or above; a dry, chesty cough; general aches and pains; a headache; tiredness and weakness.
If your child is otherwise fit and healthy, there’s usually no need to visit your GP.
Your child should rest at home until they feel better, while keeping warm, drinking plenty of water and taking liquid paracetamol if necessary.
Most children will feel better within a week.
However, you should take your child to see a GP if they:
- Are under the age of two and have a high fever.
- Have a long-term medical condition.
- Have a weakened immune system.
- Develop complications such as drowsiness, rash, vomiting and diarrhoea or a worsening cough.
- Have symptoms that get worse over time or dont improve after a week.
Victoria Pearce: ‘My youngest son had flu when he was just six months old and was so, so poorly with it. He was hospitalised for over a week needing oxygen and all sorts along with a long two-month recovery period. Last year he was still too young to receive the nasal vaccination but instead had it as an injection. He is now two years old and will be receiving the nasal flu spray version. It is totally up to you as a parent as to whether you would like your child to receive the vaccination but having witnessed it first hand, I would urge you to seriously consider getting your children vaccinated.’
Rox Hayward: ‘Disagree personally unless the child has chronic conditions or advised for medical grounds. How are our children meant to build a strong immune? My nan was only saying the other day norovirus was never heard of in her time as kids went out into muck and built an immune.’
Claire O’Connor: ‘My son is 18 months and has had chest infections and had to be admitted to hospital for twice. Every viral infection going and last week had croup which involved a stay in Robin Ward. Seeing him like this first hand I will prevent any nasties. As an adult I get the injection every year so my son will definitely be getting it.’
Emma Brooks: ‘We let our little girl have it last year and she was so poorly after it do not having it this year.’
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