Influenza vaccine for children
Most children and young adolescents can tolerate influenza (the ‘flu), but some can become seriously ill. Children and young people in risk groups often have a severe disease course and are therefore recommended to receive the influenza vaccine.
Influenza is a common infectious disease among children. Most children will have encountered several influenza viruses before the age of eight - and the vast majority of these will tolerate it well. Influenza may lead to severe pneumonia and worsening of underlying conditions. In case of serious complications of influenza, admission to hospital is necessary.
Just under 10 per cent of children in Norway are recommended to take the influenza vaccine because they have an underlying disease that increases the risk of a severe disease course. Unfortunately, vaccination coverage among these children is low – fewer than 1 in 10 of them received a vaccine in the 2021/22 season.
Figures from Norway indicate that approximately 1 per cent of Norwegian children receive an influenza diagnosis from their GP each winter, and approximately 500 influenza-related hospital admissions are seen among Norwegian children each year. Most of these children have no known risk factors for influenza. The risk of a severe disease course is nevertheless higher for children in the risk groups, who – despite the fact that they only make up a small proportion of the Norwegian child population – account for approximately a quarter of the influenza-related hospital admissions among children in Norway during the winter season.
Children in the risk groups are therefore recommended to receive the influenza vaccine from the age of 6 months.
The recommendations for the influenza vaccine for children are essentially the same as for the general population. The risk groups for severe influenza are formulated as overall categories, depending on which organ system is affected:
Risk groups for a severe influenza disease course
- chronic lung disease (including asthma)
- cardiovascular diseases
- chronic neurological disorders or injury (e.g., epilepsy)
- impaired immune function as a result of disease or treatment (e.g., organ transplantation, cancer)
- chronic liver failure or chronic renal failure
- diabetes (especially poorly regulated blood glucose levels)
- morbid obesity
- other serious or chronic diseases where influenza is a serious health risk, after individual assessment by a doctor (e.g., children with congenital chromosomal abnormalities, genetic syndromes and complex chromosomal abnormalities)
In addition, children born prematurely have an increased risk of admission to hospital for influenza. The risk is highest for those born before week 32 of pregnancy. Children who were premature at birth are recommended to take the vaccine every year, from 6 months old (chronological age) up to 5 years.
In addition to these groups, vaccination is recommended for those who live with - or are similarly close to - immunosuppressed children.
Vaccination is the best preventive measure
Approximately 80,000 children between the ages of 0 and 17 in Norway belong to one or more of the risk groups in the above list. The vast majority of these children have asthma or another lung disease. In addition, there are several thousand children with heart disease, diabetes and neurological diseases such as epilepsy.
In the event of influenza, children with risk conditions may experience a worsening of their illness and may more easily develop secondary diseases such as pneumonia.
The influenza vaccine is the measure that best prevents influenza and its consequences. In the 2021/22 season, however, only eight out of a hundred were vaccinated. Children with at-risk conditions should be offered the vaccine every autumn.
Where can my child get a vaccine and how much does it cost?
The vaccine is available from mid-October. As a parent, you usually have to book an appointment for your child's vaccination. The municipalities organise local vaccination of the risk groups. Vaccination usually takes place between October and December. To find out where your child can get the vaccine, check the municipality's website or the website of your child's doctor. Children who go to a hospital or specialist for follow-up and treatment can also be vaccinated there.
In the 2023/24 season, influenza vaccines cost NOK 100 for people in risk groups and other target groups. This applies to all vaccine types.
There is no fixed price for administering the vaccine to the risk groups other than the vaccine price itself. The total price for vaccination may therefore vary.
Vaccination at pharmacies is not part of the influenza immunisation programme, and anyone who is vaccinated there must pay the full price for the vaccine and vaccination. This also applies to people in the target groups.
The influenza vaccine has been in use for many years. Every year, the WHO assesses which influenza viruses are most likely to circulate next season, and on that basis recommends which viruses the vaccines should contain. The vaccines will therefore be updated every season, and this is one of the reasons why you have to take the vaccine every year to get the best possible protection. It takes about two weeks for the vaccine to work. Children who still get influenza after vaccination have a lower risk of a severe disease course and admission to hospital.
Influenza vaccines for children
In Norway, there are two different types of influenza vaccine approved for children - live attenuated nasal spray vaccine and inactivated injectable vaccine. Inactivated injection vaccine is approved for children from 6 months, while the nasal spray vaccine is approved for the age group 2-17 years. The nasal spray vaccine should not be used by children with severe asthma, active breathing difficulties, immunodeficiency or an open nasopharyngeal cleft. None of the vaccines should be given if there is a known allergy to the influenza vaccine.
For children aged 6 months to 9 years, who have not been vaccinated or have previously been diagnosed with influenza, two doses of influenza vaccine with an interval of at least 4 weeks are recommended, regardless of the type of vaccine.
The injected vaccine contains parts of the influenza virus, in addition to sterile water, various salts and other necessary substances.
The nasal spray vaccine contains live attenuated influenza viruses that have been modified to only survive for a short period in the nasal mucosa and not in the rest of the body. In addition, it contains sterile water, salts, sugar and gelatin.
Effect of the influenza vaccine
The effect of the vaccine varies from year to year but is on average about 60 per cent. This means that approximately 6 out of 10 vaccinated people are protected against influenza disease. The effect depends on the characteristics of the virus, the vaccine and those who are vaccinated. Some people get influenza despite being vaccinated, although it seems that the vaccine can reduce the risk of a severe disease course.
The influenza vaccine can cause soreness, redness and swelling at the injection site, as well as fever, mild malaise and muscle pain. Allergic reactions or other serious side effects are rare.
The injectable vaccine contains fragments of inactivated influenza viruses and therefore cannot cause influenza disease.
The nasal spray vaccine for children can cause a stuffy or runny nose, as well as headache, slight feeling of malaise, fever or muscle pain. This vaccine contains attenuated (weakened) viruses that can only survive for a short period in the nasal mucosa and therefore cannot cause influenza.