Flu vaccine - Eligibility for the flu vaccine

You should have the flu vaccine if you are:

• pregnant
• aged 65 or over (or turn 65 before the end of the flu vaccination programme) , or
• aged six months to 64 years with a long-term health condition, including:
  • problems with your chest or breathing. This includes chronic obstructive pulmonary disease (COPD) or asthma, that need regular steroid inhalers or tablets
  • a heart problem
  • kidney disease (from stage 3)
  • liver disease
  • nerve conditions, such as Parkinson’s disease or motor neurone disease
  • a learning disability
  • severe mental illness
  • diabetes
  • adrenal insufficiency, such as Addison’s disease
  • epilepsy
  • a weak immune system due to illness or treatment
  • a missing spleen or a problem with your spleen, or
  • being very overweight. This is a body mass index (BMI) of 40 or more and aged 16 or over.

Even if you feel well, you are at higher risk of getting seriously ill from flu if any of the above apply to you.  

The following people should also have the flu vaccine to help protect themselves and those around them.

• People living in a care home or other long-stay care facility
• People working directly with patients or clients in health or social care
• People who are homeless
• People living in prison
• People who work with chickens (poultry workers) who are at high risk
• People who work with cows and pigs (livestock workers) who are at high risk
• Children aged two and three years (age on 31 August)
• School-age children and young people from reception to year 11
• Carers
• First responders and members of voluntary organisations providing planned emergency first aid
• Those who live with someone who has a weak immune system

Most children and young people will have their vaccine as a quick and painless nasal spray, where a fine mist is sprayed up the nose from the tip of each nostril. The nasal spray vaccine is the recommended flu vaccine for most children and young people from the age of two.

If your child is eligible for a flu vaccine, you should be contacted by their GP surgery or school nurse. If you think your child might have missed their vaccine, contact the school nurse if they are school age or GP surgery if they are not in school.

If you think you might have missed your invitation for a flu vaccine, contact your GP or your local pharmacy.

The table below shows who can have the flu vaccine and where to get it.

Ideally, the flu vaccine should be given before flu starts to spread. However, it can still be given at a later date. 

The flu vaccine is safe during all stages of pregnancy.

If someone who is pregnant gets flu, they are at risk of hospitalisation. Therefore, their baby is more likely to be born early, have a low birthweight, be stillborn or at risk of death. The vaccine also helps protect the baby in their first months of life, when flu can be very serious.

You should have the flu vaccine as soon as you know you are pregnant (if the vaccine is available). You can have it at the same time as the respiratory syncytial virus (RSV) vaccine, whooping cough vaccine and COVID-19 vaccine (if eligible due to disease or treatment). However, don’t delay your flu vaccine simply so you can have other vaccines at the same time.

If you are pregnant, you can get your flu vaccine from your GP or local pharmacy. In some areas of Wales, midwives can give flu vaccines.

The flu vaccine is recommended every time you are pregnant, even if you have had the vaccine before.  

Getting vaccinated each flu season protects you against new strains of the virus and reduces the risk of spreading flu to your baby. The protection you get from the vaccine will pass to your baby through the placenta. The placenta is on the inside of your womb and links your blood supply with your unborn baby.

In winter, thousands of people die from flu-related illnesses in the UK. Having a flu vaccine every year is one of the best ways to help protect you and your baby against flu.

Even if you feel well, you are at higher risk of getting seriously ill from flu if any of the below apply to you:

• problems with your chest or breathing. This includes chronic obstructive pulmonary disease (COPD) or asthma, that need regular steroid inhalers or tablets
• a heart problem
• kidney disease (from stage 3)
• liver disease
• nerve conditions, such as Parkinson’s disease or motor neurone disease
• a learning disability
• severe mental illness
• diabetes
• adrenal insufficiency, such as Addison’s disease
• epilepsy
• a weak immune system due to illness or treatment
• a missing spleen or a problem with your spleen, or
• being very overweight. This is a body mass index (BMI) of 40 or more and aged 16 or over.

If you are an adult in this group, you can get your flu vaccine at your GP surgery or local pharmacy. Children in these groups may get their vaccine at school (if they are the right age) or at their GP surgery.

If you are aged 65 or over (including those aged 65 by 31 March), you are more likely to become seriously ill from flu.

You can get your flu vaccine from your GP surgery or local pharmacy.

If you care for someone whose health or welfare would be at risk if you got flu, you should have a free flu vaccine. This includes unpaid carers. Having your flu vaccination helps protect both you and the person or people you care for.

You can get the flu vaccine at your GP surgery or local pharmacy.

If you work in a care home, are a domiciliary care worker or a healthcare worker, you can find out how to get your flu vaccine at Influenza (flu) – Information for health and social care workers eligible for the vaccine – Public Health Wales

If you are a member of a voluntary organisation and provide planned first aid, or if you are a community first responder, you should also have a flu vaccine. You can get this from your GP surgery or most local pharmacies – you just need to take proof of your role.

Very few people cannot have the flu vaccination. You should not have the vaccine if you have had a serious (life-threatening) reaction to:

• a previous dose of the same vaccine, or
• any ingredient in the vaccine.

Speak to the person giving you the vaccine if you have had a serious allergic reaction to the vaccine or its ingredients in the past.

A cold or other minor illness is not a reason to delay a flu vaccination.

If you are unwell with a high temperature, delay the vaccination until you feel better.

All children aged two and over can have a free flu vaccine. This includes:

• children who are aged two or three on 31 August
• all primary school children
• all secondary school children in years 7 to 11
• children who do not attend school (they can have their vaccine at their GP surgery), and
• children aged six months or older with a long-term health condition that puts them at higher risk from flu.

Flu is caused by viruses and spreads easily. Anyone can get flu, but children are more likely to get it and flu can be serious for them.

Flu can lead to:

• bronchitis (lung inflammation)
• pneumonia (lung infections), and
• ear infections.

Some children get so ill they need to go into hospital.

If your child is aged six months or older and has any of the following health conditions, it is important they have a flu vaccine every year:

• Diabetes
• Adrenal insufficiency, such as Addison’s disease
• A heart problem
• A chest or breathing problem, including asthma, that needs regular steroid inhalers or tablets
• Kidney disease (from stage 3)
• A weak immune system due to an illness or treatment
• Liver disease
• Nerve conditions, such as Parkinson’s disease or motor neurone disease
• A missing spleen or a problem with their spleen
• A learning disability
• Severe mental illness
• Children (aged six months or older on 1 September) with a body mass index (BMI) of 40 or above
• Epilepsy

Children and young people in Wales who are homeless can also have a flu vaccination.

Children in these groups may get their vaccine at their school if they are in school years reception to year 11. Children who do not attend school can get the flu vaccine from their GP surgery.

The nasal spray vaccine cannot be given to children and young people who:

• are under two years old
• are on long-term aspirin (salicylate) treatment
• have had a severe life-threatening allergic reaction to the vaccine or its ingredients
• have a weakened immune system due to a disease or treatment
• are pregnant
• have a wheezy chest on the day of the vaccination or in the previous three days, or
• have increased the use of their asthma inhalers in the previous three days.

There are some situations where you should get advice about your child having the nasal spray vaccine. Speak to your health visitor, school nurse, immunisation team or GP surgery if your child:

• has asthma that needs regular oral steroids or has needed intensive-care treatment for it
• is having a cochlear implant fitted (it is not ideal if they have the nasal spray vaccine in the week before or two weeks after)
• has an unrepaired craniofacial malformation, or
• is in close contact with someone who has a severely weakened immune system. For example, people who are in a protected environment after having a bone marrow transplant.

If a child or young person cannot have the nasal spray flu vaccine, they can get a flu vaccine injection instead. This is available from their GP surgery and through some school nursing services.

A cold or other minor illness is not a reason to delay a flu vaccination

If your child is unwell with a high temperature, it is best to delay their vaccination until they are feeling better.

Most people with allergies can have the vaccine with no problems.

The vaccine should not be given to anyone who has had a serious (life-threatening) reaction to:

• a previous dose of the vaccine, or
• any ingredient in the vaccine.

Make sure you tell the person giving the vaccine if your child has had a serious allergic reaction to the vaccine or its ingredients in the past.

The nasal spray vaccine can be safely given to most children with an egg allergy. If your child has had a serious (life-threatening) reaction to egg that needed intensive-care treatment, they should be offered an appropriate flu vaccine by injection.

The nasal spray flu vaccine contains small traces of highly purified pork gelatine.

 The nasal spray vaccine is the recommended flu vaccine for most children and young people.

Some people don’t eat pork gelatine because of their faith. Both Muslim and Jewish communities have approved the use of the flu nasal spray vaccine. This is because the flu nasal spray is a non-oral product and a medicine.

If you decide you do not want your child to have the nasal spray, they can have an injection instead. This does not contain pork gelatine. You can highlight this on your consent form. Or you can contact your health visitor, school nurse, immunisation team or GP surgery to discuss with them how to get the injection.

You can find more information about vaccines and pork gelatine.

The Welsh Government have taken advice from vaccine experts.

People who work with chickens (poultry workers) and people who work with cows and pigs (livestock workers):

The aim is to lower the risk of getting human flu and avian flu (bird flu) at the same time. It also aims to lower the risk of getting human flu and another type of flu carried by cows and pigs at the same time. This helps reduce the chance of a new type of flu developing that could spread between people.

In Wales, you may be eligible for a flu vaccine if you are:

• aged 16 or over
• live in Wales, and
• meet the following criteria:

1. You work on a site where these animals are suspected or confirmed to have animal flu and:

• cull or handle live unwell animals
• clean enclosed areas, or
• collect dead animals.

2. You regularly work at or visit registered poultry sites with 50 or more birds, or cow or pig sites. You have direct contact with animal waste as part of your work, and:

• regularly go into enclosed areas where animals are kept or raised
• collect and remove animal waste or bedding from sheds, or carry out full cleaning of sheds and buildings
• sort eggs if the sorting area is part of the production unit, or
• catch or cull chickens in enclosed areas where they are raised or eggs are produced.

3. You work in chicken, cow or pig processing units and: 

• catch and handle live birds
• kill and process animals, or
• clean and disinfect areas and equipment covered in bird droppings or animal waste.

No, the flu vaccine will not protect you from avian (bird) flu, or flu from animals such as cows or pigs. However, the vaccine will help protect against human flu.

By reducing your risk of catching human flu, the vaccine also lowers your chance of having both human and bird or animal flu at the same time. This is important. Catching both types of flu at the same time could create a new type of flu that spreads more easily between people.

The flu vaccine will also help reduce the risk of severe illness if you were to catch both strains at the same time.