COVID-19

What do you need to know about the new variants of COVID-19?

COVID-19 appears to generally cause mild illness in children. This includes the Omicron variant that we’ve started seeing since December 2021. Even though it transmits more easily (in children and adults) compared to previous variants , it does not appear to cause more severe disease in adults or children.

However, at this time, when everyone is preoccupied with COVID-19, it's really important to realise that not every illness your child has is due to COVID-19. All the 'normal' infections that can make children and babies really unwell still remain and there is a major risk that parents may delay bringing their child to the attention of a healthcare professionals even if they are unwell. If you are not sure if your child is unwell and whether they need to be seen by someone, click here to help you decide. GPs and hospitals are still providing the same safe care that they always do for children.

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Should you be worried about the new variants of COVID?

There is no evidence to suggest that the Delta or Omicron variants are more likely to infect children compared to previous strains. And even if children are infected, they generally experience mild illness. There have been relatively few children across the UK admitted to hospital with severe COVID infection. This includes children with other health conditions, including those undergoing treatment for cancer or those with weakened immune systems or underlying chest problems - even when they have been infected with COVID, they have generally experienced mild infection.

Hospital admission rates in the week ending 5 December 2021.

There are still little data available about the severity of the Omicron variant but there is no suggestion so far that this will lead to severe infection in children, including those who are unvaccinated (such as children under 12 years of age).

For specific information for children and young people with cancer undergoing cancer treatment, click here.

If you are worried about your child's breathing and are not sure if they need to be seen by a healthcare professional, click here to help you decide. Our local and regional paediatric services are well set up and have detailed plans in place to treat and support all children who have severe COVID-19 disease. There is a national plan in place for children that require intensive care support (PICU).

It is extremely important to realise that not every child with a fever has COVID-19. All the other conditions that can make children unwell are still ongoing during the COVID-19 pandemic. If you are not sure if your child is unwell and whether they need to be seen by someone, take a look at the red / amber / green criteria below to help you decide.

COVID vaccines in children

The COVID-19 vaccination is now recommended for all children aged 5 years and over. However, for children aged 5-11 years, the vaccine is initially being prioritised for children at higher risk of severe COVID-19 infection. Once the vaccine has been offered to this group, it will then be offered to all other 5-11 year olds. 

Children should receive their 2nd COVID vaccine 12 weeks after their 1st dose (although a second dose can be given after 8 weeks in children at higher risk of severe COVID-19 infection). Click here to book it now. 

Although the risk of severe COVID-infection in children remains extremely low, the main reason for vaccinating children is to offer protection against a future strain that could potentially be more severe. In addition, it has also been shown that the risk of COVID-19 associated inflammatory syndrome (PIMS) is lower in children who have been vaccinated. Most young people are extremely keen to be vaccinated. Some concerns have been raised about the risk of young people developing inflammation of the heart (myocarditis or pericarditis) following the COVID-vaccine. However, we now have a far better understanding of this because many countries have been vaccinating children aged 5 years and over for many months. The risk of myocarditis and pericarditis is low (approximately 1 in 100,000 risk) and is usually very effectively treated with simply treatment such as non-steroidal anti-inflammatory drugs such as ibuprofen. It is slightly more common in boys than in girls and is more likely to occur after the 2nd dose of the vaccine rather than the 1st. Very few cases have been reported in children below 12 years of age. The image below weighs up the benefits and risk of children being vaccinated (thanks to BBC news):

The COVID vaccine has been offered to vulnerable children aged 5-11 years from the start of February 2022. It will then be made available to all other 5-11 year olds after that. It is important that parents have clear information about why the COVID vaccine is being offered to these children; here are some questions commonly asked by parents:

  • Which children aged 5-11 years should be receiving the COVID vaccine urgently? Following updated guidance in December 2021 from the UK Joint Committee on Vaccination and Immunisation (JCVI), it was recommended that children at serious risk from the complications of COVID-19 infection receive two doses of the Pfizer BioNTech vaccine. This includes children with:
    • severe neurodisabilities
    • immunosuppression –whose immune systems don’t work well
    • profound and multiple or severe learning disabilities
    • being on the learning disability register
    • those with Down’s syndrome
    • those with long term serious conditions affecting their body. Your GP or hospital consultant will know if they need to have the vaccine
    • The vaccine is also recommended for those children living with people who have a weakened immune system (who are immunosuppressed).
  • Why should I have my child vaccinated? Although COVID is usually extremely mild in children, children with long term conditions are more likely to get unwell if they are infected. This may result significant breathing difficulty requiring admission hospital. That’s the reason for prioritising the vaccine to the specific groups of children above. In addition, if your child regularly comes into contact with a family member with a weakened immune system (which means that the vaccine will be less effective in them), by having the vaccine they will be less likely to get infected and less likely to transmit COVID to them. Otherwise healthy children will be offered the COVID-19 vaccine in due course; although Omicron infection is likely to be extremely mild or asymptomatic in these children, and protection against Omicron infection appears to be short lived after the vaccine, the vaccine is likely to offer broad protection against severe COVID-19 in the event of a potential future wave of COVID-19 with a strain that may be more severe than Omicron.
  • Is it safe? A reduced dose of the vaccine (10mcg) is being offered to children aged 5-11 years compared to a 30mcg dose in older children and adults. Research studied have found the vaccine to be safe and effective in children and real world data from Europe, America and Israel backs this up. Immune responses in vaccinated 5 to 11 year olds are as good as those measured in 15 to 25 year olds and adverse reactions due to vaccination such a having a sore arm or experiencing chills are generally mild and usually only last for a day or two. No cases of myocarditis have been observed so far in this age group.
     
  • Do I have to give consent? Yes, your child will not be vaccinated without your consent. In all instances, you and your child will be provided with appropriate information to enable you, and those with parental responsibility, to provide informed consent prior to vaccination. Click here for more information about the COVID vaccine in children.
     
  • How many doses will my child receive? Current guidance recommends two doses (although children with very severely weakened immune systems may need an extra (third) dose from 8 weeks after their second dose).
  • How long does my child need to wait between the first and second dose? There should be interval of 8 weeks between the first and second doses. The minimum interval between any vaccine dose and recent COVID-19 infection should be 4 weeks.
     
  • I am immunosuppressed – is it safe for my child to have the vaccine? Yes. The vaccine is not a live vaccine to poses no risk to you. We would encourage your child to be vaccinated if you are immunosuppressed to protect you from getting COVID.
  • My child is eligible, where can they get the vaccine? You will be contacted by your GP to arrange an appointment at the nearest suitable location. This might be at your GP surgery or in a community location.

 

 

My child is poorly – do we need to isolate and do they need a COVID test?

The commonest symptoms of COVID in children are a high temperature and/or persistent cough. However, it’s important to remember that most illnesses that children will get will not be caused by COVID-19 and that COVID-19 generally causes far milder illness in children compared to adults.

If you child is unwell, look at the red/amber/green section below for information about what you should do. They can goback to school when they no longer have a high temperature and they are well enough to attend. They do not require a COVID test unless specifically instructed by a healthcare professional.

If your child has none of the symptoms above but is poorly with headache, muscle aches, fatigue, abdominal pain, diarrhoea and/or vomiting or lethargy, they should remain at home until they feel better (click here for more information). If they have diarrhoea or vomiting they should not return to school until 48 hours after last having diarrhoea or vomiting. If you are worried that your child is unwell, look at the red/amber/green section below for information about what you should do.

If your child has a runny nose, sore throat or occasional cough but none of the symptoms above, they can go to school.

Click here for information on self-isolation and for info for other household members.

  • To reduce the risk of spread to other household members, get them to cover their mouth and nose with a tissue or sleeve when coughing and sneezing and to throw used tissues in the bin immediately. They should also regularly wash their hands with soap and water (for at least 20 seconds each time).
  • In addition, keep shared spaces and surfaces visibly clean using household detergents, washing hands after cleaning. Household bleach using in accordance with the instructions can be used to disinfect surfaces. Use hot water and detergent or a dishwasher for crockery and cutlery.

Click here to watch a video of some really useful practical tips about looking after a children with presumed COVID-19 and click here for more information if you or other family members become unwell with COVID-19.

 

Red Features

If your child has any of the following:

  • Becomes pale, mottled and feels abnormally cold to the touch
  • Has pauses in their breathing (apnoeas), has an irregular breathing pattern or starts grunting
  • Severe breathing difficulty - to breathless to talk/ eat or drink
  • Is going blue round the lips
  • Has a fit/seizure
  • Becomes extremely distressed (crying inconsolably despite distraction), confused, very lethargic (difficult to wake) or unresponsive
  • Develops a rash that does not disappear with pressure (the ‘Glass test’)
  • Babies under 1 month of age with a temperature of 38°C / 100.4°F or above
  • Has testicular pain, especially in teenage boys

You need urgent help:

Go to the nearest A&E department or call 999

Amber Features

If your child has any of the following:

  • Is finding it hard to breathe including drawing in of the muscles below their lower ribs, at their neck or between their ribs (recession)
  • Seems dehydrated (sunken eyes, drowsy or no urine passed for 12 hours)
  • Is becoming drowsy (excessively sleepy) or irritable (unable to settle them with toys, TV, food or picking up) - especially if they remain drowsy or irritable despite their fever coming down
  • Has extreme shivering or complains of muscle pain
  • Babies 1-3 months of age with a temperature of 38°C / 100.4°F or above
  • Infants 3-6 months of age with a temperature of 39°C / 102.2°F or above
  • For all infants and children with a fever of 38°C or above for more than 5 days.
  • Has persistent vomiting and/or persistent severe abdominal pain
  • Has blood in their poo or wee
  • Increasingly thirsty and weeing more
  • Any injury of arms or legs causing reduced movement or persistent pain
  • Head injury causing constant crying or drowsiness
  • Is getting worse or if you are worried

Immediately contact your GP and make an appointment for your child to be seen that day.

If symptoms persist for 4 hours or more and you have not been able to speak to either a member of staff from your GP practice or to NHS 111 staff, then consider taking them to your nearest ED.

Green Features

If none of the above features are present

  • Children and young people who are unwell and have a high temperature should stay at home. They can go back to school, college or childcare when they no longer have a high temperature, and they are well enough to attend. They do not require a COVID test unless specifically instructed by a healthcare professional.
  • Additional advice is available to families for coping with crying of well babies
  • Additional advice is available for children with complex health needs and disabilities.
  • If your child has been burned, click here for first aid advice and for information about when to seek medical attention

Self Care:

Continue providing your child's care at home. If you are still concerned about your child, call NHS 111 - dial 111.

Mental Health

  • The COVID-19 pandemic has had a huge impact on the mental health and emotional wellbeing of children and young people. If your child is feeling extremely anxious, click here for information about how best to support them. If you are worried and your child is known to child or adolescent mental health services (CAMHS), please contact them.
  • Kooth is a free online counselling and emotional wellbeing support service offered to young people aged 11 - 25 years (up to their 26th birthday) living in Dorset, Hampshire and the IoW with a safe and secure means of accessing support with their emotional and mental health needs from a professional team of qualified counsellors. By accessing Kooth, young people can benefit from a free, confidential, anonymous and safe way to receive support online, online counselling from a professional team of BACP qualified counsellors is available via 1-1 chat sessions or messaging on a drop in basis or via booked sessions including out of hours’ availability - counsellors are available from 12pm to 10pm on weekdays and 6pm to 10pm at weekends, every day of the year on a drop in basis
  • If your child needs urgent mental health support or advice from local 24/7 services, click here or text SHOUT to 85258. If you live in Hampshire or on the Isle of Wight, the NHS 111 mental health triage service can provides advice, support and guidance, 24 hours a day, seven days a week. The Mental Health Triage Team has a wide range of skills, including on the phone brief psychological support and has access to key services and organisations that can offer mental health support to you and your child in your time of need. Just dial 111 or online at www.111.nhs.uk.
  • If you notice any self-harm injuries on your child, please contact the NHS 24/7 Mental Health online support or your GP.
  • If you are worried about an eating problem/disorder, click here, or contact BEAT or your GP.
  • Helpful advice is also available at Every Mind Matters and MindEd for Families.

Worried about your baby aged under 3 months

It can be confusing to know what to do when your baby is unwell during the coronavirus pandemic. Remember that the NHS is still providing safe care. GP practices and hospitals have made changes to help reduce the risk of infection. Only one parent/ carer will be able to attend A&E with their child. Please use the hand sanitisers provided, wear a face covering in enclosed spaces and maintain social distancing.

Click here for a downloadable version of the Red, Amber and Green table above.

COVID-19 associated inflammatory syndrome (PIMS)

What is PIMS?

In April 2020, doctors in the UK first started to see children with serious inflammation throughout their body, which seemed to be linked to COVID-19. Inflammation is a normal response of the body’s immune system to fight infection. But sometimes the immune system can go into overdrive and begin to attack the body. If this happens, it is important that children receive urgent medical attention.

Doctors are concerned that in the 2-4 weeks following infection with COVID, some children develop an inflammatory syndrome that can affect their heart muscle (myocarditis) their blood vessels (vasculitis), particularly those around the heart. If untreated, the inflammation can cause tissue damage, poor function of vital organs or potentially even death. Fortunately, there are readily available treatments that are highly effective to treat this.

Some of the symptoms of PIMS can overlap with other rare conditions, such as Kawasaki disease and Toxic Shock Syndrome which is why it has been described as ‘Kawasaki-like’. Complications from each of these conditions can cause damage to the heart. Kawasaki tends to affect children under five whereas PIMS seems to affect older children and teenagers.

Can PIMS be treated?

Yes. Doctors know what to look out for and will do tests to diagnose what’s wrong and what treatment to give the child. Even where doctors aren’t 100% sure whether a child or teenager has PIMS, they know how to treat the symptoms associated with it. Treatments to reduce inflammation in the body may need to be given.

Researchers have conducted studies to provide information about how best to treat children with PIMS.

What symptoms should I look out for?

All children with PIMS will have a fever, which persists over several days. There’s a very wide range of other symptoms that children might have, including: tummy pain, diarrhoea, vomiting, rash, cold hands and feet and red eyes. These symptoms can be found in other illnesses too.

While most won’t be seriously unwell, some children may be severely affected by the syndrome. The most important thing is to remember that any child who is seriously unwell needs to be treated quickly – whatever the illness.

If the child has a temperature of 38⁰ or higher, cold hands and feet and is sleepy, call your GP or 111. If symptoms persist and you have not been able to speak to either a GP or 111, take your child to the nearest A&E.

If your child doesn’t have these signs of being seriously unwell but you are still concerned, talk to your GP.

How many children have been affected?

Based on data collected across the UK, the risk of developing PIMS-TS following COVID is about 0.05% (of ten thousand children who are infected with COVID, only about 5 will develop PIMS-TS). Almost all of these have been successfully treated. 

Have any children died from PIMS?

A very small number of children have died from PIMS in the UK. Most children make a full recovery. In the UK, many more children die of other infections such as flu or even chicken pox every year, compared to PIMS. All children with PIMS will receive a medical follow up.

Is PIMS caused by COVID-19?

PIMS seems to be linked to COVID-19 because most of the children either had the virus or tested positive for antibodies indicating they had been infected (even if they hadn’t seemed ill at the time). But a very small number of the children with PIMS symptoms didn’t test positive for either.

How can doctors tell if a child has PIMS?

There currently isn’t a test which can tell doctors whether a child definitely has the syndrome. A syndrome is a collection of many different symptoms which, together, can give doctors an indication of whether or not someone has a particular illness. Doctors will look for a pattern of symptoms relating to PIMS and then do more tests, such as blood pressure and blood analysis, to make a diagnosis.

Are black or Asian children more likely to be affected?

Children from all ethnic minority backgrounds have been affected by PIMS. There have been more children affected by PIMS who are from Black and Asian backgrounds, but it is not clear what the reasons for this are at the current time. It is possible that this is because there were higher numbers of COVID-19 cases in these communities. But it is important for families with all ethnic backgrounds to be aware of the signs and symptoms of the condition, however rare.

Doctors are learning more and more about this condition all the time and we hope to have more information over the next weeks and months. We will update our guidance regularly.

For more information, click here.

Long COVID

Children and teenagers may be experiencing long term symptoms or problems from COVID-19. Symptoms may include fatigue, brain fog, pain, breathing difficulties, headaches, anxiety, low mood and sleep disturbances. You may see the effect of this in different ways including poor school attendance, difficulty maintaining usual activity levels and increased anxiety.

Whilst most children / teenagers will get better without any specialist help, if symptoms are persisting for more than 12 weeks and these is having a significant impact on how they are able to function, help should be sought from your GP who can assess your child and refer them to a Long Covid service if appropriate. Your local long COVID service is likely to include a multidisciplinary specialist team such as a paediatrician, occupational therapist, physiotherapist and psychologist. They will review your child’s symptoms, and meet with them face to face if necessary. The team will work with colleagues to help the child receive the right help, therapy and support that they need. They will also provide signposting to self-help / community resources.

Resources:

https://www.yourcovidrecovery.nhs.uk/

Sleep hygiene information and downloadable leaflet

Fatigue management

Instructions for completing daily fatigue diary

Energy Measure Instructions

If your child lives in Hampshire or the Isle of Wight, click here for more information about the long COVID service.

Talking to children about COVID-19

In the same way that we have all been talking constantly about COVID-19 over the past few months, so have our children.

Many of them (especially those with other underlying health conditions such as heart and lung problems, weakened immune systems or diabetes) are really scared that they will get extremely unwell or even die from COVID-19.

They need you to make time for them and listen to their concerns and reassure them. You need to explain to them that they are extremely unlikely to get unwell from the infection. As you can see from the following diagram, the people most at risk from severe COVID-19 are the elderly; extremely few children children have died. he vast majority of children who get infected with COVID have very mild symptoms or no symptoms at all.

Deaths from COVID registered in the week ending 26 November 2021.

Primary school children

The World Health Organisation have produced a free book for primary school children called “My Hero is You, How kids can fight COVID-19!” which explains how children can protect themselves, their families and friends from coronavirus and how to manage difficult emotions when confronted with a new and rapidly changing reality. Staff from Southampton Children's Hospital have also written a brilliant free book about COVID-19 for primary school children - click here to read it with your child.

You can also listen to Dr Ranj answering questions posed by children about COVID-19.

Secondary school children

The LifeLab team at Southampton have produced the following video about COVID for young people.

In addition, the Children's Commissioner for England has produced resources on COVID-19 for secondary school children - click here .

For more information about supporting your child/children during the COVID-19 pandemic, click here.


Here are a few animations answering questions commonly asked by children and young people:

What is a virus and how does our body fight COVID-19?


What is Coronavirus, how did it start and how does it spread?


Will i get COVID-19 and how do i stay safe?


Is there a cure for Coronavirus, when will life go back to normal and will the virus ever go away?


What is a vaccine, how does the coronavirus vaccine work and can you still catch COVID-19 if you have had the vaccine?


What is it like having a COVID test?


Annabelle’s lateral flow swab test


Who needs to have a COVID lateral flow test at school?

Protecting your child from COVID

COVID-19 is spread by droplets. That means your child needs to be in extremely close contact with someone with COVID-19 (who is coughing) to become infected (within 1-2 metres of them). However, the droplets containing COVID-19 can survive for hours on hard surfaces (door handles, handrails etc). This means that your child is much more likely to get infected by picking up COVID-19 on their hands and then infecting themselves by touching their face (which allows the virus to enter via their mouth, nose or eyes).

This is why washing hands with soap and water is so important, especially after being in areas containing other people:

In addition, trying to stop your child touching their face (unless they have just washed their hands) will also reduce the risk of them getting infected:

For more information about reducing the risk of you or your child catching COVID-19, click here.

Face masks and children

The rules about people being made to wear face masks / face covering on public transport and in most indoor places applies to children aged 11 years of age and older - click here for more information. However, for younger children, it is up to the parent/carer as to whether they wear a face mask or not.

However, face masks should NOT be used for babies and children under 3 years or those who may find it difficult to manage them properly.

Wearing a face mask in this age group can put babies and children at serious risk of harm or death:

  • Babies and young children have smaller airways so breathing through a mask is harder for them
  • Masks could increase the risk of suffocation because they are harder to breathe through
  • Babies are unable to remove the mask should they have trouble breathing
  • Infants could be at risk of becoming tangled, especially if they try to remove a mask, potentially causing serious injury
  • Older infants or young toddlers are not likely to keep the mask on and will touch their face more to try and remove it.

Making the process of testing for COVID-19 less scary for children

1) The reason that you are being tested for COVID-19 is that you have developed a cough or high temperature. Although we don't think that COVID-19 will make you poorly, we don't want it to spread to other people - this is why we are testing you for it.


2) Although the people doing the testing look scary, they are just normal people underneath the funny mask and clothes:


3) They will gently swab your nose and throat. It might feel a little uncomfortable but it won't hurt. You usually won't require any blood tests.


4) It might take 2-3 days for the test result to come back. It's really important that you continue to regularly wash your hands and make sure you cover your mouth when you cough and nose when you sneeze - and throw the tissues straight in the bin afterwards.

6-8 week mother and baby check and the importance of childhood vaccines

Your baby should have had a routine physical examination at 6 to 8 weeks, usually by your GP. As you know, COVID-19 has placed a huge challenge on the on the NHS and, if this screening opportunity has been missed due to current circumstance, here is some advice about what you should look out for.

Your baby should have had a full physical examination soon after birth. This will have picked up many, but not all, of the problems which we look for during the 6-week postnatal check.

If your baby does not have a 6-8 week check, you should ask yourself the following questions. If the answer to any is “yes”, you should contact your health visitor or GP.

Eyes

  • Do you think your baby can’t ever fully open both eyes?
  • Do you think your baby doesn’t make good eye contact and hold his/her gaze at you?
  • Do you think that your baby doesn’t follow your face if you move your head from side to side when standing near him/her (less than 1 metre)?
  • Do you think that your baby’s eyes shake/flicker/ wobble?
  • Do you think there is something unusual about, or in, your baby’s eyes, for example, the dark central area (pupil) looks cloudy or the eyeball is an unusual shape or size?
  • If the whites of your baby’s eyes are yellow, contact your health visitor or GP.

Hips

  • When you change your baby’s nappy, do you find that one leg cannot be moved out sideways as far as the other?
  • Does one leg seem to be longer than the other?
  • Do you have any other concerns about your baby’s hips?

Heart

If the answer to any of these is "yes", you should speak to someone the same day:

  • Does your baby seem breathless or sweaty, at any time, especially when feeding?
  • Does your baby have blue, pale, blotchy or ashen (grey) skin at any time?

Remember: if the answer to any of the questions above it "yes", you should contact your health visitor or GP.

The routine 6-8 week review is also an opportunity for you to talk to your health visitor about any other issues you may have with your baby and to talk about how you are feeling. Further information regarding the 6-week postnatal review can be found on the NHS website.

VACCINATIONS

COVID-19 has shown how important it is to protect ourselves against infections. Vaccinations are by far the most effective way of achieving this. That’s why is so important that your child still receives their normal childhood vaccinations; to protect them not just during the COVID-pandemic but also for the rest of their lives. Make sure that your child doesn’t miss out - your GP practice is still open to administer them. Click here for more information.

Why your child should have the flu vaccine this winter

All children between 2 and 15 years of age (year 11) should receive the children's flu vaccine. This is not only to stop them getting unwell with flu, but also to stop them spreading flu to other members of your family. If your child is at school, the school will arrange for them to be vaccinated.

This year, it is especially important that your child receives their flu vaccine. By being vaccinated, your child is less likely to develop a flu-like illness (cough/fever). If your child develops such symptoms this winter, they will be excluded from nursery or school until they have a negative COVID-19 test (through the test and trace system). In addition, if they get flu, they may need treatment in hospital and/or may transmit flu to other family members who may become unwell (children are super-spreaders of flu).

There are other groups of children with long-term health conditions that should have the flu vaccine every year. This includes children with weakened immune systems (including those on steroids or with problems with their spleen), chronic heart or lung problems, diabetes, asthma, chronic kidney or liver disease. It is especially important that these children are vaccinated because they have the greatest risk of becoming very unwell if they get flu. Children aged from 6 months to 2 years who are at risk from complications of flu should be given the inactivated (injected) flu vaccine rather than the intranasal vaccine.

Click here for more information

Common myths about flu and the flu vaccine

'Flu isn't serious, so my child doesn't need a flu vaccine' and 'My children never get ill, so they don't need the vaccine'

It is tempting to think that flu is no worse than a bad cold, but in fact it is a serious disease which can infect anyone. Although most children do not become severely unwell with flu, in children with other medical conditions (heart or lung problems or weakened immune systems), flu can lead to hospitalisation or even death. In addition, children are superspreaders of flu, which means that even if they are mildly affected, they can easily infect other family members, such as grandparents or people with medical conditions who may become extremely unwell.

'My child is outside of the age range for routinely receiving the flu vaccine. Should I arrange for them to have it anyway?'

Although it is recommended that all children between 2 years of age and up to the 1st year of secondary school (year 7) have the flu vaccine, there are a large number of children outside of this age range that should also have it. This is because they have medical conditions that mean that they are at higher risk of getting severe infection if they are infected with flu. This includes children with:

  • Respiratory (lung) diseases, including asthma
  • Heart disease, kidney disease or liver disease
  • Neurological (brain or nerve) conditions including learning disability
  • Diabetes (see a short film of a woman with Type 1 diabetes talking about why she gets the flu vaccine)
  • A severely weakened immune system (immunosuppression), a missing spleen, sickle cell anaemia or coeliac disease
  • Being seriously overweight (BMI of 40 and above)

If your child falls into any of these categories and is not due to have their flu vaccine at school, please book them in to your GP practice to have it given (pharmacies are unable to give the flu vaccine to children).

'The nasal spray that children get is a live vaccine - I'm worried that if my child has it they will infect relatives/grandparents'

There is no evidence that healthy unvaccinated people can catch flu from the nasal flu spray (either from airborne spray droplets in the room where the vaccine is given, or from vaccinated individuals ‘shedding’ the virus).

It is known that vaccinated children shed the virus for a few days after vaccination (through sneezing or coughing). However, the vaccine virus is weakened (it is “cold adapted” which means it dies at 37°C), so cannot infect the lungs and so it is much less able to spread from person to person. The amount of virus that children shed is normally below the levels needed to pass on infection to others. The virus does not survive for long outside the body.

It is therefore not necessary for children to be excluded from school during the period when the vaccine is being given. The only exception is the very small number of children who are extremely immunocompromised (for example, those who have just had a bone marrow transplant).

'Last year my children had the flu vaccine but they got ill anyway, so it doesn't work'

No vaccine is 100% effective, including the flu vaccine. However, the vaccine usually prevents about half of all flu cases. For people who get flu after being vaccinated, the disease is often less severe than it would have been. It is important to remember that the flu vaccine only protects against flu, but there are other illnesses which have flu-like symptoms which you can still catch after getting the flu vaccine. It takes up to two weeks for the vaccine to take effect, so you could still catch flu if you are exposed to the virus during this time. Getting vaccinated as early as possible in the season can help to prevent this.

Use this video to explain to your child why they are having the flu vaccine

COVID-19 and pregnancy

COVID-19 vaccines are recommended in pregnancy. Vaccination is the best way to protect against the known risks of COVID-19 in pregnancy for both women and babies, including admission of the woman to intensive care and premature birth of the baby

Studies from the UK show that although pregnant women are no more likely to get COVID-19 than other healthy adults, they are at increased risk of becoming severely unwell compared to non-pregnant women, particularly in the third trimester.

In pregnant women with symptoms of COVID-19, it is twice as likely that their baby will be born early, exposing the baby to the risk of prematurity. A recent study has also found that pregnant women who tested positive for COVID-19 at the time of birth were more likely to develop pre-eclampsia, more likely to need an emergency caesarean and their risk of stillbirth was twice as high, although the actual number of stillbirths remains low.

Please click here for further information

Is it safe for me to have the COVID-19 vaccine during pregnancy or if I'm breastfeeding?

COVID-19 vaccines are recommended in pregnancy. All pregnant women and girls in the UK aged 16 and over have now been offered a COVID-19 vaccine.

On 16 April 2021, the Joint Committee on Vaccination and Immunisation advised that all pregnant women should be offered the COVID-19 vaccine at the same time as the rest of the population, in line with the age group roll out. Previously their advice was that pregnant women at high risk of exposure to the virus or with high risk medical conditions should consider having a COVID-19 vaccine in pregnancy.

Vaccination is the best way to protect against the known risks of COVID-19 in pregnancy for both women and babies, including admission to intensive care and premature birth.

The decision whether to have the vaccination in pregnancy is your choice. Make sure you understand as much as you can about COVID-19 and about the vaccine and you may want to discuss your options with a trusted source like your doctor or midwife.

COVID-19 vaccines are recommended to breastfeeding women. There is no plausible mechanism by which any vaccine ingredient could pass to your baby through breast milk. You should therefore not stop breastfeeding in order to be vaccinated against COVID-19.

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Should I continue to breastfeed my baby if I have suspected/ confirmed COVID-19?

Yes. There is a wealth of evidence that breastfeeding reduces the risk of babies developing infectious diseases. There are numerous live constituents in human milk, including immunoglobulins, antiviral factors, cytokines and leucocytes that help to destroy harmful pathogens and boost the baby’s immune system. There is currently no evidence that Covid-19 can be passed to the baby through breastfeeding. There is also evidence that mothers with Covid-19 pass their antibodies to their baby through breastmilk, thereby giving protection to their baby.

You may wish to consider the following precautions

  • Wash your hands before touching you baby, breast pump or bottles
  • Try and avoid coughing or sneezing on your baby whilst feeding at the breast
  • Consider wearing a face mask while breastfeeding if available
  • Follow recommendation for pump cleaning after each use

(Source: https://www.unicef.org.uk/babyfriendly/covid-19/ )

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Keeping up to date with the situation

  • The situation continues to change day by day. For the most up to date information on the situation, including advice about school attendance, need for testing or attendance to hospital for assessment, look at the updates provided by the UK government.
  • For up to date information about COVID-vaccine recommendations in children, click here
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