Flu Vaccination Counseling for Children - A High-Yield PLAB 2 Guide

Ann Augustin
Jul 14
2 min read

Updated: Jul 26

As a doctor preparing for PLAB 2, you're expected to confidently discuss flu vaccination with parents, especially in a simulated consultation or health promotion station. This blog summarises the key clinical knowledge and communication tips you need.

🩸 What is the Flu Vaccine?

In the UK, children aged 2 to 17 years are offered the Live Attenuated Influenza Vaccine (LAIV) as a nasal spray each autumn/winter. It helps protect against four strains of seasonal flu (2 influenza A and 2 influenza B).

Route: Intranasal (no injection)
Type: Live attenuated (weakened virus)
Brand name: Fluenz Tetra
Frequency: Once a year due to frequent changes in circulating flu strains

🎒 Key Clinical Points for PLAB 2

🌡️ Why Is It Given Annually?

Flu viruses change (antigenic drift) each year.
Vaccine is updated yearly to match new strains.
Immunity fades over time, so yearly doses are needed.

🚗 Where Is It Given?

GP surgeries: for younger children
Schools: for children aged 4+ via school immunisation teams

⛔ Contraindications

Contraindication	Reason
<2 years old	Risk of wheeze/bronchospasm
Severe asthma/recent wheeze	May worsen condition
Ongoing aspirin therapy	Risk of Reye's syndrome
Immunocompromised (e.g. SCID, cancer)	Live vaccine risk
Severe egg allergy	Some formulations contain egg protein

⚠ Common Side Effects

Mild fever
Runny nose
Tiredness
Headache

🔍 Tip for PLAB 2: Emphasise that LAIV cannot cause flu. It contains a weakened virus that does not spread to the lungs or cause severe illness.

💬 How to Explain It to a Parent (Layman Version)

"The flu vaccine is a gentle nasal spray that helps protect your child from getting the flu and its complications, like chest infections and ear infections. It’s very safe and doesn’t involve any needles. Some kids may feel a bit tired or have a runny nose, but that’s just their immune system learning how to fight the virus. The spray can’t give them the flu.”

🌟 Scenario Tips for PLAB 2

If a parent says a neighbour's child had a seizure: Explain that high fever (not the vaccine itself) may trigger febrile fits in children prone to them.
If a parent asks about why it's given every year: Say the flu virus changes yearly, so protection needs to be updated.
If a child is on long-term aspirin: Do not give LAIV → offer inactivated flu vaccine instead.
If parent is unsure: Focus on risks of flu itself (pneumonia, hospitalisation) vs minor vaccine side effects.

🔹 Final Checklist for PLAB 2 Flu Vaccine Counselling

✅ Identify if the child is eligible (age 2–17)
✅ Check for contraindications (asthma, aspirin, immunosuppression)
✅ Reassure about safety and explain mild side effects
✅ Explain why annual vaccination is needed
✅ Document consent and offer written leaflet if needed

📚 References: