It didn't take long for the naysayers to react. "Don't poison your children," tweeted one mother in response to the Government's announcement yesterday that all children aged from two to 17 would be offered the flu vaccine.
Andrew Lansley, the Health Secretary, announced the move following a recommendation from vaccination experts that it would save lives, prevent children being hospitalised and save costs. But vaccine experts, bearing the scars of the MMR safety scare on their backs, know how sensitive promoting the new vaccine to healthy children could be.
The Joint Committee on Vaccination and Immunisation (JCVI) acknowledged the new strategy could provoke "mixed reactions". It called for an information campaign to explain the rationale to parents, children and healthcare staff. Flu vaccination is offered to over-65s, pregnant women and patients of all ages with chronic health problems such as asthma.
Sally Davies, the Government's chief medical officer, claimed if even 30 per cent of the nine million eligible children opted for the vaccine, around 2,000 deaths and 11,000 hospitalisations a year might be avoided.
Official figures show the total annual number of excess deaths attributed to flu in adults and children varies widely, depending on the severity of that winter's virus, ranging from 9,798 in 2008-09 to 661 last winter, which was exceptionally mild.
A flu vaccine for healthy children could be a tricky sell. Flu is not a dread disease such as meningitis, polio or diphtheria. It is mild in most people – like rubella (German measles), the third component of the MMR vaccine. Moreover the nasal spray is based on a live vaccine – unlike jabs, which use a killed virus – and it can cause mild flu-like symptoms in some children.
Like rubella, however, having the vaccine protects not only the individual but those with whom they come in contact. If rubella is passed to a pregnant woman it can cause serious damage to her unborn baby. Flu in an older child could pose a serious risk to their younger siblings – and their grandparents, who are most vulnerable.
The vaccine will be given as a nasal spray and could be introduced from 2014, if the sole supplier, AstraZeneca, can produce enough. It has been used in the US for a decade and is reported to have an excellent safety record.
But there are doubts about how it can be administered. For older children aged five to 17, it could theoretically be given by school nurses – but they are already overstretched and two doses are required in children under nine. Younger children would need to be vaccinated by their GP. The vaccine must be given within a six- to eight-week window in the autumn.
Dr David Elliman, a community child health consultant at Great Ormond Street Hospital, said: "I have immense concerns in terms of the human resources required to deliver this."
A spokesperson for the Department of Health said the practical details had still to be worked out, including negotiating a contract price for the vaccine. The JCVI estimated the cost of the programme at £100m a year.
11,000 fewer hospital admissions and...
2,000 fewer deaths each year if...
30% of two- to 17-year-olds take up the offer of the vaccinations, according to the chief medical officer.
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