The Health Promotion Board (HPB) has engaged Dr. Karen Donceras Nadua, a Consultant with the Paediatric Infectious Disease Service at KK Women’s and Children’s Hospital, to find out more about the influenza vaccine.

For the past year and a half, COVID-19 has been at the forefront of our concerns as we witness its disruption to our lives. Fortunately, most of the children with COVID-19 infection develop mild symptoms. Our children however, are still at risk of other infectious diseases which may cause significant impact on their health.

One such infection is influenza, which has caused epidemics and pandemics well before the world experienced the COVID-19 pandemic. The Spanish flu pandemic in 1918 caused nearly 50 million deaths worldwide.

How Does Influenza (Flu) Affect Your Child?

Like COVID-19, influenza is spread through respiratory droplets in close contact settings. The influenza virus causes symptoms like high fever, chills, muscle aches, cough, sore throat and nasal congestion. Like COVID-19, the influenza virus can also cause lung infection (pneumonia) and bronchiolitis/bronchitis (inflammation of the airways within the lungs) resulting in breathlessness.

Serious lung infections can be life-threatening. Influenza also increases the risk of bacterial infections. Rarely, it may also cause inflammation in the heart or the brain or even paralysis.

Healthy young children less than 5 years old are at higher risk for more severe complications and hospitalisation if they are infected with influenza. The rate of hospitalisation from influenza for healthy young children is comparable to those belonging to other high-risk groups such as children with underlying medical conditions or impaired immune systems. Parents are also affected when they have to take time off work or regular routines to look after sick children. Parents, thankfully there are proactive steps you can take to safeguard and protect your kids because influenza is preventable with an annual influenza vaccination.

Is the Recommended Influenza Vaccination Safe for Your Child?

All vaccines used in Singapore are assessed to be safe for use by the Health Sciences Authority (HSA) so don’t worry, mum and dad! The influenza vaccination is recommended for infants (aged 6 months and above) and young children in many countries. This is supported by the World Health Organization (WHO), U.S Center for Disease Control and Prevention (CDC) and Singapore’s own Ministry of Health (MOH).

The current influenza vaccines available in Singapore are inactivated, meaning the influenza virus within the vaccine has been killed. It is a very safe vaccine, with millions of vaccine doses are given to children each year, and there has been no increase in significant medical events for children who have been vaccinated. The influenza vaccine is also safe for those with egg allergy** and the vaccine can be taken together with other vaccinations, including the COVID-19 vaccination.*** The most common side effects, which are usually mild, are pain and tenderness at the injection site. 

Singapore’s National Childhood Immunisation Schedule (NCIS) recommends influenza vaccinations to all healthy children who are aged 6 months until 59 months and any age child in a high-risk group. These children should get yearly influenza vaccines. The flu vaccine is formulated each influenza season as the virus tends to change its structure frequently.

The high-risk groups of children who would benefit would be children with underlying conditions such as: chronic lung disorders (including asthma), heart conditions, chronic kidney, liver, and nervous system disorders, blood disorders; and children with impaired immune systems.

Children who are receiving long-term aspirin or medications containing salicylate are also recommended to be vaccinated, as they are at risk of developing Reye's syndrome, a rare disease that causes brain and liver damage.

Under the National Childhood Immunisation Program (NCIP), the vaccine is free for children in the recommended age group and high-risk groups.*

Does The Influenza Vaccine Protect Against All Types of Flu?

Influenza vaccine protects against both Influenza Type A and Type B virus strains. Influenza vaccination has been proven effective in reducing the risk of influenza infection, and most importantly, hospitalisation due to moderate to severe influenza. It is also linked to lower rates of bacterial infection and antibiotic prescriptions.

For infants younger than 6 months, they are in the highest risk group for influenza complications. However as they are unable to be vaccinated yet, they can benefit from the vaccination of their mothers during pregnancy. Routine influenza vaccination of young children also protects our elderly and other young infants in the community.

When Is The Best Time To Go For The Influenza Vaccination?

Against the dual threat of COVID-19 and influenza, let us provide our children with the best public and personal health defence by vaccinating them. Singapore typically has two peak influenza periods every year: one around April to June and the other towards the last quarter of the year. The flu vaccine takes about two weeks to take effect, so be sure to take your child for their influenza jab before the peak flu season starts!


*Fully subsidised in polyclinics and CHAS GP clinics for children aged 6 months to 59 months. Charges may apply in hospital and private healthcare settings.

**Children with severe egg allergy are recommended to get vaccinated in a setting where medical services are available to address allergic reactions.

***Although a 14-day interval is encouraged, a person who has received influenza vaccination recently can also be vaccinated against COVID-19.

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