The Chief Medical Officer is advising all parents to get their toddlers vaccinated against flu to protect them from severe illness.
Two million two, three and four-year-olds are eligible for the free nasal spray flu vaccine from their GP.
Children under five are more likely to be admitted to hospital with flu than any other age group - and are five times more likely than 65-year-olds.
However, just over a quarter of children eligible have received the free vaccine so far - fewer than this time last year. And half of parents do not know the free spray exists or that children need vaccinating every year.
Chief Medical Officer, Professor Dame Sally Davies, said: 'Flu can be really nasty for toddlers, leading to time off nursery which has a big impact on mums and dads and sometimes even a stay in hospital.
'They also spread the virus easily and often pass flu to grandparents and other relatives who can become very ill, fast.
'Giving two, three and four-year-olds the free nasal spray really is in everyone's interests if you want to help avoid a miserable winter for all the family.'
Flu leads to hundreds of thousands of GP visits and tens of thousands of hospital stays a year.
Young children are more likely to spread flu because they tend to have greater contact with others, and may not cover their mouths when coughing and sneezing or wash their hands enough.
There are more than 15m people in England with at least one long-term health condition and they are 11 times more likely to die if they catch the virus.
The nasal spray vaccine offers the best protection for children and the only likely side effect is a slight runny nose for a short time, according to the Department for Health. This year the free vaccine was extended to four-year-olds and the aim is to gradually roll it out to all two to 16 year olds.
Groups eligible for free flu vaccinations on the NHS are:
- children aged two, three and four
- pregnant women
- under 65s with long-term conditions
- over 65s
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