Some parents are skeptical about the nasal flu vaccine being offered to children in schools. They believe that the vaccine causes “shedding” and prefer to take their children out of school during mass vaccination drives. Parents, alternative health activists, PTFA members, and doctors have expressed concerns about children shedding the virus and being exposed to strains contained within the vaccine. The nasal flu vaccine used in the UK is AstraZeneca’s Fluenz Tetra, which contains live flu virus and is administered through a spray in the nostrils. The vaccine was extended to include healthy children and adolescents aged two to 17 through general practice and school pilot programs in 2012. Although the vaccine is not mandatory, parents worry about shedding, genetically modified organisms, and the administration of vaccinations in schools. Some parents have taken their children out of school during the vaccination campaigns, and it is unclear how many will do the same this year. The government states that excluding children from school during vaccination is unnecessary, except for those who are severely immunocompromised. Concerns include children being vaccinated in error and being made fun of by peers. Dr. Jayne Donegan, a homeopathic and naturopathic practitioner, says that some teachers ridicule children whose parents have declined vaccinations. She also mentions that children over the age of 11 can consent to vaccination even if their parents have declined. The evidence on the safety and effectiveness of the flu nasal spray is said to be strong, but some argue that there is a lack of conclusive evidence regarding reduction in hospitalizations and deaths in children. Regardless, getting vaccinated is considered the best way to protect children from the flu.