Hundreds of thousands of children will be able to access a painless, needle-free flu vaccination for free as governments attempt to curb falling vaccine rates.

New South Wales has become the latest state to offer a nasal spray flu vaccine to children for free, following Queensland, South Australia and Western Australia.

The needle-less vaccine is applied with one spray into each nostril, making it a gentle and painless option that could make it easier for parents to get their children vaccinated.

“I know how unsettling it can be for some parents taking a child to receive a vaccine, so being able to offer a needle-free alternative is a real win for those parents,” the NSW health minister, Ryan Park, said on Tuesday.

NSW and SA are providing the treatment free for children aged two to four inclusive. Queensland is offering it to those between two and five, and WA is funding it for kids aged two to 11.

The spray could play a key role in reinvigorating languishing flu vaccine numbers.

The flu vaccine is recommended for everyone over six months but vaccination rates for those under five – who are at higher risk of becoming seriously unwell from the flu – have dropped significantly since 2020.

By September 2025, only 25.7% of children under five had received a flu jab compared with 44.6% in 2020, according to the National Centre for Immunisation Research and Surveillance.

Less than a quarter of this demographic were vaccinated in NSW in 2025, far below the 40% target set in the state’s 2024-28 immunisation strategy.

There were more than 24,500 cases of influenza in children under five in NSW during the previous flu season.

Emergency departments across the state received more than 4,600 presentations for influenza-like illness in children under five in 2025, and more than 960 hospital admissions.

This marked a 40% increase in both presentations and admissions.

Though the nasal spray is available to anyone in Australia over two and under 18, those who do not live in NSW, SA, WA or Queensland, or are not within the funded age ranges, would have to pay about $50 to $70 for the vaccination.

The Royal Australian College of General Practitioners Victoria has called for free access to the spray to be expanded to lift vaccine uptake and help ease pressure on the state’s hospitals.

The traditional flu jab remains free for children aged six months to under five as well as pregnant women, Aboriginal people aged six months and over, anyone over 65 and those with serious health conditions.