For the past two years GP practices have delivered an expanded flu vaccination programme, however this year's campaign will revert to the pre-pandemic cohorts. This means that those aged between 50 and 65 who are not in a clinical at-risk group and secondary school aged children will not be eligible for the vaccine during the 2022 to 2023 season.
The DHSC has warned that the next flu season could see higher numbers of cases than before the pandemic. The annual flu letter says: 'As social contact returns to pre-pandemic norms there is likely to be a resurgence in influenza activity in winter 2022 to 2023 to levels similar to or higher than before the pandemic.'
It adds that 'co-circulation' of flu, COVID-19 and other respiratory viruses 'could add substantially to pressures in the NHS in 2022 to 2023, by addition, or by prolongation of the overall period for which respiratory viruses circulate in sequence'.
Who is eligible for the flu jab this year?
- Children aged two or three years on 31 August 2022
- All primary school aged children (from reception to year 6)
- Those aged six months to under 65 years in clinical risk groups (see Green Book for full list)
- Pregnant women
- Those aged 65 and over
- Those in long-stay residential care homes
- Close contacts of immunocompromised individuals
- Frontline staff employed by the following types of social care providers without employer led occupational health schemes:
- a registered residential care or nursing home
- registered domiciliary care provider
- a voluntary managed hospice provider
- direct payment (personal budgets) or personal health budgets, such as personal assistants
All frontline health care workers, including clinical and non-clinical staff who have contact with patients, should also be offered the vaccine, which should be provided by their employer as part of the employer's occupational health responsibility.
The government has said it will continue to keep the JCVI's advice on flu immunisation under review but at present there is no plan to vaccination 50- to 64-year-olds or secondary school children (even though the JCVI has recommended vaccinating the latter group).
Which vaccines to use
For 2022/23 reimbursement will be available for the following vaccines:
- Those aged 65 and over should receive an aQIV or QIVr vaccine (a QIVc vaccine can be given if neither of these is available).
- Those in at-risk groups aged between 18 and 64 should receive a QIVr or QIVc vaccine (a QIVe vaccine can be given if neither of these is available).
- As in previous years, vaccines for children are purchased centrally and can be ordered via ImmForm so are therefore not reimbursable.
At-risk children aged six months to less than two years should be offered QIVe, with those who are allergic to eggs given the QIVc off-label. All other children should be offered LIAV, or QIVc if this is contraindicated.
Practices must demonstrate a 100% offer to all eligible patients. The aim is to achieve at least uptake levels of 2021 to 2022 in each cohort and ideally exceed them. The letter says improved uptake in the clinical at risk group, children aged two and three and pregnant women is expected.
Uptake for 2021 to 2022 was:
- Aged 65 years and over – 82.3%
- In clinical risk group – 52.9%
- Pregnant women – 37.9%
- Two-year-olds – 48.7%
- Three-year-olds – 51.4%
- Frontline healthcare workers – 60.5%
- Eligible school-aged children – 51.5%
The letter also says that practices should make efforts to tackle health inequalities and show improvement in coverage among groups living in 'deprived areas, from ethnic minorities and other underserved communities'. The aim is to ensure uptake in these groups is the same as in the population as a whole. It adds that practices should have 'robust plans' in place that include engagement with 'local communities, employers, and faith and advocacy groups' to achieve this.
The enhanced service for the flu programme is not yet available.