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This year's flu campaign was originally intented to revert to pre-pandemic cohorts. However, rising cases of COVID-19 have led the Joint Committee on Vaccinations and Immunisations to recommend on 15 July that this should now be extended to include all over 50s and secondary school aged children in years 7, 8 and 9. An updated flu letter and vaccine reimbursement letter have now been published (see links below).
General points
The DHSC has warned that the next flu season could see higher numbers of cases than before the pandemic. The initial annual flu letter said: '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 added 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)
- Secondary school children in years 7, 8 and 9 (these groups have been added to the programme since the initial flu letter was sent out)
- Those aged six months to under 50 years in clinical risk groups (see Green Book for full list)
- Pregnant women
- Those aged 50 and over (this inlcudes those who turn 50 by 31 March 2023).
- Those in long-stay residential care homes
- Carers
- 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.
Healthy 50- to 64-year-olds
The updated flu letter says that vaccination for this group will be offered later in the season and practices should not start vaccinating this group until 15 October. The DHSC is not centrally procuring additional vaccines for this group this year and so practices should order additional stock from their manufacturers based on coverage that was achieved during the last two years.
Priority should be given to those aged 65 and over and in clinical at-risk groups.
The updated flu letter details the suppliers that have vaccines available to order.
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).
- 50- to 64-year-olds not in an at risk groups can receive a QIVe, QIVc or QIVr vaccine. However QIVc and QIVr vaccines should only be offered to this cohort if it does not divert stock from clinical at-risk groups and those aged over 65.
- 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.
Full details of adult vaccines are here. Details of child vaccines are here.
Vaccination targets
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.
Other information
The enhanced service for the flu programme is not yet available.
Useful links
- Flu letter for 2022 to 2023
- Statement of amendments to flu letter (details changes to the programme - dated 21 July 2022)
- NHS England letter about the expansion to the flu programme
- Vaccines that will be reimbursed
- Green Book chapter on flu
- Vaccination PGDs
- Details on training and promotional material from the UKHSA
- The flu enhanced service specification will be published here before September 2022
