Encouraging vaccination take-up

The Department of Health and Social Care, NHS England and the UK Health Security Agency published their annual flu letter on 12 March 2024 which sets out guidance for the 2024 to 2025 season.

The letter confirms that there are no changes to the eligible cohorts for the coming year, although there are changes to timing. The Joint Committee on Vaccination and Immunisation has advised moving the start of the programme for most adults to the beginning of October, so most vaccinations are completed by the end of November, closer to the time that the flu season commonly starts - flu typically peaks in December or January.

The letter says all frontline health care workers, including both clinical and non-clinical staff who have contact with patients, should be offered flu vaccine from October (exact start date to be confirmed in due course) as a vital part of the organisation's policy to prevent the transmission of flu. Social care workers directly working with people clinically vulnerable to flu should also have the flu vaccine provided by their employer. There are circumstances where frontline staff, employed by specific social care providers without access to employer led occupational health schemes (see cohort eligibility below), can access the vaccine through the NHS free of charge. 

As flu circulation in children normally precedes that in adults, the JCVI has agreed that the children’s programme should continue to start in September as early as delivery and supply allows. Vaccination of pregnant women should also start in September. For more detail, see the National flu immunisation programme 2024 to 2025 letter - GOV.UK.

The letter says the following groups are to be offered flu vaccination in line with the announced and authorised cohorts (see timings section):

From 1 September 2024:

• pregnant women
• all children aged 2 or 3 years on 31 August 2024
• primary school aged children (from Reception to Year 6)
• secondary school aged children (from Year 7 to Year 11)
• all children in clinical risk groups aged from 6 months to less than 18 years

From October 2024, exact start date to be confirmed by NHS England in due course:

• those aged 65 years and over
• those aged 18 years to under 65 years in clinical risk groups (as defined by the Green Book, Influenza Chapter 19)
• those in long-stay residential care homes
• carers in receipt of carer’s allowance, or those who are the main carer of an elderly or disabled person
• close contacts of immunocompromised individuals
• frontline workers in a social care setting without an employer led occupational health scheme including those working for a registered residential care or nursing home, registered domiciliary care providers, voluntary managed hospice providers and those that are employed by those who receive direct payments (personal budgets) or Personal Health budgets, such as Personal Assistants

GPs can use their clinical judgement and bring forward vaccination from October in exceptional circumstances, as outlined in the Green Book.  For example, for those who are due to commence immunosuppressive treatment, such as chemotherapy.

The letter also contains details of the recommended vaccines, so stocks can be ordered by NHS flu vaccination providers.

Update 12 April 2024

National Booking Service opens for spring Covid-19 vaccinations from 15 April

The NHS national booking system will open for spring Covid-19 vaccination bookings on 15 April, with those eligible able to book appointments from the following week. Those eligible include

• Adults aged 75 years and over by 30 June 2024
• Residents in care homes for older adults
• Individuals aged 6 months and over who are immunosuppressed.

Eligibility for a spring vaccination is similar to previous years but those with a weakened immune system are now eligible from 6 months instead of 5 years.

Anyone eligible can book a vaccine appointment via the NHS.UK website or by calling 119 for free, with parents or carers able to book a Covid-19 vaccination for children under 16 on their behalf.

Eligible people aged 16 and over can also use the NHS App to book an appointment.

The NHS is sending texts, emails, NHS App messages or letters to those who are eligible, but they do not have to wait for the invitation to book.

15 April will also see the start of visits to older adult care homes and eligible household patients. For those that receive all their care at home, a home visit should be arranged via their GP.

This year there are thousands of appointments available every day across the country including at pharmacies and GP practices. Some areas also offer convenient walk-in options, with a list of available walk-in sites online.

Spring vaccinations will be available until 30 June 2024.

COVID-19 vaccination: spring 2024 campaign resources - GOV.UK (www.gov.uk)
 

Update February 2024

Health Minister, Maria Caulfield, has accepted official advice from the Joint Committee on Vaccination and Immunisation to offer a COVID spring vaccine to those most at risk of serious illness in England.

JCVI advises that the following should be offered a COVID-19 vaccine this spring:

• adults aged 75 years and over
• residents in a care home for older adults
• individuals aged 6 months and over who are immunosuppressed (as defined in tables 3 or 4 in the COVID-19 chapter of the Green Book)

The advice on eligibility is similar to last spring, but with the age of individuals who are immunosuppressed now eligible reduced to aged 6 months and over, from 5 years and over in 2023. This follows updated advice last April on COVID-19 vaccination of children aged 6 months to 4 years in a clinical risk group.

Statement by the Joint Committee on Vaccination and Immunisation on the COVID-19 autumn booster programme,

The Health Minister said it is important the most vulnerable groups are offered a vaccine through the NHS programme to strengthen their immunity to protect themselves and reduce pressure on the NHS.

UKHSA surveillance data on last spring’s programme showed that those who received a vaccine were around 50% less likely to be admitted to hospital with COVID-19 from two weeks following vaccination, compared to those who did not receive one.

Vaccine uptake for last year’s spring programme for those aged 75 years and over was 67.5%.

NHS England will confirm details on how and when eligible people can access the spring vaccine in due course.

Update 5 January 2024

The UK Health Security Agency (UKHSA) is encouraging those at higher risk of flu and COVID-19 to make a new year’s resolution to get winter strong.

Eligible groups can book their vaccine by contacting their local GP surgery or pharmacy to make an appointment. More information on eligibility and how to book your vaccination is available here.

Vaccinations against COVID-19 are being offered until 31 January 2024, while flu vaccinations are available until 31 March 2024.
 

Update 1 December 2023

NHS online bookings close but local vaccination services remain open

On 1 December 2023, the NHS issued a press release asking people to get vaccinated before the NHS online booking system, NHS App and 119 phone service closed for bookings from 15 December. The 119 booking service also closed but remains open for queries until 22 December.  It will be possible to book COVID vaccinations after 15 December through local NHS vaccination services until 31 January. After that, COVID vaccinations will close, and people will be need to wait for a future campaign unless they develop a new health condition or start treatment that severely weakens the immune system. For those eligible for a free flu vaccine after 15 December, it will be possible to book by contacting a GP or finding a pharmacy if people are 18 or over. The free flu vaccine offer closes on 31 March 2024.

The UKHSA urged people from ethnic minority groups to protect themselves with vaccines. This follows statistics which show differences in emergency hospital admission rates between ethnic groups.

Update 8 August 2023

The Joint Committee on Vaccination and Immunisation (JCVI) announced on 8 August 2023 its advice regarding persons who will be eligible for a COVID-19 booster vaccine in autumn 2023.

JCVI’s statement on the autumn 2023 programme follows interim advice published in January. Specifically, JCVI advised the following groups be offered a COVID-19 booster vaccine this autumn:

• residents in a care home for older adults
• all adults aged 65 years and over
• persons aged 6 months to 64 years in a clinical risk group, as defined in tables 3 and 4 of the COVID-19 chapter of the Green book
• frontline health and social care workers
• persons aged 12 to 64 years who are household contacts, as defined in the Green book, of people with immunosuppression
• persons aged 16 to 64 years who are carers, as defined in the Green book, and staff working in care homes for older adults

JCVI advised that to optimise protection over the winter, the autumn programme should aim to complete vaccinations by early December 2023.

Eligible groups omit healthy adults below the age of 65, who are not included in any other eligible group.

JCVI also advised that, from autumn 2023, primary course COVID-19 vaccination should consist of a single dose of vaccine, with eligibility the same as for autumn 2023 booster. Details of exceptions to this advice, such as for those who are immunosuppressed, are set out in the Green book.

JCVI advice is generally accepted by all UK national governments.

Subsequently plans for COVID-19 vaccination were brought forward.

The precautionary measure was taken as scientists from UK Health Security Agency (UKHSA) examine the new variant, BA.2.86, which was first detected in the UK on 18 August. According to a risk assessment by the UKHSA, BA.2.86 has a high number of mutations and has appeared in several countries in individuals without travel history. While BA.2.86 is not currently classified as a variant of concern, advice from the UKHSA suggests that speeding up the autumn vaccine programme will deliver greater protection, supporting those at greatest risk of severe illness and reducing the potential impact on the NHS.

Latest updates on the new COVID-19 variant: COVID-19 variants identified in the UK – latest updates - GOV.UK (www.gov.uk)

The variant JN.1, a descendant of BA.2.86, was being tracked by the World Health Organisation in December 2023.

There is more about the individual national campaigns below.

The National Booking Service opened on 18 September 2023 for eligible people in England to book an autumn COVID-19 booster vaccination, and closed on 15 December 2023.  People can still book vaccinations with local NHS services. 

Those eligible include the most at risk from winter illness – people in care homes for older people, the clinically vulnerable, those aged 65 and over, health and social care staff and carers may also be contacted by their GP surgery or other local NHS services to arrange vaccination appointments.

Campaign assets and publicity material to support the vaccination campaign are available from: Health and Social Care Workers Winter Vaccinations Campaign Resources.
 

The United Kingdon Health Security Agency has published an online guide and printed version, available to order free, together with links to translations and accessible versions. 

Stickers saying ‘I have had my autumn COVID-19 vaccination’ are available to order free in sheets of 55:  COVID-19 vaccination: autumn programme resources - GOV.UK (www.gov.uk).

Previously, the Department of Health and Social Care’s announced that autumn 2023 flu and Covid-19 vaccine programmes would start earlier than planned in England as a precautionary measure, following the identification of a new Covid variant, NHS England published the NHS vaccination response to urgent BA2.86 risk and changes to autumn/winter 2023/24 vaccination delivery programme, with more information about how the accelerated programme will operate. Vaccinations then started on 11 September, with adult care home residents and those most at risk to receive vaccines first. 

Flu vaccination

Although the NHS booking system has now closed, eligible people can still book a free flu vaccination with their GP or local service, such as a participating pharmacy.

UKHSA issued a winter briefing setting out the serious impacts of flu and urging eligible people to be vaccinated. Data shows last year’s programme prevented around 25,000 hospitalisations in England.

There is information about the flu vaccination campaign for 2023/24 here. 

Flu vaccination: who should have it this winter and why - GOV.UK

Flu vaccination for children: leaflets and posters - GOV.UK

Plain English and easy-read guides have been published for people people with a learning disability. People with a learning disability, and their carers, can get a free flu jab from their doctor or pharmacist. Some people with autism may also be eligible for a free flu vaccination.

All frontline health care and social care workers should be offered flu vaccination by their employer’s occupational health scheme if they have one. The guidance states that it is an employer’s responsibility to help protect their staff and patients or clients and ensure the overall safe running of services.

Free flu vaccinations are available for frontline staff who do not have an employer-led occupational health scheme, who are employed by a registered domiciliary care provider, and who are directly involved in the care of vulnerable patients or clients who are at increased risk from exposure to influenza even where the employer does not operate an occupational health scheme.

There is information for social care staff on flu vaccination at:

Flu immunisation for social care staff - GOV.UK (www.gov.uk)

Careworkers whose homecare employers do not have occupational health schemes should be able to access free vaccinations via GPs and pharmacies, but may need identification, see below.

Useful information from previous vaccination campaigns

Homecare staff in England have been eligible in each campaign for free COVID-19 vaccination boosters (as well as primary course vaccination if staff have not had this already).

The National Booking Service is generally used for vaccination bookings – see Book or manage a coronavirus (COVID-19) vaccination.

Care workers are encouraged to be vaccinated and able to self-declare they are frontline health and social care staff for the purposes of booking an appointment. 

Some COVID-19 and flu vaccination centres may check eligibility on site before administering the vaccination, so it may be advisable for careworkers to take one of the following with them to show, if asked:

• A workplace photo ID card; or
• A payslip from the last three months; or
• A letter from their employer dated within the last three months.

The Care Provider Alliance has issued a template letter for employers of proof of workers’ employment status (this requires a small amount of updating for use in 2022/23).

Local authorities in England are encouraged to use the Good practice for local booster vaccination guidance (February 2022) to promote uptake amongst social care staff.

Targeted communications resources:

• Pregnant Women – DHSC video featuring Dr Viki Male, an immunologist researching vaccines in pregnancy at Imperial College. She explains some of the data and encourages pregnant women to come forward for their autumn booster: Twitter and Facebook.
• Autumn Booster graphic – outlines the eligibility for online booking: Twitter.
• Explainer Video – featuring the Deputy Chief Medical Officer, Dr Thomas Waite, outlining the importance of getting vaccinated if eligible: Twitter and Facebook.

In previous years there have been schemes to ensure people who are unable to go out can be vaccinated at home.  Please check your local arrangements for information.

COVID-19 vaccination

There is information about the winter vaccination programme in Wales at: People in Wales reminded how they can help stop the spread of respiratory infections.

Eligibility criteria for COVID-19 Autumn booster 2023 vaccination in Wales includes frontline health and social care workers: https://www.gov.wales/covid-19-vaccination-programme#107233.  This information lists local health board contact details.

Public Health Wales information on immunisation and vaccines: https://phw.nhs.wales/topics/immunisation-and-vaccines/

Vaccine resources for health and social care professionals: https://phw.nhs.wales/topics/immunisation-and-vaccines/vaccine-resources-for-health-and-social-care-professionals/

Flu vaccination

Flu vaccination information: https://phw.nhs.wales/topics/immunisation-and-vaccines/fluvaccine/

Influenza (flu) - Information for health and social care workers eligible for the vaccine:

https://phw.nhs.wales/topics/immunisation-and-vaccines/fluvaccine/influenza-flu-information-for-health-and-social-care-workers-eligible-for-the-vaccine/

Domiciliary care workers are eligible for a free NHS flu vaccine, this is generally given at their community pharmacy.

Details of the Winter flu and COVID-19 Vaccination Programme - News - Public Health Scotland were issued in August, 2023.

Subsequently, Public Health Scotland (PHS) and Scottish Government stated they are working closely with Health Boards on bringing winter vaccinations forward for those at highest risk of becoming seriously ill from flu and COVID-19. More information. This follows concerns about the Covid variant BA.2.86, described in the England section above.

There is information on Winter Vaccinations in Scotland and Eligible groups for COVID-19 vaccination, Public Health Scotland. Those eligible include frontline social care workers.

Further details of Flu immunisation is available at: Flu immunisations - Seasonal immunisations - Immunisations - Our areas of work - Public Health Scotland

Further details of COVID-19 vaccination is at: COVID-19 vaccinations - COVID-19 - Conditions and diseases - Our areas of work - Public Health Scotland.

Resources to help employers promote the flu and COVID-19 vaccination programme to frontline care home and social care staff: Winter vaccine resources for social care workers - Publications - Public Health Scotland.  These include videos on how to book a vaccine appointment online, reschedule your appointment or recover your username or password.

Eligible groups for Covid-19 autumn booster were announced in August 2023: https://www.health-ni.gov.uk/news/eligible-groups-covid-19-autumn-booster-announced.

Information about getting a vaccination is here: https://www.nidirect.gov.uk/articles/get-covid-19-vaccination-northern-ireland

The Public Health Agency in Northern Ireland is bringing forward vaccination: COVID-19 still with us, but vaccination and taking practical steps can reduce spread | HSC Public Health Agency (hscni.net).  This follows concerns about the Covid variant BA.2.86, described in the England section above.

Flu vaccination

Health and social care workers are among the eligible groups for flu vaccination:

https://www.nidirect.gov.uk/articles/flu-vaccine#toc-4

Health and social care workers

Frontline health and social care workers should get the vaccine.

Those eligible for free flu vaccination include clinical and non-clinical staff who have contact with patients. This includes:

• staff involved in direct patient care
• non-clinical staff in secondary or primary care or community healthcare settings
• laboratory and pathology staff
• frontline social care workers

You can get the vaccine:

• from your employer (if your employer offers this service
• at a participating community pharmacy(external link opens in a new window / tab)
• from your local Trust

Useful information from previous campaign

• Get a COVID-19 vaccination in Northern Ireland | nidirect
• Northern Ireland COVID-19 Vaccination Programme | HSC Public Health Agency (hscni.net)
• There is a search facility to locate vaccination clinics at: COVID-19 Vaccine Service for NI (hscni.net)
• Protect yourself this winter | HSC Public Health Agency (hscni.net)

Homecare staff needed to present their ID to confirm eligibility.

More information on flu vaccination from: Flu vaccine | nidirect.

Update - resources issued on 23 October 2022:

• Pregnant Women – DHSC video featuring Dr Viki Male, an immunologist researching vaccines in pregnancy at Imperial College. She explains some of the data and encourages pregnant women to come forward for their autumn booster: Twitter and Facebook.
• Autumn Booster graphic – outlines the eligibility for online booking: Twitter.
• Explainer Video – featuring the Deputy Chief Medical Officer, Dr Thomas Waite, outlining the importance of getting vaccinated if eligible: Twitter and Facebook.

Winter Vaccinations Public Facing Campaign | Campaign Resource Centre (phe.gov.uk)

Communications pack launched to accompany vaccination campaign (homecareassociation.org.uk)

Vaccinations communications toolkit updated (homecareassociation.org.uk)

There is technical health information on COVID-19 vaccination and who should receive it at: COVID-19: the green book, chapter 14a

NHS England and NHS Improvement London » COVID-19 vaccine communication materials.  

These are video clips by NHS doctors, nurses and other frontline staff to reassure communities that COVID-19 vaccines are safe, effective and have been independently tested to the highest standards.  They are recorded in 18 languages, with a downloadable script in English.

Questions and Answers on vaccination for health and social care stakeholders

There are questions and answers (not official guidance), prepared by the Department of Health and Social Care for stakeholders: DHSC's Questions and Answers on vaccination


Webinar – Your questions answered on the COVID-19 vaccine

This is a recording of a DHSC webinar for careworkers featuring Professor Jonathan Van Tam, Deputy Chief Medical Officer and Dr Nicki Kanani, GP and Deputy Lead of the COVID-19 Programme answering questions on topics such as side effects, and pregnancy and fertility.

Webinar: Your Questions Answered on the COVID-19 vaccine - YouTube, 21 May 2021.

Additional resources to address vaccine hesitancy

• NHSE/I series of animations and suggested information aimed at tackling disinformation about the COVID-19 vaccine and encouraging uptake among ethnic minority groups. The animations are available in 17 different languages available from YouTube.
• Dr Ammalina Bakri Insta Live Q&A on vaccine hesitancy
• Young NHS volunteer explains why she now feels confident getting the vaccine
• NHS video: every vaccine gives us hope  
• Main link on the NHS website for the public to find out more information about the vaccine
• NHS video: what is the vaccine and how does it work?
• SE London ICS video: Tyrick’s Story
• SE London ICS video: Olie and Kadi’s story
• Videos from Islington Council showing social care staff, and local community leaders talking about their views and experiences about getting the Covid-19 vaccine.
• Shareable video with comedian Jason Forbes challenging misconceptions.
• DCMS toolkit to tackle false and misleading information about the vaccine.
• Why is there Vaccine Hesitancy in the Black Community? (africacentre.org.uk)
• Vaccinations and religious belief - developments (homecareassociation.org.uk)

Pregnant Women

COVID-19 vaccination: a guide on pregnancy and breastfeeding - GOV.UK)

DHSC video featuring Dr Viki Male, an immunologist researching vaccines in pregnancy at Imperial College. She explains some of the data and encourages pregnant women to come forward for their autumn booster: Twitter and Facebook.

There is a section in COVID-19: the green book, chapter 14a on pregnancy and fertility and COVID-19 vaccination and information at:

• COVID-19 vaccination: women who are pregnant or breastfeeding - GOV.UK
• Guidance - Safety of COVID-19 vaccines when given in pregnancy
• COVID-19 vaccines, pregnancy and breastfeeding, Royal College of Obstetricians and Gynaecologists

Department of Health and Social Care information states:

• Vaccination remains the best way to protect against the known risks of Covid-19 in pregnancy for both mother and baby, including admission to intensive care and premature birth.
• Research shows pregnant women are more likely to become seriously ill from COVID-19 and 98 per cent of those in hospital due to COVID-19 are unvaccinated. Published data from mid-July show no pregnant woman who has had two doses of the vaccine was hospitalised from COVID-19 in the UK.  
• Pregnant women are also more likely to have severe COVID-19 infection if they are overweight or obese. The Royal College of Obstetrics and Gynaecology (RCOG) and the Royal College of Midwives (RCM) recommend vaccination as one of the best defences against severe infection. The JCVI recommends Pfizer or Moderna COVID-19 vaccines as the preferred vaccines for pregnant women coming for their first dose.
• Advice for all women of childbearing age, pregnant or breastfeeding is here. If you are 40 or over, and are booking your COVID-19 vaccination on NBS you’ll be asked if you are pregnant. This is to make sure people who are pregnant are only shown appointments for Pfizer or Moderna vaccines.
• Here is a video from Jacqueline Dunkley-Bent, Chief Midwife for NHS England and NHS Improvement.
• NHS England » NHS encourages pregnant women to get COVID-19 vaccine

Sources of information include the British Fertility Society, Association of Reproductive and Clinical Scientists and the Royal College of Obstetricians and Gynaecologists (RCOG).

BFS & ARCS Covid-19 Vaccines & Fertility - updated FAQs - British Fertility Society and Association of Reproductive and Clinical Scientists 

The RCOG FAQs are here – Also on this page is a video from Prof Lucy Chappell about how the vaccine does not impact fertility. 

There is a British Medical Journal article showing there is ‘no evidence that vaccines can affect fertility’. 

Pregnancy, breastfeeding, fertility and coronavirus (COVID-19) vaccination - NHS (www.nhs.uk)