The annual flu letter, published today (May 25) by the UK Health Security Agency (UKHSA), NHS England (NHSE) and the Department of Health and Social Care (DH), set out vaccination plans for next winter.

The next flu season, due to start from September 1, will see eligibility criteria for free jabs return to pre-pandemic arrangements, it indicated.

Read more: Flu jabs: Pharmacies top 2021/22 record two months before end of season

Last year, NHSE announced in March that the list of patients eligible for a free jab would be in line with “pre-pandemic” recommendations, scrapping eligibility for those aged 50-64.

But it U-turned on the decision in July, meaning that all those aged 50 and over were eligible for a free flu jab last season.

Eligible cohorts

The groups eligible for free flu vaccinations in 2023/24, based on advice and recommendations from the Joint Committee on Vaccination and Immunisation (JCVI), are:

• Those aged 65 years and over

• Those aged six months to under 65 years in clinical risk groups 

• Pregnant women

• All children aged two or three years on August 31 2023

• Primary school aged children 

• 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 

All frontline health care workers, including both clinical and non-clinical staff who have contact with patients, should be also offered a flu vaccine as part of the organisations’ policy, the letter said.

And it added that an “expansion” of the programme to include secondary school aged children in years seven to 11 is “being considered”.

Read more: Flu wars: Which pharmacy chain is offering the cheapest jabs?

It remains unclear how much pharmacists will be paid for delivery.

However, the letter confirmed that vaccination of frontline healthcare staff except those in certain social care settings “will not be reimbursed and does not qualify for a payment”.

The community pharmacy enhanced specifications will be “updated and published shortly following usual engagement with professional bodies”, it said.

“Limited” vaccine availability

The letter said that providers must “ensure that they have ordered adequate supplies of the recommended vaccines to vaccinate all eligible individuals”. 

But it admitted that some vaccines “may only be available in limited quantities or batches of vaccine may be subject to delay” due to “manufacturing processes and commissioning arrangements”.

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It recommended that providers place orders “with more than one manufacturer to ensure [they] receive sufficient stock” and that they “remain flexible when scheduling vaccination sessions and [are] prepared to reschedule if necessary”.

The letter said that providers should only purchase alternative vaccines to those recommended if “all attempts to secure the recommended first line vaccines have failed” and that they may be asked to provide commissioners with evidence of this. 

Recommended vaccines

The letter confirmed that no changes were made to adult flu jab vaccinations for the upcoming season and that QIVc and QIVr should be prioritised for 18-64s in eligible groups.

As in previous years, aQIV may be offered “off-label” to those who turn 65 before March 31 2024, while LAIV is the “vaccine of choice” for the childhood flu programme the over-twos, it said.

It added that commissioners will “actively reclaim any payments made for the incorrect vaccine administered”.

Uptake targets

The letter said that providers “are expected to deliver a 100% offer to eligible groups” and should “aim to equal or exceed” last season’s uptake particularly in clinical risk groups, children aged two and three years old and pregnant women.

They should also have “robust plans in place for tackling health inequalities for all underserved groups”, it said.

It also set out a “goal”of vaccinating over 75% of healthcare workers.

“A key priority”

The letter said that recent flu seasons have “been both ambitious and challenging as we sought to offer protection to as many eligible people as possible, exceeding the World Health Organization (WHO) target for those aged 65 years and above for a third season running”.

Seasonal flu vaccination remains “a key priority for 2023 to 2024 to reduce morbidity, mortality and hospitalisation associated with flu” while the NHS is both “managing winter pressures” and containing to recover from the impact of COVID-19, it added.

Read more: Deliver all adult vaccinations through community pharmacy, think tank urges

And it said that further guidance will follow on how the flu programme “should be aligned to any autumn COVID-19 vaccination programme”.

Providers are “encouraged” to align delivery of flu jabs with other commissioned vaccination programmes patients are eligible for such as shingles, pertussis or pneumococcal vaccines where it is “clinically acceptable, operationally feasible and where the patient is content”, it added.

UKHSA will develop patient group directions (PGDs) and a national protocol that will be available before the programme launches, it said.