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Delivering a flu immunisation service during the COVID-19 pandemic

What are the goals for this year’s flu vaccination service given the COVID-19 outbreak?

Unplanned learning

This article was correct at time of publishing (June 18). To keep up with the latest information please visit our coronavirus hub

The COVID-19 outbreak has resulted in unprecedented demand on healthcare services. As a result of the pandemic and greater awareness of the effects a virus can have on society, it is expected there will be increased demand for the influenza (flu) vaccine this year. Recent Public Health England (PHE) guidance advises that it is more important than ever to deliver a well-planned flu immunisation service, in order to help minimise any further impact on health and social care services and to protect those at risk of infection. PHE advises that flu vaccination is one of the most effective interventions available to help reduce this impact.(1)

Changes to delivering the service during the pandemic?

The flu immunisation programme is intended to start in September, in line with when flu vaccinations become available. The World Health Organisation makes recommendations for which strains of virus should be used in the 2020/2021 flu vaccine based on the epidemiology of flu vaccines throughout the world. Delivery of this service is expected to be more challenging due to social distancing restrictions that may be in place, a potential increase in staff absences and the impact COVID-19 has had on health services so far.(1)

Discussions are underway about expanding the service from previous years. However, current guidance advises to plan for delivering the service as usual and PHE recommends that further guidance will be issued nearer the start of the vaccination programme.(1)

Which groups are currently eligible for the flu vaccine?

Current guidance advises that groups eligible for the flu vaccine this coming 2020/21 season remain the same as last year.

Eligible groups include:(1)

  • People between the age of 6 months and 64 years who are considered to be in a clinical risk group
  • Children aged 2-10, but not 11 years or older as on August 31, 2020
  • Women who are pregnant
  • People aged 65 or over
  • Residents of long-stay care homes
  • People classified as carers
  • Health or social care employees of a registered residential care or nursing home, registered domiciliary care provider or voluntary managed hospice provider
  • Close contacts of people who are immunocompromised.

It is expected that all health and care workers will be vaccinated. Eligible groups may change depending on the outcome of discussions to expand the service.

When to administer the flu vaccine?

The flu vaccine for the 2020/21 season should be administered as early as possible to those who are eligible. Wherever possible, people should be vaccinated against the flu by November. This will help to ensure they are already protected once the flu begins to spread.(1) In previous years the focus was to administer the flu vaccine until January.(2)

Are those at higher risk of COVID-19 at higher risk of flu?

Groups at high risk of contracting COVID-19 are also at high risk of contracting the flu. Every effort needs to be made to protect these groups from infection and, as mentioned previously, flu vaccination is one of the most effective interventions available to do this.

What other precautions should be taken?

The Pharmaceutical Services Negotiating Committee (PSNC) recently requested clear guidance from Public Health England regarding personal protective equipment (PPE) for pharmacies delivering a flu immunisation service. PSNC has advised pharmacies to assume that a face mask will be a minimum requirement for delivering the service this year. Consideration also needs to be given to the necessary cleaning required between patients and measures such as suitable staffing levels.(3)

Will pharmacists be able to get hold of stock?

With the expected increased demand for the flu vaccine this season, pharmacies are advised to ensure they order sufficient stock to vaccinate eligible patients. Current orders should be reviewed and there should be sufficient numbers of vaccine ordered to meet either national ambitions or previous uptake rates, whichever is higher.(4)

Further information

Community pharmacies who deliver the service this year are reminded that it will need to be in line with the Community Pharmacy Seasonal Influenza Vaccination Advanced service specification for 2020/21.(1)

Further information on at-risk groups, patient education and anaphylaxis, see Seasonal influenza vaccination service in England.

  1. Public Health England (2020) The national flu immunisation programme 2020/21.
  2. Chemist+Druggist (September 2019)  Seasonal influenza vaccination service in England.
  3. Chemist+Druggist (2020) PSNC: ‘Assume’ face masks are ‘minimum requirement’ for flu service.
  4. Chemist+Druggist (2020) Pharmacies urged to ensure flu jab stock can meet COVID-induced demand.
Complete your CPD logsheet

Boom Shakalaka, Locum pharmacist

You must be joking!
Surgeries virtually closed
Hairdressers and barbers closed
Spa and gym facilities closed
Small businesses closed
They could all have opened if only they all had face masks!!!

Michael Mustoe, Community pharmacist

What about the re-training three-year cycle for the vaccination giving?

Christopher Jay, Community pharmacist

Martin paints an interesting picture of patients queuing in GP surgery venues and in pharmacies for 'flu vaccinations. Pharmacies have been open for business all the time during this pandemic I do hope that there is a massive uplift in patients requiring vaccination. That brings logistical problems, pharmacy teams should be deciding on their increased number of  vaccinations, order sufficient vaccine to cope with these numbers, consider how you will store these vaccines, and how you will book appointmets rather than providing a 'walk-in'service, they are easier to control and reduce the time pressures. If you can source a supply of umbrellas to keep your patients dry as they wait outside, 2m apart, then pharmacy will provide a superb service worthy of a TV appearance, and you can do it all over again when we vaccinate against Covid-19.



Martin MOLYNEUX, Community pharmacist

Has anybody got any information on how the surgeries are going to deliver/administer thousands of flu jabs in September this year ? Considering there doors are firmly closed and we are less than 3 months away from starting the flu service. The health centre next to us are currently doing triage/vaccinations etc in gazebos in the car park.....I cant see this going down well with patients in torrential rain/sleet in October. Our pharmacies could be swamped with people requesting their flu jabs from us this Autumn, it will be on us in no time. Anybody got any other observations ?




SP Ph, Community pharmacist

My guess is, the DoH and the other Sceinctific Committees will make a drastic change to their advice in the beginning of September 2020 and announce that the GP Surgeries are safe for re-opening and all eligible patients should immediately attend the surgeries for Flu vaccination. The GPs will be provided with full PPE and all the support and extra funding, while the Pharmacies will be asked to make their own arrangements !!

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