The introduction of COVID-19 restrictions – such as mask-wearing, physical and social distancing, and restricted international travel – resulted in “extremely low” levels of influenza across the world in 2020/21, the Department of Health and Social Care (DH), Public Health England (PHE) and NHS England and NHS Improvement (NHSE&I) said in a letter to flu vaccination providers on Saturday (July 17).

With a global lack of defence built up against influenza, modelling for this next season suggests that flu levels in the UK could be up to 50% larger than typically seen and the 2021/22 flu season may begin earlier than usual, the DH, NHSE&I and PHE warned.

This will also mark “the first winter in the UK when seasonal influenza virus (and other respiratory viruses) will co-circulate alongside COVID-19”, they added.

As a result, the government and health bodies are preparing “the most comprehensive flu vaccination programme in UK history”, offering more than 35 million people a free flu jab next season, they said.

Eligibility groups and reducing inequality

According to the letter, the expanded flu vaccination programme will continue from last season, with 50-64-year-olds to be offered free flu jabs in the 2021/22 season.

Community pharmacies will also continue to vaccinate both residential care or nursing home residents and staff in the home setting in a single visit, the DH, NHSE&I and PHE added.

In an effort to reduce levels of inequality in the 2021/22 flu season, with no group or community having an uptake of more than 5% lower than the national average, “providers are expected to ensure they have robust plans in place for tackling health inequalities for all underserved groups to ensure equality of access”, the letter said.

Flu jab providers are encouraged to put plans in place to try and increase provision among those living in the most deprived areas and from ethnic minority and underserved communities, the DH, NHSE&I and PHE advised.

This will “require high quality, dedicated and interculturally competent engagement with local communities, employers, faith and advocacy groups”.

Uptake ambitions

Last flu season, community pharmacies in England contributed to the “most successful programme ever”, administering a total of 2.76 million vaccinations, according to provisional data released by NHS Business Services Authority in May.

“Despite the challenges due to the COVID-19 pandemic, at the end of February 2021 NHS services had vaccinated a record 80.9% of those aged 65 years and over in England,” the letter explained.

“This is the highest uptake ever achieved for this group and exceeds the World Health Organization (WHO) uptake ambition of 75%.”

Hoping to expand on this success, vaccine uptake ambitions for the 2021/22 season include at least 75% for all 50-64-year-olds and 85% for frontline health and care workers.

Flu and COVID-19 jabs

Last week, NHSE&I published details on the booster vaccination phase of the COVID-19 vaccination programme and invited all pharmacies to register their interest in providing the service alongside the flu vaccination programme from September.

In the letter sent on Saturday, the DH, NHSE&I and PHE suggested that: “Early evidence on the concomitant administration of COVID-19 and influenza vaccines used in the UK, supports the delivery of both vaccines at the same time where appropriate.

Therefore, “planning for influenza vaccination should continue as usual for this autumn, with further advice issued should co-administration with COVID-19 vaccination be recommended so that where appropriate both vaccines could be given at the same time”, they added.

The directions, service specification and patient group direction for the 2021/22 pharmacy flu service are expected in due course.

Last week, C+D revealed that Boots had opened bookings for its flu jab service about one month earlier than it would normally, while Lloydspharmacy said 87,923 have registered their interest in an appointment for a flu jab.