Flu vaccination: What you need to know about this year's programme

With another flu season almost upon us our Medical Director Professor Paul Cosford has answered some key questions about flu and flu vaccination.

Please note we cannot answer any questions that relate to individual health concerns. You should consult your GP or specialist consultant.

What is flu?

Influenza, or flu, is a viral infection that mainly affects the respiratory system. It is usually characterised by fever, chills, headache, aching muscles, joint pain and fatigue.

When should I get vaccinated?

We encourage those who are eligible to promptly get their flu vaccine when they are called for immunisation, so they are protected for the peak of the season which is usually around January and February, although this can change every year. The flu season can last until May depending on which strain is circulating and how fast it spreads, but activity usually dies down between March and April.

Why is flu a problem?

Flu is contagious meaning it can easily be spread to others. Some people with flu do not have any symptoms however they may still be able to pass the virus to others .

In most people, flu is a self-limiting illness, however for some people, particularly those in what we call ‘at-risk’ groups, flu can results in a  serious infection.

Who is most at risk from flu?

There are certain groups who are at higher risk from flu; these include pregnant women, those over the age of 65 and those with serious health conditions. We offer the flu vaccine to people in all of these groups, as well as some children, to help protect them from catching and spreading flu. Eligible people can have their flu vaccine at their GP surgery or a local pharmacy offering the service. Some midwifery services can offer the vaccine to pregnant women each winter.

This year we are introducing a more effective flu vaccine for those aged 65 and over as well as offering all eligible adults under 65 the ‘quadrivalent’ vaccine, which protects against a total of four strains of flu.

What’s new for the 2018/19 flu season?

The newly available ‘adjuvanted’ vaccine for those aged 65 and over is expected to significantly boost effectiveness by improving the body’s immune response to the vaccine. This is important because typically, older adults’ bodies do not respond as well to the flu vaccine due to their naturally weaker immune systems. Older adults are also more likely to suffer complications from flu.

This enhanced vaccine has the potential to lead to:

  • 30,000 fewer GP appointments
  • 2,000 fewer people needing hospital care
  • 700 fewer deaths from flu in England

The broader flu vaccination programme will also be improved by offering all eligible adults under 65, including pregnant women, health care workers and those with serious health conditions, the ‘quadrivalent’ vaccine in injected form. This protects against a total of four strains of flu; two strains of flu A and two strains of flu B.

We will also extend the nasal spray vaccine to primary school children in year 5 (650,000 extra children), meaning the vaccine will be offered in schools to children in reception and in years 1, 2, 3, 4 and 5 and to two and three year olds through general practice. The programme will eventually roll out to all primary school children. Due to having typically poorer hand and respiratory hygiene than adults, children tend to spread flu more easily, so protecting them is also important for protecting the rest of the population.

National clinical leaders have sent a letter to all chief executives of NHS trusts highlighting the importance of frontline healthcare workers protecting their patients, colleagues and families by getting vaccinated against flu. NHS England has also offered the vaccine to social care workers free of charge again this year that are often in close contact with some of the most vulnerable groups.

How can I protect myself, my family and those around me from the flu?

Flu is very infectious and the virus can live on hands and hard surfaces for up to 24 hours. This is why it is important to “Catch it, Bin it, Kill it” - “Catch” any sneezes in a tissue, “Bin” any tissues immediately and “Kill” the virus by washing your hands with soap and warm water. Avoid contact with sick people and wash your hands often with soap and water or use an alcohol-based hand rub. If you are unwell, look after yourself, drink plenty of fluids and stay at home so you don’t spread flu to others.

The vaccine remains the best defence we have to protect against the spread of flu and we encourage everyone eligible to get it each year.

What types of vaccine should I get?

Adults under 65 in at risk groups and pregnant women will be offered the quadrivalent vaccine this year which protects against four strains of flu.

Those aged 65 and over will be offered the newly introduced enhanced ‘adjuvanted’ version of the trivalent vaccine, which boosts their immune response.

Children receiving the flu vaccine as part of the childhood flu vaccination programme will receive a quadrivalent vaccine as a nasal spray – or by injection if they are not eligible to receive the spray.

Will the vaccine work?

How well the vaccine will work varies year on year as we can never fully predict how flu will affect the population. Overall, our data found that the vaccine was not as effective last year as we usually see, particularly for those aged 65 and over. This is why we are bringing in the enhanced vaccine for this group this season. In addition, we are offering the quadrivalent vaccine to all under 65s in at risk groups which will protect against 4 strains of flu.

How are flu vaccine strains decided?

The World Health Organization (WHO) monitors influenza globally and each year convenes a vaccine composition group that recommends the strains of flu virus that should be included in the flu vaccine for the next flu season based on a review of data from around the world.  It then takes 6-8 months for the vaccine manufacturers to produce sufficient quantities of the flu vaccine for the annual campaign.

Flu is unpredictable. If a change in the virus is detected once production has started there isn’t time to change it ahead of the flu campaign.

What were the uptake rates for 2017/18?

Last year we saw improved uptake rates in all categories:

  • 6% in those aged 65 and over
  • 9% for those aged 6 months to under 65 years of age with one or more underlying health problem
  • 2% in pregnant women
  • 7% in healthcare workers
  • 5% in school aged children
  • 8% and 44.2% in children aged 2 and 3 respectively.

There is clearly still room for improvement within the vaccination programme and we urge everyone who is eligible or responsible for an eligible person to think about protecting their health with the vaccine this winter.

Should all healthcare workers be vaccinated?

Unless contraindicated, healthcare professionals have a responsibility to be vaccinated to protect their patients from flu. Their NHS employers have a responsibility to make it easy for staff to get the vaccine.


  1. Comment by John Smith posted on

    I find it fascinating that this is primarily framed about reducing "burden" on the NHS rather than the wellness of the population.

    "Thus enhanced vaccine has the potential to lead to:

    *30,000 fewer GP appointments
    *2,000 fewer people needing hospital care
    *700 fewer deaths from fly in England".

    I note that other coverage influenced by press releases from PHE appear to rank the reduction in "burden" on the NHS as more significant than preventing deaths.

    "Don't be silly, these are in no particular order and free up the NHS to deal with other issues".

    That maybe so but it shows me the prevailing mindset in institutions such as PHE that the general public are essentially a nuisance and controlling the level of illness is to benefit the operation of services rather than about making their lives better.

    • Replies to John Smith>

      Comment by Allie posted on

      Very well said!

    • Replies to John Smith>

      Comment by Mike posted on

      That's how public health works... It's about quantifying benefit to a population and making the best use of resources. Comparing the value of vaccination with the cost of not vaccinating is an objective way to approach the decision about who to vaccinate. In a world with unlimited resources public health would be very different, but that is unrealistic.

    • Replies to John Smith>

      Comment by jonathan posted on

      What a ridiculous comment, what's good for the population in general is good for the NHS as well, they work hand in hand. The article also states that flu 'can result in a serious infection' ie. you may die from it.

      I'm 49 and pay for mine every year, with no side effects at all.

      • Replies to jonathan>

        Comment by Barbara posted on

        Intelligent response from a thinking person... thank you!

  2. Comment by Patricia Foster posted on

    I move between the UK and Spain which country should I be vaccinated in. I do live in Spain and usually have It done here

    • Replies to Patricia Foster>

      Comment by Blog Editor posted on

      Hi Patricia, it’s important to get the flu vaccine if you are in an eligible group.

  3. Comment by Rory O'Conor posted on

    Poor stats to just show the improvement percentages without showing the actual rates. Can be highly misleading.

    • Replies to Rory O'Conor>

      Comment by EM BARKER posted on

      My thought exactly. So what is the true uptake rate?

    • Replies to Rory O'Conor>

      Comment by R Garrett posted on

      Completely agree. Especially with the title in large bold font just a bove the stats "What were the uptake rates for 2017/18?"

  4. Comment by PaulieDoodle posted on

    Having suffered with the Australian Flu back in January of this year & the fact that it left me with some very serious health problems afterwards I deffo for one will be getting this new Flu Jab this year like I ALWAYS do anyway!! & urge everyone who like me got the original Flu Jab to take the new one!! I'm so lucky to be alive today to say that!!

  5. Comment by M floyd posted on

    Why has my surgery Albion Place Maidstone not been allocated any vaccine for over 65’s. And if I use the chemist in the same building I can’t be vaccinated until 19th November because of lack of supplies by which time I and several other over 65’s could be dead. How can I take up the offer of over 65 vaccine if none is available. I may phone the Kent Messenger and get them to investigate.

    • Replies to M floyd>

      Comment by Blog Editor posted on

      All GP practices and pharmacies have been informed that the vaccine manufacturer will be carrying out a phased delivery of adjuvanted trivalent vaccine during September, October and November. Overall in England, there is no shortage, but some patients may have to wait to receive the adjuvanted vaccine given the phased deliveries.
      In most years, flu does not start circulating before the end of November, so people aged 65 and over are advised to wait for the invitation to have the vaccine and receive their immunisation before the end of November. If you have not had your invitation before the end of November, then you should contact your general practice.
      We hope this helps.

      • Replies to Blog Editor>

        Comment by Dom Herlihy posted on

        M Floyd makes an important point which Blog Editor's reply ignores. M Floyd cannot be vaccinated until 4th week of November, I too, in North Croydon, have the same experience. Given that the vaccine isn't effective until 2 weeks later, that means protection can't be regarded as effective until 1st week of December, which is well into the start of the "flu season"!
        Of course there's a quicker route to getting vaccinated: go to a local pharmacy 'cos , surprise, surprise, these guys have acquired stocks of the 'phased delivery' when your local GP has not. This will do wonders for increasing the 6% of over-65's who get vaccinated (Not!).

    • Replies to M floyd>

      Comment by Irene warrington posted on

      Yes it’s the same at aylesford ,tried Sainsbury’s and was told they had flu vaccine for under 65,s thought it was the same vaccine .my husband thinks it’s a way to decrease. The elderly population

      • Replies to Irene warrington>

        Comment by Mary champion posted on

        In my surgery they have plenty for over 65s, it’s the under with health risk that are not being vaccinated as no stock.

  6. Comment by riancopper posted on

    Thank you for providing us,such a alert to parents on vaccinated.In your article you gave a very good explanation to parents why to be vaccinated their child in earlier stages,it is good for their in future.

  7. Comment by Kathryn posted on

    I volunteer in 2 different day hospices every week, and run a baby & toddler group 3 times a week, yet my gp won't give me the vaccine as I am not paid to work in the health sector. Surely as an unpaid volunteer I might also spread flu?!

  8. Comment by Kathryn posted on

    I volunteer in 2 different day hospices every week, and run a baby & t0oddler group 3 times a week, yet my gp won't give me the vaccine as I am not paid to work in the health sector. Surely as an unpaid volunteer I might also spread flu?!

  9. Comment by Ella posted on

    My child (6) will be receiving the injection as she is undergoing chemotherapy for Leukaemia. I’m not happy about getting son (3) vaccinated with the injection. How long after getting my daughter vaccinated would it be safe for my son to have the nasal spray?

  10. Comment by Sarah Tombe posted on

    Our GPpractice is finding it difficult to get enough vaccines. My husband and I had our appointments cancelled two weeks ago due to lack of vaccine. We’re still waiting to hear (we’re both 66).

  11. Comment by Niki posted on

    Are the uptake rates really that low - in the single percentage? It seems to me the wrong stats have been reported

  12. Comment by Sara Lee posted on

    My GP surgery is expecting more vaccine for over 65's & asking you to book in beginning of November...the Chemist onsite also.I am away on holiday November 6th for a fortnight. I am really worried that I may not get my jab before I go. The last thing that I want to do is to be sitting on a plane without one. Any suggestions?

  13. Comment by R Garrett posted on

    Completely agree. Especially with the title in a large bold font just above the stats "What were the uptake rates for 2017/18?"

  14. Comment by Doz posted on

    I had the new over 65 flu shot last tuesday... i,d had a bit of a cold that had lingered for a week or two, but was,nt poorly with it when I had the shot. Since then apart from usual sore arm and feeling a bit uncomfortable (though that would,nt stop me having it) I have felt quite run down disturbed sleep and tired since.. is this just a lingering side effect if the new shot which i,m told the over 65 one is stronger than normal flu shot or because I'd had a cold prior to shot?

    • Replies to Doz>

      Comment by Laura posted on

      Hi Doz, It is more than likely because of your cold symptoms. Having the flu jab with any form of viral or bacterial infection can heighten symptoms. I hope you’re feeling better now.

    • Replies to Doz>

      Comment by Zena posted on

      Yes I’ve had tiredness and sleeplessness too

      • Replies to Zena>

        Comment by Doz posted on

        Thanks for your reply's I think a few people have had a few lingering colds but feeling much better now xx

  15. Comment by Bernard posted on

    If this wasn’t free would we be so fixated on having this done?
    Anything for nothing today, we have people here in Essex who think it’s their divine right to get an appointment with their gp for another packet of paracetamol for nothing, when we just go and spend 25p on a packet from Savers.

  16. Comment by Richard Foinette posted on

    Yesterday I had my appointment for a flu jab next week cancelled because of a shortage of vaccine. As I am away from 6 November for 3 weeks, I have to phone for another appointment next week as their system does not allow booking that far ahead. I first asked about the flu jab in the third week of September! I just hope that I can get an appointment before the vaccine runs out or I actually catch the flu. I qualify on 2 counts, being over 65 and having had a heart attack and an increasingly concerned.

    • Replies to Richard Foinette>

      Comment by Blog Editor posted on

      It is important to ensure you receive your flu vaccine before flu starts to circulate, usually in late December. Speak to you GP or pharmacist about getting vaccinated, but you should be able to be protected in early December.

  17. Comment by Mrs veal posted on

    Side affects of new flu jabs for over 65 doesn’t any one know

    • Replies to Mrs veal>

      Comment by maureen sperinck posted on

      I had a flu jab nov 9th and it has left me with a stiff and sore arm for days ,my previous ones didn't so it must be this new one for 2018/19

  18. Comment by Bob Holbrook posted on

    It is annoying when your main surgery (Peacehaven) sends out the letters giving you a date/time. 100s queue in the street with their letters and 1/2hour later a member of staff stands at each he back of the queue ensuring late comers can’t join. Another 1/2 hour passes and half the queue are told. “ Go home as we have not enough vaccinations” there were lots of very elderly and infirm people in that queue. Having heard roumers of shortages, I’d even checked with the surgery the day before that there was sufficient. Well done admin staff at Meridian/Anchor health Center. Have your Xmas present suggestions ready for your relatives. Abacus comes to mind.

  19. Comment by Eddie Lord posted on

    No Flu jabs for over 65s in Tavistock Devon,? told might be late November
    I fear a cold coming on .........

  20. Comment by Chris Green posted on

    You all seem very concerned about getting vaccinated, whether it will be free and when it will be available but the question you should be asking is
    It certainly gave no protection whatsoever to over 65's in 2016/2017.
    Was totally ineffective against strain A(H3N20) in 2018 and there is no reason to believe the adjuvant added to the trivalent vaccine that is to be offered to the over 65's this season will prove any better than previous years all but useless vaccinations.
    Personally I sincerely doubt it.

    • Replies to Chris Green>

      Comment by Blog Editor posted on

      Since we launched the seasonal flu vaccination programme in 2000, the best clinical guidance has been used to inform the vaccines issued. We hope the adjuvanted vaccine will show improved effectiveness in older people and will help to prevent deaths and ease the burden on health services from flu. We can’t estimate effectiveness in advance but mathematical modelling has showed that the implementation of the newly available vaccine could prevent over 700 deaths in hospital, 2000 hospitalisations and 30,000 GP consultations every year. We will monitor the effectiveness of the adjuvanted vaccine use this winter and will report back on it later next year.

  21. Comment by Amanda Chapman posted on

    Can you tell me what is in the vaccine please ?? I keep reading that it's got Antifreeze and poisons in it and I'm worried . I've felt terrible since I've had it .

    Amanda Chapman

    • Replies to Amanda Chapman>

      Comment by Blog Editor posted on

      Ingredients in this year’s flu vaccines can be found here: There is no antifreeze present in any of the vaccines. Serious side effects of the injected flu vaccine are very rare. You may have a mild fever and aching muscles for a couple of days after having the vaccine, and your arm may be a bit sore where you were injected.

  22. Comment by Mr. D. Daw posted on

    I worked with a colleague for 35 years and each year I would contract a cold shortly after his inoculation, this was a regular thing, I do not partake in the process of inoculation and have relied on natural resistance to to keep the "bug"( whatever strain) at bay, I do have an occasional cold/hay-fever infection but nothing too devastating, I do think that by joining the inoculation "club" the spread of the virus is advanced.. I am 78 years of age and must have sampled a variety of different "cold" bugs from the times of Real austerity I. E. Wartime and the aftermath where food and fruit availability was at a genuine low. Antibiotics were not as common as they are today and that diet and hygiene were not exactly the main theme, in general, clinical conditions were appalling and strangely, as a result we have to date, a large number of ageing survivors to tell the tale... So, are we missing something? Fast food and obesity, air pollution, and the stress of living beyond our means and overuse of antibiotics.( A potent warning to the "not so aged"!)
    I do think good food and hygiene and healthy exercise is paramount to restoring general health and is the antidote to most illnesses (over patronising the pharmaceutical barons is not the answer) My use of drugs extends to using a couple of aspirins now and then. Finally, having an inoculation to help prevent a flu infection is one thing, but in its wake, unwittingly infects someone else is not such a good idea! Please don't say this doesn't happen as I have experienced it!

  23. Comment by Jenny posted on

    My elderly house bound parents have told me that they have been given last years flu vaccine today because of the shortage of the over 65 jab Is this the correct action ?

    • Replies to Jenny>

      Comment by Blog Editor posted on

      We are unable to provide advice on individual situations. We recommend contacting your GP to discuss your options.

  24. Comment by Deborah Rutherford posted on

    Can I ask who determines if you are eligible for a free flu jab please. I’ve had it done for years but have been told I no longer qualify this year despite my condition being life long. Thanks

  25. Comment by Brenda Ayer posted on

    At 82 I had the under65’s flu jab at the pharmacy. I hav e since discovered that there is a stronger one for the over 65’s. should I also have this stronger vaccine at the GP’s?

    • Replies to Brenda Ayer>

      Comment by Blog Editor posted on

      We are unable to provide advice on individual situations. We recommend contacting your GP to discuss your options.

  26. Comment by Dave posted on

    I hear in the news more and more on how the old are living longer. The news goes on to say that it's costing the NHS billions each year. Call me a cynic but because of all the bad press I have read about people living too long I for one, the first time in 20 years will not be having the shot for over 65s or the other one come to that. I don't trust government and they could be out to shorten our lives not save them.

  27. Comment by S. Hammond posted on

    SH OADBY Leics. we are so lucky to have the choice of having a flu jab. So what if it's a little late. Better late than never.

  28. Comment by Angela Bouch posted on

    Same everywhere not bring able to get vaccinated if over 65. No information given out at GP'S as to reason why, just a lot of notices and even a large carboard cut out urging you to book your flu jab now. Impossible when they don't have any. I will be very interested to see what the uptake will be compared to previous year.

  29. Comment by K J Oliver posted on

    We had ours in Newquay at GP’s surgery

  30. Comment by Mike Matthews posted on

    I would love to know what the exact uptake rates are for the UK. Not the quoted annual increase. Are they trying to hide the true figures because they are pretty low ? I would love to be informed. I await with interest

  31. Comment by Michael Matthews posted on

    I would love to know what the exact uptake rates are for the UK. Not the quoted annual increase. Are they trying to hide the true figures because they are pretty low ? I would love to be informed. I await with interest

  32. Comment by Paul Manning posted on

    Milton Keynes 2nd November 2018.
    No flu vaccine available at my G.P. have been phoning every day for last month as I have COPD that I dont want to exacerbate, by contracting flu, if at all possible. None available to buy at any MK pharmacy groups inc Boots, lloyds, Tesco...
    All have said sorry; supply problems; one supplier only for UK; keep calling back, maybe next week; can't say when...
    This is really rubbish!
    Do you have any solid information, as I have seen comments by NHS England denying a shortage; which is evidently not true.
    Who do I talk to about this?
    I have written to my M.P. ; useless prat though he is, however, I would encourage other people to do the same and ask them to question the Health Minister. Why is there an almost complete absence of Flu vaccine in the UK for the over 65's?

  33. Comment by John Charles Brown posted on

    This is all beginning to look like a pack of lies. Lloyds and Boots pharmacies in Towcester, Daventry and Banbury have no vaccine at all for the >65, and they say that "regulations do not allow us to issue the <65 one".
    My GP "hopes" to run a vaccination clinic on 19th. November "if the vaccine arrives". The earlies I can book is 30th. November, and according to advice, I will not build up immunity until 14th. December. My GP's counter staff no doubt wanted to cover for somebody, and told me to turn up at a walk-in clinic. In a waiting room designed for 25 people there must have been 100, with just 1.5 hours to go before that clinic closed.
    You run extensive advertising campaigns to get people vaccinated, and then make no effort at all to deliver the vaccine.

    • Replies to John Charles Brown>

      Comment by Blog Editor posted on

      It is important that those eligible are protected before flu starts to circulate, usually in late December. NHS England has confirmed that there is no overall shortage of the ‘adjuvanted’ vaccine, but there is a staggered roll out. GPs and pharmacies who have ordered the vaccine will receive their order this season, but delivery has been staggered between September and November, meaning that adults aged 65 and over will be invited to come in at varying times in the lead up to the flu season to be vaccinated. The manufacturer, Seqirus, has confirmed all orders for the over 65 population will be delivered by mid-November.

  34. Comment by Adam posted on

    To all the pathetic people that have an overwhelming sense of entitlement please get a grip! We don’t live in a world with unlimited resources and you clearly have nothing better to do than to sit here and ridicule the NHS so why don’t you simply lock yourself in your house for the next few months and not bother with the jab. You would be contributing to making the world a better place. Thanks

  35. Comment by Brian posted on

    There is no good reason the under 65 vaccine can't be used for those over 65, in fact for those in good health might be better. Unless you believe some amazing metaphorphis takes place the second you hit 65!


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