Research and analysis

Flu and COVID-19 vaccine uptake in healthcare workers: explainer

Updated 18 December 2023

Applies to England

Frontline healthcare workers (HCWs) are eligible for both COVID-19 and influenza vaccinations this winter. This background note explains the important differences between the 2 major sources of data on vaccine uptake in healthcare workers.

The UK Health Security Agency (UKHSA) are responsible for monitoring vaccine coverage as outlined in the annual UKHSA remit letter from the Parliamentary Under Secretary of State for Health and Social Care. The UKHSA Flu and COVID-19 frontline healthcare workers vaccine uptake survey is published as government official statistics and mandated by the Data Alliance Partnership Board (DAPB2204 Amd 49/2022).

NHS England (NHSE) undertake real-time monitoring of programme performance for both COVID-19 and influenza vaccination. These administrative figures are used for operational and in-season performance management purposes.

The uptake rates reported by UKHSA provide important information to assist with the implementation of the vaccination campaign locally, regionally and nationally and should be used in communications and briefings for the public domain.

UKHSA Flu and COVID-19 frontline healthcare workers vaccine uptake survey

This survey is a monthly manual collection that collects figures for vaccinated frontline healthcare workers by occupational staff grouping. Data provided is from Acute, Ambulance, Primary Care, Community, Foundation, Mental Health Trusts and Independent Sector Healthcare Providers (ISHCPs) and includes agency staff. The data in this survey is used to generate the flu and COVID-19 vaccination vaccine uptake in frontline healthcare workers report. This is published monthly by UKHSA as official statistics, starting 23 November 2023, and covering data up to and including the month prior to publication.

The survey does not include data on:

• staff who are not present at work and not in direct patient contact for that survey period
• organisations not submitting data (response rates are reported alongside the data)

Staff who have direct patient contact but are employed by a third party are included in the survey. Staff numbers and the number of those staff vaccinated are updated and checked by the submitting organisations each month. Where trusts and organisations, such as ISHCPs, have missing records of vaccination for their frontline staff, the reported uptake may be an underestimate. The same data collection methodology has been used for 20 years (since 2002 to 2003), producing a data series analysing longer-term trends.

The COVID-19 frontline healthcare workers vaccine uptake survey uses the same collection methods for frontline HCWs as the flu vaccination programme and is therefore directly comparable to the influenza data, previously published as official statistics by Public Health England (PHE): Seasonal flu vaccine uptake in healthcare workers: monthly data, 2020 to 2021.

This publication has included both influenza and COVID-19 vaccine uptake since the 2021 to 2022 season. These government official statistics should be referred to in official public communications by ministers and others on vaccine uptake in all frontline healthcare workers.

For any queries related to the official statistics data collections on COVID-19 vaccine uptake and seasonal flu vaccine uptake in healthcare workers, please contact HCWvac@ukhsa.gov.uk

NHSE frontline trust healthcare workers in the NHS Electronic Staff Record

The NHSE healthcare worker publication shows uptake among staff on the Electronic Staff Record (ESR) in NHS Trusts. This covers staff active in job roles that have been identified as frontline by their employers and are therefore eligible for vaccination.

This collection provides a dynamic, real-time view of vaccination of staff members delivered in any setting (this could be by their employer, at a GP surgery, a community pharmacy, or other) by automatically matching vaccination episodes to the staff record in ESR.

The NHSE data collection is mandated by the Data Alliance Partnership Board (DAPB4075) and is the recognised data collection method to accompany the NHS Standard Contract. This allows performance management of SC21.4.

This data collection is used as the basis for payments for COVID-19 and flu vaccinations including the activity-based reimbursements made for COVID-19 vaccinations (Standard Contract Schedule 3: payment) and for the CQUIN indicator 01: Flu vaccinations for frontline healthcare workers (from 2023 to 2024).

Data on vaccinations of frontline healthcare workers on ESR in NHS Trusts is available on the NHSE supplementary information page. It is broken down by region and trust on a monthly basis from Thursday 30 November 2023 during seasonal campaigns, and covers data to midnight the previous Sunday.

NHSE data is not comparable with the flu and COVID-19 vaccine uptake rates of frontline healthcare workers published by UKHSA for public health surveillance purposes. NHSE data is used operationally, to support trusts in understanding their own uptake rates, for programme monitoring and performance of vaccine administration.