Correspondence

People experiencing homelessness eligible for pneumococcal vaccination letter

Published 14 July 2026

14 July 2026

Dear colleagues,

People experiencing homelessness (PEH) as a new clinical risk group eligible for pneumococcal vaccination from 1 October 2026.

This letter should be read by those responsible for commissioning and operationally delivering the national NHS pneumococcal vaccination programme. Please share this guidance with all those involved in delivering the programme in your area.

In the UK, pneumococcal vaccination has been recommended for clinical risk groups aged 2 to 64 years since 1992, and for all adults aged 65 years and over since 2003. In 2006, the UK introduced the pneumococcal vaccination into the infant immunisation programme, currently offered at 16 weeks of age, followed by a second dose at 1 year of age.

At its June 2024 meeting, the Joint Committee on Vaccination and Immunisation (JCVI) advised that people experiencing homelessness (PEH) were a new clinical risk group who should be routinely offered pneumococcal and seasonal influenza (flu) ^{[footnote 1]} vaccinations. This advice was based on evidence of high comorbidity rates placing them at a similar level of risk of hospitalisation and death from these diseases as people aged 65 and over.

Key points

Key points about the pneumococcal vaccination programme cohort change:

• from 1 October 2026, pneumococcal vaccination should be offered to PEH
• eligible PEH are defined as individuals experiencing homelessness who are rough sleepers and those using hostels for the homeless or night shelters
• PEH aged 16 years and over will be eligible through NHS England (NHSE) commissioning arrangements, while retaining a degree of flexibility in practice to accommodate younger individuals experiencing homelessness (as defined above) when appropriate
• seasonal flu vaccination is an opportunity to offer vaccination with PCV20 (Prevenar 20® vaccine). PCV20 can be co-administered with seasonal flu vaccine and all other vaccines for which the individual may be eligible. Administration of any vaccination presents an opportunity to review an individual’s vaccination history and offer any outstanding vaccinations for which they are eligible; see: Vaccination of individuals with uncertain or incomplete immunisation

Providers are expected to deliver a 100% offer to the eligible groups; however, achieving full coverage may be challenging due to limitations in identifying all eligible individuals within routine health data.

Commissioners and providers should ensure they have robust plans in place to identify and address health inequalities for all underserved groups, and it is expected that progress will be made on reducing unwarranted variation and improving uptake.

Further information

Annexe A provides information and resources for healthcare professionals to support implementation.

For any clinical or operational queries, please contact your NHS England Regional Public Health Commissioning Team in the first instance. For queries about supporting programme resources, please email immunisation@ukhsa.gov.uk.

We would like to take this opportunity to thank everyone involved in the commissioning and operational delivery of the national immunisation programme in England.

Yours sincerely,

Caroline Temmink, Director of Vaccination, NHS England

Dr Mary Ramsay CBE, Director of Public Health Programmes (including immunisation), UK Health Security Agency

1. Flu vaccination for PEH is covered in the amendment to the annual flu letter 2026 to 2027. ↩