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Vaccine update: issue 324, November 2021 flu special edition

Published 16 November 2021

Applies to England

Flu vaccination programme 2021 to 2022

In 2021 to 2022 the expanded influenza vaccination programme continues as part of our wider winter planning when we are likely to see both influenza and coronavirus (COVID-19) in circulation. This means that alongside the usual eligible groups, all 50 to 64 year olds are being offered influenza vaccination and the programme is being further expanded into secondary schools up to Year 11 for the first time. In order to support the expanded vaccination programme and achieve even higher vaccine uptake rates compared to last year, the Department of Health and Social Care (DHSC) has secured an additional supply of influenza vaccines (see Vaccine supply for more details).

As a result of COVID-19 restrictions influenza activity levels were extremely low globally last year. With social mixing and social contact returning towards pre-pandemic norms, it is expected that winter 2021 to 2022 will be the first winter in the UK when the seasonal influenza virus (and other respiratory viruses) will co-circulate alongside COVID-19.

There is typically substantial variation in influenza burden from season to season and predictions for the 2021 to 2022 influenza season are more uncertain than in previous years. However, it could be that influenza activity is higher than is usually seen because of the low activity levels last year.

In September the Joint Committee on Vaccination and Immunisation (JCVI) published their statement confirming a third dose COVID-19 booster vaccine for those who received vaccination in phase 1 (priority groups 1 to 9). JCVI confirmed that where operationally expedient, COVID-19 and influenza vaccines may be co-administered as this is generally well tolerated with no diminution of vaccine-induced immune responses to either vaccine. However, JCVI advised that the COVID-19 booster vaccine programme should not disrupt or delay the deployment of the influenza programme. Both programmes are important for individual and public health, especially over winter 2021 to 2022.

This year a new marketing campaign was launched, with a joint winter vaccines campaign to encourage the uptake of influenza and COVID-19 booster vaccines. The campaign supports both vaccination programmes in the first joint campaign. Some people will be eligible for both vaccines and there may be an opportunity to co-administer them. However, it is still likely to mean separate vaccination appointments for most patients and so eligible patients should be encouraged not to delay either vaccine.

Whilst immunisation teams have been busy with COVID-19 vaccination for those aged 12 to 15 years old, it is important that the majority of school influenza vaccination sessions are still held before Christmas to protect population health and as the live attenuated influenza vaccine (LAIV) has a short shelf life.

Please also note that NHS England and NHS Improvement (NHSEI) published a letter on the 29 September confirming that general practices and community pharmacies are able to vaccinate all eligible primary care contractors (general practices, pharmaceutical services, dentists and general ophthalmic services) and their frontline staff, including locums, for this influenza season. The general practice and community pharmacy seasonal influenza vaccination programme service specifications 2021 to 2022 have been updated to reflect the changes.

We apologise that this Vaccine Update Special is with you later than anticipated this year, but we hope you still find it useful. We would like to extend our thanks to all for their hard work delivering the programme. Last year we had the best influenza vaccine uptake rates ever achieved and vaccination this winter has also got off to a strong start with uptake levels similar to those this time last year. This autumn, influenza vaccination continues to be an important priority to reduce morbidity and mortality associated with influenza.

Tripartite annual flu letter

The annual flu letter was published on 17 July 2021 on behalf of DHSC, Public Health England (now part of the UK Health Security Agency, UKHSA) and NHSEI. It sets out the details of the programme for 2021 to 2022 including eligibility, which influenza vaccines to offer, and uptake ambitions.

Eligibility for flu vaccination

The following are eligible for an NHS vaccine in 2021 to 2022:

• all children aged 2 or 3 years old (on 31 August 2021)
• school-aged children from Reception class to Year 11

• those aged 6 months to under 50 years in clinical risk groups such as those with:

  • chronic (long-term) respiratory disease, such as asthma (requires continuous or repeated use of inhaled or systemic steroids or with previous exacerbations requiring hospital admission), chronic obstructive pulmonary disease (COPD) or bronchitis
  • chronic heart disease, such as heart failure
  • chronic kidney disease at stage 3, 4 or 5
  • chronic liver disease
  • chronic neurological disease, such as Parkinson’s disease or motor neurone disease
  • learning disability
  • diabetes
  • splenic dysfunction or asplenia
  • a weakened immune system due to disease (such as HIV/AIDS) or treatment (such as cancer treatment)
  • morbidly obese (defined as BMI of 40 and above)
• pregnant women
• those aged 50 years and over
• those in long-stay residential care homes
• carers
• close contacts of immunocompromised individuals

• frontline health and social care staff employed by:

  • registered domiciliary care provider
  • direct payment (personal budgets) or Personal Health Budgets, such as Personal Assistants
• frontline health and social care staff employed by:
  • a registered residential care or nursing home ^{[footnote 1]}
  • a voluntary managed hospice provider ^{[footnote 1]}
• those living in:
  • long-stay facilities ^{[footnote 1]}
    • nursing homes ^{[footnote 1]}
    • other long-stay health or social care facilities ^{[footnote 1]}
    • a housebound patient (defined in the Enhanced Services Specification) ^{[footnote 1]}
• locum GPs ^{[footnote 1]}
• primary care contractors (primary medical services, pharmaceutical services, primary dental services or general ophthalmic services) and their frontline staff, including locums, involved in the patient-facing frontline provision of NHS primary care services and non-clinical staff who play an integral part in patient-facing care on a day-to-day basis ^{[footnote 1]}

Of the eligible cohorts listed above, those marked with footnote 1 may be vaccinated by any general practice, regardless of whether they are registered with that general practice.

Green book influenza chapter 19

The influenza chapter of the ‘Immunisation against infectious disease’ (the ‘Green Book’) will be updated shortly.

Guidance on immunisation training for 2021 to 2022 influenza season

All healthcare professionals involved in administering the influenza vaccine must have the necessary skills, training and mechanisms in place to supply and safely administer influenza vaccines.

The updated Flu immunisation training recommendations were published in July 2021. These include recommended training requirements by workforce group for influenza vaccination (Appendix A), suggested content that should be covered in theoretical or work-based training (Appendix B) and a competency assessment tool that all new influenza vaccinators should complete (Appendix C).

All those who advise on or administer influenza vaccines are also recommended to complete the flu specific e-learning programme which is updated annually and available free of charge with open access for all on the e-Learning for Healthcare (eLfH) website. This e-learning programme consists of a core module and separate sessions on the inactivated and live influenza vaccines.

The national flu immunisation programme for 2021 to 2022 slideset is available to download and an information document for healthcare practitioners on the influenza vaccination programme for 2021 to 2021 has also been published. This document contains information on the influenza programme recommendations, the vaccines available and commonly raised issues for influenza vaccination.

Patient Group Direction (PGD)

Patient Group Directions (PGDs) were originally published for the 2021 to 2022 influenza season in August 2021 and were then re-issued in November to include the additional cohort of primary care contractors. The latest versions are available to download. These include a PGD for live attenuated influenza vaccine, the LAIV PGD, and a separate inactivated influenza vaccine PGD. Practitioners must not use these PGDs until they have been authorised in Section 2. This is a legal requirement in accordance with the Human Medicines Regulations 2012. Practitioners should follow local policy or procedures to access authorised PGD documents.

There is a separate PGD for the community pharmacy seasonal influenza vaccine service which is authorised nationally by NHSEI and published on the associated NHS webpage for the community pharmacy seasonal influenza vaccine service.

National protocol for inactivated influenza vaccine

For the 2021 to 2022 influenza season, there is a national protocol for the administration of inactivated influenza vaccine to individuals eligible for vaccination as part of the nationally commissioned influenza vaccination programme. This was originally published in August and re-published in November to include the additional cohort of primary care contractors.

The national protocol allows for a mixed workforce model for vaccination similar to that used for COVID-19 vaccination. In accordance with the national protocol for inactivated influenza vaccine, administration of inactivated influenza vaccine may be by appropriately trained persons, following assessment of the individual by a specified registered professional as detailed in the national protocol.

Can flu and COVID-19 vaccines be given at the same time?

The currently available COVID-19 vaccines are considered to be inactivated (including the non-replicating adenovirus vaccine). If an individual has recently had a COVID-19 vaccine, they can proceed to have an inactivated or live (attenuated) influenza vaccine.

Similarly, if an individual has recently had an inactivated or live (attenuated) influenza vaccine, they can proceed to have a COVID-19 vaccine.

If an individual presents requiring both influenza and COVID-19 vaccination, it is generally better for vaccination to proceed to avoid any further delay in protection and to avoid the risk of the individual not returning for a later appointment.

For further information and advice on co-administration of COVID-19 with other vaccines, please see chapter 14a of the Green Book.

Key information for parents on influenza and COVID-19 vaccine in schools

A set of Q&As are available to provide information for schools and parents or guardians on the influenza vaccine and COVID-19 vaccine. (weblink 20).

Frontline healthcare workers

All frontline healthcare workers should receive a vaccination this season in order to meet their responsibility to protect their staff and patients and ensure the overall safe running of services. All employers should support the vaccination of frontline staff through occupational health services already in place or commission a service that makes access easy to the vaccine for all frontline staff, or encourage staff to visit a general practice or community pharmacy to get vaccinated, and should monitor the delivery of their programmes. To maximise the number of staff covered, and to increase the opportunity for co-administration of COVID-19 boosters and influenza vaccines as recommended by the JCVI, we have aligned the definitions of frontline healthcare workers for 2021 to 2022.

The definition for COVID-19 is unchanged (from the C1008 Operational Guidance of Frontline Healthcare workers 26 January 2021), but the definition of frontline healthcare workers in trusts who should be vaccinated for influenza has been expanded to include non-clinical staff who have contact with patients. See the COVID-19 and seasonal influenza vaccination in Trusts for full details.

Frontline social care workers

All frontline social care workers who are directly involved in the care of clinically vulnerable clients, and who are at increased risk from exposure to influenza, should receive a vaccination this season. This should be provided by their employer, in order to meet their responsibility to protect their staff and patients and ensure the overall safe running of services. Employers should commission a service that makes access easy to the vaccine for all frontline staff, encourage staff to get vaccinated and monitor the delivery of their programmes.

Where employer-led occupational health services are not in place, the NHS will continue to support vaccination of social care workers employed by registered residential or domiciliary care providers, voluntary managed hospice providers, as well as those employed through direct payment or personal health budgets to deliver domiciliary care to patients and service users. Vaccination will be available through community pharmacy or their registered general practice. This scheme is intended to complement, not replace, any established occupational health schemes that employers have in place to offer influenza vaccination to their workforce.

Therefore, if an individual’s employer informs them that they will not be offering the influenza vaccination in their workforce then that person should get in contact with a community pharmacy or your GP practice to make arrangements to get the influenza vaccine.

Please see Flu immunisation for social care staff for additional information on influenza immunisation for the social care sector.

Health and social care worker marketing campaign

This year NHSEI is running an integrated Health and Social Care Workers Winter Vaccinations campaign to communicate the importance of both the influenza vaccine and the COVID-19 booster. Communications play a critical role in maximising and encouraging uptake of both vaccines amongst eligible groups, ahead of winter.

Printed materials are available to order from the Campaign resource centre and digital versions of assets are available for download. These include:

• A4 posters
• A4 empty belly poster
• DL leaflet
• A5 Q&A leaflet
• stickers
• email signature
• toolkits for social media, the campaign and communications

Public facing marketing campaign

This year the NHS launched an important new national marketing campaign to drive uptake of this winter’s essential vaccinations – influenza and COVID-19 boosters. The campaign supports both vaccination programmes to reach the ambitious government vaccine uptake targets, set to protect the nation this winter from these 2 dangerous viruses and help reduce the burden on the NHS over what is always a challenging time of the year.

The campaign narrative sets out that both influenza and COVID-19 are life-threatening viruses and they will both be circulating at the same time this winter. Therefore, this autumn its more important than ever to take up the influenza vaccine, COVID-19 booster, or both if offered to protect ourselves and others ahead of winter.

The campaign launched with a PR announcement and some priming social media activity in early October and broadcast marketing activity went live later in the month and will run through to mid-December. The campaign consists of TV, video on demand, outdoor, radio and digital (social and display) advertising, supported by search, PR and partnership activity. It is aimed at the groups most at risk from influenza and COVID-19 and those who could spread them to people more vulnerable.

Printed materials are available to order from the Campaign resource centre.

Flu publications available to order

Leaflets remain an effective way of communicating the need and the benefits of having a vaccine and form an essential part of the consent process. It is important that people receive a leaflet that is accessible to them.

We want every eligible person to have the flu vaccine information in a format that meets their needs. Accessible versions are one of the key resources to improve uptake in underserved communities. We want everyone to have a positive vaccination experience and having accessible information is a large part of that experience.

Promoting the availability of accessible versions to colleagues and team members can make a positive difference. Good uptake of these resources will help us to develop similar accessible resources for other parts of the routine programme. Ordering stock of them is helpful, but only if they actually reach their intended audience

Helpful to know

All our leaflets and resources are available to order or download and also have an HTML version which is text only. This is helpful to search engines on the web that look for content, people who use screen readers and assisted technology. It can also be signposted to by E-consent applications which need to include this leaflet when asking for consent.

Benefits

The HTML is very accessible and translates well to online, smartphone, tablet as well as laptop, TV and games console.

Things to consider

We develop each publication carefully with the user needs in mind and in conjunction with our annual attitudinal survey. The people that you see in the portfolio represent the user groups, so when talking about children’s vaccines, we show examples of children of the right age. We work hard to make sure that the representation in our leaflets is culturally diverse, and reflects the range of people in any cohort.

We also consider diversity, age, gender and disability carefully so that the whole portfolio is representative of the population. It is not possible to show everyone in every leaflet so we plan and make sure that our ‘framing’ of the information helps to create positive sentiment, and helps the user to relate the content to themselves and their families. If we look at the HTML version, we only see text. It is the same text but without the imagery and design, this can be less appealing and the ‘framing’ is lost.

Framing as explained above is helpful in building and maintaining trust and confidence in the programme and parents and children both appreciate the benefit of it in the attitudinal survey.

If using E-consent it is very important to recognise that not all parents and carers have access to digital resources and can utilise them. It is essential to provide the leaflets as paper copies as a matter of course so that they can engage with the resources and have equitable access.

A mixed model would mean having the paper leaflet to consider, having a paper consent form but being able to click ‘yes’ or ‘no’ on the e-consent to avoid having to write, which we know is a barrier where literacy is an issue.

Schools and the school immunisation service provider can identify which accessible versions would be helpful for their cohorts. For example, if they have students who are deaf or use British Sign Language (BSL), they can make the videos available on screens or share the link to parents and children. It is important to recognise that many BSL users rely on BSL resources as written literacy in this group can be lower.

We have a wide range of information and promotional resources in translated versions, simple text, easy read, large print, braille and BSL video versions. We urge everyone to familiarise yourself with the resources available and order stock of the hard copies as soon as possible. Translated resources are available to download and this year it is now possible to order hard copies (paper) of all of the translated resources for flu.

Large print guides can be download and ordered for print, and braille printed leaflets are also in stock, with new BSL videos to view and download.

Simple text leaflets for adults and children with low literacy are available. Easy read resources, also videos to support flu vaccination for those who have learning disability.

Audio versions are in production and will be available soon.

Stay up to date with all of the publications to support the annual flu programme.

Flu vaccination programme resources

Information leaflets

Protecting your child against flu – information for parents and carers of preschool and primary school-aged children

This leaflet is for parents and carers of 2 and 3 year olds, and primary school-aged children. It explains why children are eligible for a flu vaccination, as well as describing the disease and the nasal flu vaccine. Copies of this leaflet can be downloaded or ordered, using product code 2902552C1.

It is also available to download in English large print, Albanian, Arabic, Bengali, Brazilian Portuguese, Bulgarian, Chinese, Estonian, Farsi, Greek, Gujarati, Hindi, Latvian, Lithuanian, Panjabi, Polish, Romanian, Romany, Russian, Somali, Spanish, Turkish, Twi, Ukrainian, Urdu and Yiddish.

A braille version of this leaflet is available to order and a BSL video is available to download.

Protect yourself against flu – information for those in school years 7 to 11

This leaflet is for those in secondary school years 7 to 11. It explains why secondary school children are eligible for a flu vaccination this year, as well as describing the disease and the nasal flu vaccine. Copies of this leaflet can be downloaded or ordered, using product code FLU2021251E.

It is also available to download in English large print, Albanian, Arabic, Bengali, Brazilian Portuguese, Bulgarian, Chinese, Estonian, Farsi, Greek, Gujarati, Hindi, Latvian, Lithuanian, Panjabi, Polish, Romanian, Romany, Russian, Somali, Spanish, Turkish, Twi, Ukrainian, Urdu and Yiddish.

A braille version of this leaflet is available to order and a BSL video is available to download.

Guidance and resources for schools

Resources including advice for headteachers, teachers and all school support staff, are available, along with templates for the informed consent form and invitation letter.

Programme briefing for schools

The programme briefing for schools can be downloaded or ordered, using product code 2021FB111.

Flu consent form and letter

The flu consent form has been updated and is available to download.

A letter template for school-age immunisation provider teams to use is available to download.

Posters

There are 2 posters aimed at parents which explain the vaccine and the benefits of vaccinating children against flu – copies can be downloaded or ordered:

• 5 reasons to vaccinate your child against flu (primary school poster) is aimed at pre-school and primary school-aged children
• 5 reasons to vaccinate your child against flu (secondary school poster) is aimed at secondary school aged children

They are also available as translated versions. It is helpful to have a range of these posters including the copies in English to display in all education settings. They can also be used in emails or on websites.

Both posters are available to download in Albanian, Arabic, Bengali, Brazilian Portuguese, Bulgarian, Chinese, Estonian, Farsi, Greek, Gujarati, Hindi, Latvian, Lithuanian, Panjabi, Polish, Romanian, Romany, Russian, Somali, Spanish, Turkish, Twi, Ukrainian, Urdu and Yiddish.

Guidance and resources for preschool children

Immunising preschool children guidance

This guidance is about the annual flu vaccination programme for preschool children. It informs those working in the early years sector about the programme and how they can support it. It is aimed at nursery and preschool managers and staff, and childminders delivering the Early Years Foundation Stage Framework, and those who provide informal childcare, such as nannies.

Template letters for GPs

GP practices can use this letter template for children aged 2 and 3 years to invite parents and guardians to get their child vaccinated at the local surgery).

Letter template for at risk patients and carers for GPs to invite patients at risk of flu due to a medical condition or age, and their carers, to have their annual flu vaccine.

The ‘Flu vaccination: who should have it and why’ leaflet

This guidance explains to patients how they can help protect themselves and their children against flu this winter. It includes information about children, eligible adults and pregnant women. The guidance can be downloaded and ordered, using product code FLU21259EN.

It is also available to download in English large print, Albanian, Arabic, Bengali, Brazilian Portuguese, Bulgarian, Chinese, Estonian, Farsi, Greek, Gujarati, Hindi, Latvian, Lithuanian, Panjabi, Polish, Romanian, Romany, Russian, Somali, Spanish, Turkish, Twi, Ukrainian, Urdu and Yiddish.

A braille version of this leaflet is available to order and a BSL video is available to download.

Flu vaccines guide and poster

Flu vaccines: 2021 to 2022 flu season

Poster showing the different types of flu vaccines available for the 2021 to 2022 flu season and the clinical risk groups that they apply to.

Flu vaccines for children and young people

A quick reference guide to the childhood flu vaccines for winter 2021 to 2022.

Simple text versions

Protect yourself from flu

Aimed at individuals with a low reading age, simple text versions All about flu and how to stop getting it, are available to download and order all about flu and vaccination:

• simple text for adults – product code FLU2021STA
• simple text for children – product code FLU2021STC

Easy-read versions

Our easy-read guides for individuals in all settings with a learning disability are available for the 2021 to 2022 flu season. These resources are aimed at people who have a learning disability or who have autism or who care for someone with a learning disability.

They provide advice on:

• the flu virus and why you need a vaccine every year
• signs of flu
• flu jabs and where to get one

Easy-read guides can be downloaded and ordered using the following product codes:

• Protect yourself from flu: easy-read leaflet – EASYREADFLU1
• Protect yourself from flu: easy-read poster – EASYREADFLU2

Having your flu vaccination during a pandemic: easy-read poster

This easy-read guide to having your vaccines during a pandemic is aimed at people with a learning disability and their carers. It explains the need to have the vaccine and what to expect at the appointment. It is available to download and order using product code EASYREADFLU3.

Vaccination videos

Flu vaccination films for people with a learning disability and autistic people and their family or carers

Two short films about the importance of the flu vaccination for people with a learning disability and autistic people with certain health conditions. The film covers why it is important, who is eligible for a free vaccine, where you can get the vaccine and reasonable adjustments.

Reasonable adjustments

The importance and range of reasonable adjustments that can be made so people with a learning disability or other disabilities have good access to healthcare is explained in a new film below. Resources and tools to support this legal requirement are available.

reasonable adjustment video

Disease surveillance and vaccine uptake reporting by UKHSA

On 1 October 2021 Public Health England (PHE) Immunisation and Countermeasures division transitioned into the UK Health Security Agency (UKHSA). The Immunisation department retains the same responsibilities for reporting official government statistics on influenza disease surveillance and vaccine uptake.

Last season (2020 to 2021) flu and COVID-19 disease surveillance reporting was combined into one report to create the Weekly national influenza and COVID-19 surveillance report. For the 2021 to 2022 season the data will continue to be published weekly on Thursdays at 14:00.

The report summarises information from the surveillance systems which are used to monitor influenza, SARS-CoV-2 (the virus that causes COVID-19), and other seasonal respiratory viruses in England. As per previous seasons from week 41 (14 October 2021) onwards ‘toplines’ on vaccine uptake by cohorts will be included in the weekly surveillance report.

For the 2021 to 2022 season monthly vaccine uptake will be published as official statistics on the following dates:

School age manual survey collection	Survey month	Data from 1 September 2021 up to date	Publication date 9.30am
Flu	September	Thursday 30/09/2021	Thursday 28/10/2021
Flu	October	Sunday 31/10/2021	Thursday 25/11/2021
Flu	November	Tuesday 30/11/2021	Thursday 23/12/2021
Flu	December	Friday 31/12/2021	Thursday 27/01/2022
Flu	January	Monday 31/01/2022	Thursday 24/02/2022

All GP practices monthly surveys	Survey month	Data from 1 September 2021 up to date	Publication date 9.30am
Flu	September	Thursday 30/09/2021	Thursday 28/10/2021
Flu	October	Sunday 31/10/2021	Thursday 25/11/2021
Flu	November	Tuesday 30/11/2021	Thursday 23/12/2021
Flu	December	Friday 31/12/2021	Thursday 27/01/2022
Flu	January	Monday 31/01/2022	Thursday 24/02/2022
Flu	February	Monday 28/002/2022	Thursday 24/03/2022

Frontline HCWs survey	Survey month	Data from 1 September 2021 up to date	Publication date 9.30am
Flu and COVID-19	September	Thursday 30/09/2021	Thursday 28/10/2021
Flu and COVID-19	October	Sunday 31/10/2021	Thursday 25/11/2021
Flu and COVID-19	November	Tuesday 30/11/2021	Thursday 23/12/2021
Flu and COVID-19	December	Friday 31/12/2021	Thursday 27/01/2022
Flu and COVID-19	January	Monday 31/01/2022	Thursday 24/02/2022
Flu and COVID-19	February	Monday 28/002/2022	Thursday 24/03/2022

Please note that the September monthly collection (published on 28 October 2021) was an additional collection to previous schedules. Further communication on data collection tools and user guides has been shared with stakeholders separately. For any queries regarding the data collections, please see use the usual PHE mailboxes which will continue to be used whilst UKHSA emails are rolled out.

The collection of seasonal flu vaccine uptake figures are available:

• school age collection
• frontline healthcare workers
• GP patients

Vaccine supply

Guidance on accessing DHSC centrally supplied influenza vaccines

Following the success of the 2020 to 2021 seasonal flu immunisation programme, DHSC announced its intention to continue with the expanded influenza programme in the 2021 to 2022 influenza season as part of its continued response to the COVID-19 pandemic. This includes a drive to increase uptake in existing cohorts eligible for a free vaccine under the NHS programme, and also expansion to new groups, such as secondary school children up to year 11.

In order to support the expanded vaccination programme and achieve even higher vaccine uptake rates compared to last year, DHSC has secured an additional supply of influenza vaccines. These vaccines will be available for NHS providers, including GP practices, to top up local supplies once they run low. Additional supply arrives later in the season and is intended to complement existing supply, so providers should have exhausted local supplies before accessing central supply.

Further information is available on accessing government-secured flu vaccines: guidance for primary care 2021 to 2022 and guidance for NHS providers.

Vaccines for the 2021 to 2022 children’s flu programme supplied by UKHSA

As in previous years, all flu vaccines for children are available to order by providers of the children’s flu programme in England via UKHSA’s ImmForm website.

UKHSA does not supply any flu vaccines for patients aged 18 years and over.

Please refer to guidance from your respective health departments for arrangements in Scotland, Wales and Northern Ireland.

Vaccines and availability

The 3 vaccines available, and the groups these vaccines should be ordered for, are shown in the table below. The latest and most accurate information on availability of centrally supplied vaccines for the children’s flu programme is available on the ImmForm news page at all times. It is strongly advised that all parties involved in the provision of influenza vaccines to children ensure they remain up to date with this.

Vaccine	Manufacturer	Available to order for
Fluenz® Tetra (LAIV)	AstraZeneca	All children from 2 years of age and in school years R-11, and children in clinical risk groups aged 2 to <18 years [footnote 2]
Flucelvax (QIVc)	Seqirus	Eligible [footnote 3] children aged 2 to <18 years for whom LAIV is unsuitable
Quadrivalent Influenza Vaccine (split virion, inactivated) (QIVe)	Sanofi Pasteur	Children in clinical risk groups aged 6 months to <2 years

LAIV ordering information for general practice

As in previous years, ordering controls are in place for general practices, to enable UKHSA to balance supply with demand. These controls work by allocating an amount of vaccine based on the number of registered eligible patients and are tailored to each practice. At the time of publication, each GP practice has been allocated sufficient vaccine to vaccinate at least 70% of their eligible patients (all 2 and 3 year olds, plus children in clinical risk groups from age 4 to less than 18 years). Further amendments to these allocations may be made in response to demand and vaccine availability.

Requests for extra vaccine will be considered on a case by case basis throughout. These should be sent to the ImmForm helpdesk (helpdesk@immform.org.uk) in good time before your order cut-off. Out of schedule deliveries will be by exception only.

Multi-branch practices and LAIV allocations

Please note that GP practices or groups that operate over multiple sites but are part of the same organisation will have a joint allocation (as in previous years), even where each site has a unique ImmForm account.

This means that it is possible for one site to potentially order all of the available vaccine for the group, unless there is local agreement on how the allocated volume is shared. UKHSA recommend that this agreement is in place before ordering opens to reduce the risk of supply interruption. The information above allows practices to estimate the amount of vaccine they will be allocated, and how it should be split between all sites.

LAIV ordering information for school-age providers

For the first time in 2021 to 2022, school teams are able to place 2 orders and receive 2 deliveries of LAIV per week to assist in the management of vaccine volumes required across limited storage space at delivery points.

This operates on a 48 hour delivery schedule requiring the order to be placed before the 11.55am cut off 2 working days before the required delivery day. The table below illustrates the respective delivery days versus ordering day.

Order day (before 11.55am cut off)	Delivery day
Monday	Wednesday
Tuesday	Thursday
Wednesday	Friday
Thursday	Monday
Friday	Tuesday

Please ensure that the point of delivery will be open and manned on the delivery day when placing orders.

Please note that this does not affect the ordering and delivery schedule of any other vaccines (including inactivated influenza vaccines) ordered from ImmForm and is applicable to Fluenz® Tetra (LAIV) only.

A default weekly ordering cap of 450 packs (4,500 doses) per week is in place for school provider accounts.

Where this cap is insufficient and a provider needs a larger weekly volume of vaccine to deliver the programme (for example where a provider covers a large area using a single account), a higher weekly cap should be requested via the UKHSA Flu Vaccine Operations team by emailing childfluvaccine@phe.gov.uk

For one-off larger orders, requests should be made via helpdesk@immform.org.uk in good time before the order cut-off.

Inactivated influenza vaccine ordering

UKHSA is also supplying 2 inactivated vaccines for the 2021 to 2022 season:

• Quadrivalent Influenza Vaccine (split virion, inactivated) (QIVe) which should only be ordered for children in clinical risk groups aged from 6 months to less than 2 years old, with an initial order cap of 2 doses per week

• Flucelvax (QIVc), which is available for:

  • children aged 2 to less than 18 years old in clinical risk groups for whom LAIV is unsuitable
  • healthy children from 2 years old and all eligible school aged cohorts, who object to LAIV on the grounds of its porcine gelatine content
  • this vaccine is available to order in a single dose pack to GPs, with an initial order cap of 8 doses per week
  • this vaccine is available to order by school-age providers in a 10-dose pack with an order cap of 45 packs (450 doses) per week – each pack will be supplied with a separate pack of 10 patient information leaflets (PILs)

Requests for larger orders should be sent to the helpdesk (helpdesk@immform.org.uk) in good time before your order cut-off. Out of schedule deliveries will be by exception only.

All influenza vaccines for the 2021 to 2022 season

Information on all influenza vaccines that have been marketed in the UK for the 2021 to 2022 season are available.

1. NHS England Enhanced Services Influenza Specifications. ↩ ↩² ↩³ ↩⁴ ↩⁵ ↩⁶ ↩⁷ ↩⁸

2. Unless clinically contraindicated or otherwise unsuitable. ↩

3. Children in clinical risk groups aged 2 to <18 years, and healthy children aged from 2 years and in eligible school aged cohorts. ↩