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Vaccine update: issue 369, February 2026

Published 11 March 2026

RSV programme expansion

The respiratory syncytial virus (RSV) programme is being expanded to protect those aged 80 years and older, as well as residents in care homes for older adults.

The expansion letter was published on 2 February and provides information about the forthcoming expansion of the eligibility criteria for the NHS RSV vaccination programme to include adults aged 80 years and over, and all residents in care homes for older adults.

We encourage you to share this guidance with all those involved in delivering the programme in your area. From 1 April 2026, the eligibility criteria for the programme will change to allow people aged 80 years and over, and all residents in care homes for older adults, to receive the RSV vaccine on the NHS. This is an expansion of the current eligibility and is based on the latest advice from the Joint Committee on Vaccination and Immunisation (JCVI).

The expanded RSV programme

Since September 2024, RSV vaccination has been routinely available to older adults as they turn 75 years of age, with an initial catch-up also offered to adults who were aged 75 years and over on 1 September 2024 and had not yet reached 80 years of age.

The forthcoming change from 1 April 2026 will expand the eligibility criteria for the older adult RSV programme to also include those aged 80 years and over (with no upper age limit). This means all adults aged 75 years and over who have not previously received a single dose of RSV vaccine under the NHS RSV campaign will be eligible for the vaccine from this point forward. In addition, all residents in care homes for older adults will also become eligible, regardless of their age, due to their increased risk from RSV.

The vaccine used in the programme will continue to be Abrysvo® on a one-dose schedule.

The timing of the introduction also provides the opportunity to co-administer with the COVID-19 vaccine during the spring 2026 campaign to individuals eligible for both vaccines. JCVI has advised that the latest evidence shows COVID-19 and RSV vaccines can be co-administered. Co-administration is encouraged, particularly for residents in care homes for older adults, to help achieve high uptake before rates of RSV circulation increase in the winter months, and to reduce costs to the NHS. However, RSV vaccines can be administered at any time and offers of vaccination should continue throughout the year.

GP providers are expected to deliver a 100% offer to eligible groups, with call and recall delivered at the earliest opportunity. Providers should also ensure they have robust plans in place to identify and address health inequalities for all underserved groups, and it is expected progress will be made on reducing unwarranted variation and improving uptake.

Further information

Annexe A of the letter provides detailed information, guidance and resources for healthcare professionals.

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

Respiratory syncytial virus: the Green Book

The Respiratory Syncytial Virus Green Book chapter was published on 2 February and was updated with latest evidence and details of the expansion to people aged 80 and over, JCVI advice on clesrovimab and MHRA guidance on preF vaccines.

Please bookmark the chapter in your browser and register on the page to get emails when this page is updated.

Respiratory syncytial virus vaccine: patient group direction (PGD)

This PGD is for the administration of RSV vaccine to individuals eligible for the national vaccination programme aged 75 years and over or resident in a care home for older adults and for individuals who are pregnant, from week 28 of pregnancy. This PGD is for use by registered healthcare practitioners identified in section 3, subject to any limitations to authorisation detailed in section 2. Reference no: RSV vaccine PGD Version no: v2.0 Valid from 1 April 2026.

The complete routine immunisation schedule from 1 January 2026

From 1 January 2026, MMRV vaccine will be offered to children as part of the updated routine immunisation schedule. Children will also now have an appointment for vaccination at 18 months.

Further information about these changes are available in the Changes to the routine childhood schedule letter. The pneumoccocal vaccine offered to those over 65 years of age and 2 to 64 years in clinical risk groups changed to PCV20 in January 2026.

The immunisation schedule is now available to download in 37 community languages: Albanian, Arabic, Bengali, Bulgarian, Chinese (simplified), Chinese (traditional cantonese), Estonian, Farsi, Fijian, French, Greek, Gujarati, Hindi, Latvian, Lithuanian, Nepalese, Pashto, Polish, Portuguese, Punjabi, Romanian, Romany, Russian, Somali, Spanish, Swahili, Tagalog, Tamil, Telugu, Thai, Turkish, Twi, Ukrainian, Urdu, Vietnamese and Yiddish.

Easy read guide to the MMR vaccination

You can view, download, or order printed copies of this leaflet for free from Find Public Health Resources using the product code: 12643449EN001.

These easy-read leaflets are aimed at those eligible for the MMR vaccine who have a learning disability and their parents or carers. This should be given to any eligible person with a learning disability, or those that care for them before their appointment.

The importance of maintaining the cold chain

Loss of vaccine resulting from cold chain failure and other incidents comes as a significant cost. Can you help towards reducing overall vaccine wastage and cost to the NHS?

During 2025, vaccine wastage incidents voluntarily reported through ImmForm due to both avoidable and unavoidable incidents remained significant, at £6.4 million, based on the published list price for each vaccine. This is potentially an under-reporting of vaccine wastage and the true cost may be higher.

Most of the total value of reported causes of wastage incidents was avoidable (84%, £5.4 million).

Causes of vaccine wastage

• 64% cold chain failure (for example: fridge left open, vaccine left out of fridge)
• 13% unavoidable (cold chain failure, for example: power cut)
• 11% expired seasonal (for example: influenza vaccine)
• 10% expired non-seasonal vaccine
• 1% unavoidable (for example: vaccine prepared but patient refused)
• 1% vaccine preparation error

Please consider best practices around ordering, receipt and storage of vaccines which are provided centrally for the national immunisation programme. If vaccines are not stored correctly, it is not only wasteful and expensive for the NHS but vaccines may lose their effectiveness, and this could result in a failure of the vaccine to provide the required immune response.

Please continue to report incidents of vaccine wastage through ImmForm, to help us monitor and support reduction of the costs to the NHS.

Reducing avoidable wastage

All healthcare providers should have their own local policies that describe how vaccines will be ordered, stored, handled, and disposed of correctly, and how to respond to vaccine storage failures.

These local policies should reflect national policy and best practice recommendations which can be found in Chapter 3 of the Green Book. Everyone who orders, stores or handles vaccines, should be trained and assessed as competent, before they undertake these tasks. Good practice in vaccine storage should be covered in all immunisation training courses. The Immunisation programme available on e-learning for healthcare includes an online training module and assessment about Vaccine Storage. It is suitable for both beginners and those wishing to refresh their knowledge

Keep your vaccines healthy poster and magnet

A poster and fridge magnet with reminders about how to keep vaccines healthy is available.

These resources can be ordered for free from Find Public Health Resources, product code: CCPVP01 (poster) and product code: CCPVM02 (magnet).

Responding to vaccine storage failures

To minimise wastage that may occur if there is a cold chain failure, healthcare providers should order little and often, and hold only enough routine vaccines for appointments that have been scheduled in the following 2 to 4 weeks. Particular attention should be paid to the stock holding of seasonal vaccines and it is recommended that only 2 weeks’ stock should be held in local fridges where possible, with stock levels regularly reviewed to be reflective of demand throughout the autumn/winter.

The UK Health Security Agency (UKHSA) has published guidance on how to respond to errors in vaccine storage, handling and administration.

Reconstitution of MMRV vaccine

UKHSA has received emails from several regional Screening and Immunisation Teams to report incidents where Priorix-Tetra® has been administered without being reconstituted. Although the reason for these errors varies, a few have been attributed to the way the vaccines are set out in the box, with vaccinators unaware the cardboard tab needs to be lifted to expose the vial. This has resulted in failure to reconstitute the product as directed as being required in the manufacturers SmPC and UKHSA health care practitioner guidance, and only the diluent in the syringe being administered.

Priorix-Tetra® is supplied as powder in a vial with 0.5 ml of solvent in a pre-filled syringe with plunger stopper (butyl rubber). The vial contains a whitish to slightly pink coloured powder cake, a portion of which may be yellowish. The pre-filled syringe contains a clear colourless solvent (water for injections). The powder in the vial must be reconstituted with the solvent provided before the vaccine is given. Once reconstituted (all powder has dissolved), the vaccine should be inspected visually. Its colour may vary from clear peach to fuchsia pink due to minor variations of its pH. It may contain translucent product-related particulates. This is normal and does not impair the performance of the vaccine. The ten-dose pack of Priorix-Tetra® vaccine supplied by UKHSA (through ImmForm) contains 10 single-dose vials of vaccine powder, 10 pre-filled syringes of diluent and one patient information leaflet (PIL). Each ten-dose pack of Priorix-Tetra® vaccine will be delivered with a pad of 10 additional PILs.

Packs of Priorix-Tetra® vaccine do not contain needles for administration.

ProQuad® MMRV vaccine also requires reconstitution. It is being supplied by UKHSA in single dose packs containing one vial of powder, one pre-filled syringe containing solvent and two unattached needles.

Information on reconstitution for both MMRV vaccines can be found in the following documents:

• MMRV programme: information for healthcare practitioners
• MMRV HCP Training slideset
• ProQuad powder and solvent for suspension for injection in a pre-filled syringe – SmPC
• Priorix Tetra Powder and solvent for solution for injection in pre-filled syringe – SmPC
• MMRV: PGD template
• relevant chapter of the Green Book: Immunisation against infectious disease

Where an MMRV immunisation error has occurred, guidance can be found in the document ‘MMRV information for healthcare practitioners’. Any errors should also be reported to the local Screening and Immunisation Team.

Save the date: Fundamentals of Immunisation

14 and 15 April 2026

UCL Great Ormond Street Institute of Child Health, 30 Guilford Street, London WC1N 1EH

Book your place on UCL’s website

UKHSA and UCL Great Ormond Street Institute of Child Health are running their annual Fundamentals of Immunisation course in April 2026. This two-day intense theoretical course is designed for those new to a role in immunisation and is most suited to those who give or advise on a range of different vaccines.

The course comprises a series of lectures from national immunisation experts and will provide delegates with the latest information on the range of topics included in the ‘Core Curriculum for Immunisation Training’. A basic level of prior immunisation knowledge and familiarity with the Green Book: Immunisation against infectious disease will be assumed.

The programme includes the following topics:

• why immunisation matters
• immunology of immunisation
• vaccine trials and manufacture
• the scientific basis of national vaccine policy: designing, informing and monitoring immunisation programmes
• vaccine coverage data collections
• talking with parents about immunisation
• practical issues: storage and administration
• monitoring vaccine safety
• current issues in vaccine preventable diseases
• maximising immunisation uptake
• legal issues including consent

If you have any queries, please contact Helen Bedford H.Bedford@ucl.ac.uk or Laura Craig Laura.Craig@ukhsa.gov.uk. Please note that this event is in-person only.

Vaccine supply: routine vaccination programme

Change from a single to a 10-dose pack of Rotarix vaccine

From spring 2026, the pack size of Rotarix vaccine supplied by UKHSA will change from a single-dose to a 10-dose pack. The vaccine inside remains unchanged. The 10-dose pack of Rotarix vaccine will be made available to order only after UKHSA’s stockholding of the single dose pack depletes.

The 10-dose pack of Rotarix® vaccine supplied by UKHSA will contain 10 single-dose squeezable tubes (10 x 1.5 ml) of vaccine and one patient information leaflet (PIL). Each ten-dose pack of Rotarix® vaccine supplied by UKHSA will be delivered with a pad of 10 additional PILs.

A high-level ordering control is in place to reduce the risk of ordering errors only. This is not intended to restrict activity. Further details about Rotarix® vaccine can be found in the SmPC.

To help with planning storage requirements:

• the dimensions of each larger ten-dose pack of Rotarix® vaccine are 127 x 160 x 20 mm (H x W x D)

To minimise wastage due to fridge failures, please order no more than 2 to 4 weeks’ worth of stock. Further guidance can be found in the Green Book: chapter 3.

ImmForm customers can contact helpdesk@immform.org.uk for ordering queries.

Non-ImmForm customers should refer to their local ordering guidance.

Change of vaccine for the routine adult pneumococcal vaccination programme and individuals at increased clinical risk

Since early 2026, the vaccine used for the routine 65 years and over pneumococcal vaccination programme and for those aged 2 years and above in clinical risk groups for pneumococcal disease other than those listed below, has changed from Pneumovax® 23 (PPV23) to Prevenar 20® (PCV20).

Please continue to administer Pneumovax® 23 (PPV23) until your local stockholdings deplete.

Prevenar 20® (PCV20) is now available to order for:

• those aged 2 years and above with severe immunosuppression (changed from PPV23)
• children aged less than 2 years of age with asplenia, splenic dysfunction, complement disorder or severe immunosuppression (changed from PCV13)

Prevenar 13® (PCV13) remains the vaccine for the routine childhood pneumococcal vaccination programme and should continue to be offered to all children at 16 weeks and one year of age.

Details about the pneumococcal vaccination programme are published in the Green Book: Pneumococcal chapter.

Details about the change in vaccine can be found at Change of vaccine for the routine adult pneumococcal vaccination programme and individuals at increased clinical risk

Prevenar 20® vaccine has been supplied by UKHSA since early 2026. High-level ordering controls are in place to reduce the risk of ordering errors only. These are not intended to restrict activity.

The 10-dose pack of Prevenar 20® vaccine supplied by UKHSA contains 10 pre-filled syringes and 10 patient information leaflets (PILs). Unlike with Pneumovax® 23, the pack does not contain any needles for administration. Guidance on the choice of needle size can be found in the Green Book: chapter 4. Needles and syringes should be obtained locally. Further details about Prevenar 20® vaccine can be found in the SmPC

To help with planning storage requirements:

• the dimensions of each 10-dose pack of Prevenar 20® vaccine are 99 x 62 x 123 mm (H x W x D)

Please add Prevenar 20® to your routine ImmForm order where possible, rather than creating additional orders.

To minimise wastage due to fridge failures, please order no more than 2 to 4 weeks’ worth of stock. Further guidance can be found in the Green Book: chapter 3.

ImmForm customers can contact helpdesk@immform.org.uk for ordering queries.

Non-ImmForm customers should refer to their local ordering guidance.

Introduction of a combined measles, mumps, rubella and varicella (MMRV) vaccine

Since 1 January 2026, the NHS routine childhood vaccination programme includes a combined measles, mumps, rubella and varicella (MMRV) vaccine. Details about the introduction of MMRV vaccination can be found at Introduction of a routine varicella (MMRV) vaccination programme.

The current MMR vaccines (M‑M‑RvaxPro® and Priorix®) will continue to be supplied by UKHSA for administration outside of the routine childhood programme, for example for vaccination of older individuals born on or before 31 December 2019, who have not received 2 doses of MMR and are not eligible for MMRV.

ProQuad® and Priorix-Tetra® are the vaccines used for the MMRV programme and are now supplied by UKHSA.

ProQuad® vaccine should be ordered for all MMRV vaccinations, unless a patient requires a porcine gelatine-free MMRV vaccine. ImmForm customers in England and Wales may currently order ProQuad® vaccine with only a high-level ordering control in place to reduce the risk of ordering errors only. This is not intended to restrict activity. Additional ordering controls may be put in place to enable UKHSA to balance incoming deliveries and outgoing orders.

In addition, ImmForm customers in England and Wales may order up to 10 porcine gelatine-free Priorix-Tetra® doses per account per week. Please note there are 10 Priorix-Tetra® doses in each vaccine pack ordered via ImmForm.

Customers in Scotland and Northern Ireland should refer to local ordering guidance.

The single-dose pack of ProQuad® vaccine supplied by UKHSA contains one pre-filled syringe, one vial of solvent for reconstitution, one patient information leaflet, and 2 unattached non-safety needles. One needle should be used for reconstitution and a separate, new needle for injection. Further details about ProQuad® vaccine can be found in the SmPC.

The 10-dose pack of Priorix-Tetra® vaccine supplied by UKHSA contains 10 single-dose vials of vaccine powder (covered by a flap in the box), 10 pre-filled syringes of diluent and one patient information leaflet. Vaccines need to be reconstituted prior to use. Each 10-dose pack of Priorix-Tetra® vaccine supplied by UKHSA will be delivered with a pad of 10 additional PILs. Packs of Priorix-Tetra® vaccine do not contain needles for administration.

Further details about Priorix-Tetra® vaccine can be found in the SmPC.

Guidance on the choice of needle size can be found in the Green Book: chapter 4. Needles should be obtained locally.

To help with planning storage requirements:

• the dimensions of each single-dose pack of ProQuad® vaccine are 150 x 47 x 28 mm (H x W x D)
• the dimensions of each larger 10-dose pack of Priorix-Tetra® vaccine are 142 x 178 x 29 mm (H x W x D)

To minimise wastage due to fridge failures, please order no more than 2 to 4 weeks’ worth of stock. Further guidance can be found in the Green Book: chapter 3.

ImmForm customers can contact helpdesk@immform.org.uk for ordering queries.

Non-ImmForm customers should refer to their local ordering guidance.

Menitorix vaccine is no longer supplied by UKHSA

Following changes to the routine immunisation schedule, children in England, Scotland and Northern Ireland who turned 12 months old:

• on or before 30 June 2025, should continue to be offered Menitorix® vaccine until your local stockholdings of Menitorix® vaccine deplete, after which a hexavalent DTaP/IPV/Hib/HepB (6-in-1) vaccine should be offered to provide a 12-month Hib dose
• on or after 01 July 2025, should not be offered a 12-month Menitorix® vaccine. They should instead be offered a hexavalent vaccine at a new routine 18-month appointment from 1 January 2026

Menitorix® vaccine is no longer offered to any children in Wales. Health Boards in Wales should ensure that any remaining stock of Menitorix® vaccine is safely disposed of in accordance with local waste disposal procedures. All such wastage should also be recorded on ImmForm. Details of the changes to the routine immunisation schedule are available at Complete routine immunisation schedule from 1 January 2026

Vaccines for the 2025 to 2026 children’s flu programme supplied by UKHSA

Ordering of LAIV vaccine for the children’s flu programme will close on Thursday 12 March and ordering for the Inactivated IIVc vaccine will close on Friday 27 March.

Final deliveries of LAIV (Fluenz®) will take place on Monday 16 March. Any orders placed on or before Thursday 12th March but scheduled for delivery after Monday 16 March will not be delivered and will be cancelled.

Final deliveries of the inactivated IIVc vaccine will take place on Tuesday 31 March.

Any orders placed on or before Friday 27 March but scheduled for delivery after Tuesday 31 March will not be delivered and will be cancelled.

The latest and most accurate information will be available on the ImmForm news page at all times, so please check back regularly.

Expiry dates for all batches of Fluenz® issued for the 2025 to 2026 children’s flu programme

Batch numbers and associated expiry dates of all batches of Fluenz® that either have or will be issued this season are set out in the table below. Please ensure that the expiry date is always checked before use, and that expired stock is disposed of in line with local policies. Any disposed stock should be recorded through the ImmForm stock incident page.

Batch number	Expiry date
YF2962	09 December 2025
YF2962B	09 December 2025
YF2965	10 December 2025
YF2965B	10 December 2025
YF2963	15 December 2025
YF3265	15 December 2025
YF3265B	15 December 2025
YF2964	16 December 2025
YF3276	16 December 2025
YH2667	22 December 2025
YH2667B	22 December 2025
YF3414	29 December 2025
YF3414B	29 December 2025
YK2680	05 January 2026
YK2680B	05 January 2026
YK2763	06 January 2026
YK2682	12 January 2026
YK2682B	12 January 2026
YK2998	19 January 2026
YL2477	02 February 2026
YL2477B	02 February 2026
YM2013B	09 February 2026
YL2672	16 February 2026
YL2672B	16 February 2026
YM2014	23 February 2026
YL2671	02 March 2026
YL2671B	30 March 2026

Providing a second dose of flu vaccine after all Fluenz® has expired

If you still need to give a second dose of flu vaccine four weeks after the first dose (for example, for children in clinical risk groups aged 2 to under 9 years who have not received influenza vaccine before), then it is safe and effective to give inactivated vaccine as a second dose where Fluenz® is no longer available.

All IIVc vaccine will expire on 31 May 2026.

Place orders only for delivery on days when your site is open

ImmForm customers should place orders only for delivery on days when their site is open and able to accept the delivery. Non-ImmForm customers should refer to their local ordering guidance.

Delivery failures because of a site being closed, create additional, unnecessary workload within the distribution network.

ImmForm customers can use the deferred order function to place orders for future dates when a site is open. In the case of a one-off closure, ImmForm customers should immediately re-schedule the delivery date of orders due for delivery on that day.

For long-term changes to the days when a site can accept deliveries, ImmForm customers should contact their Movianto Customer Care team with details. Contact details are included on each Movianto Delivery Note. Short-term changes to delivery days cannot be made, for example, for absence or holidays.

Vaccine supply: non-routine vaccine supply

Hepatitis A vaccine

Adult

GSK: supply of Havrix Adult PFS singles and packs of 10 are currently available.

Sanofi : Avaxim PFS singles are currently available. Avaxim packs of 10 are currently available.

MSD: VAQTA Adult is available.

Paediatric

GSK: supply of Havrix Paediatric singles and packs of 10 are currently available.

MSD: VAQTA Paediatric is available.

Sanofi Pasteur: Avaxim Junior singles are currently available.

Hepatitis B vaccine

Adult

GSK: Engerix B PFS singles and packs of 10 are currently available.

GSK: supply of Fendrix is currently available.

MSD: HBVAXPRO 10μg is available.

MSD: HBVAXPRO 40μg is available.

Valneva: PreHevbri is no longer marketed in the UK.

Paediatric

GSK: supplies of Engerix B Paediatric singles are currently available.

MSD: HBVAXPRO 5μg is available.

Combined hepatitis A and B vaccine

GSK: Twinrix Adult singles and packs of 10 are available.

GSK: Twinrix Paediatric is currently available.

GSK: Ambirix is available.

Combined hepatitis A and typhoid vaccine

Sanofi: Viatim is now a discontinued product and no longer available for sale.

Typhoid vaccine

Bavarian Nordic: Vivotif is available.

Sanofi: Typhim singles and packs of 10 are available.

Rabies vaccine

Bavarian Nordic: Rabipur is available to order with some restrictions – this product is capped at 30 doses per customer per month.

Sanofi: Verorab is available to order with some restrictions – capped at 50 doses per month for wholesalers

Pneumococcal polysaccharide vaccine (PPV)

MSD: Private supply of Pneumovax 23 (PPV23) PFS discontinued from November 2025

Pneumococcal polysaccharide conjugate vaccine (PCV)

Pfizer: Prevenar 13 is currently available.

Pfizer: Prevenar 20 is currently available.

MSD: Vaxneuvance is currently available.

Varicella zoster vaccine

GSK: VARILRIX is currently available.

MSD: VARIVAX is available.

MSD: ZOSTAVAX is a discontinued product.

Diphtheria, tetanus and poliomyelitis (inactivated) vaccine

Sanofi: Revaxis is available.

Diphtheria, tetanus, pertussis (acellular) and poliomyelitis (inactivated) vaccine

GSK: supply of Boostrix-IPV is currently available.

Sanofi: Repevax is currently available.

MMR vaccine

MSD: MMR VaxPro is currently available.

GSK: Priorix is currently available.

Meningitis ACWY vaccine

GSK: Menveo is currently available.

Pfizer: Nimenrix is currently available.

Sanofi: MenQuadfi is available.

Yellow fever vaccine

Sanofi: Stamaril is available to order without restrictions

Human papillomavirus vaccine

MSD: GARDASIL has been discontinued.

MSD: Gardasil 9 is currently available.

GSK: Cervarix has been discontinued.

Cholera vaccine

Bavarian Nordic: Vaxchora is available.

Valneva: Dukoral is available.

Japanese encephalytis vaccine

Valneva: Ixiaro is available.

Meningococcal group B vaccine

GSK: Bexsero is currently available.

Diphtheria, tetanus, pertussis, Hib vaccine and poliomyelitis

GSK: Infanrix IPV+Hib is currently available.

Hib + meningococcal group C combined vaccine

GSK: Menitorix is currently available.

Live attenuated rotavirus vaccine

GSK: Rotarix is currently available.

Herpes zoster vaccine

GSK: Shingrix is currently available.

Diphtheria, tetanus and pertussis

Sanofi: Adacel is currently available

Dengue tetravalent vaccine

Takeda: Qdenga is currently available.

Respiratory syncytial virus vaccine

Pfizer: Abrysvo is currently available.

GSK: Arevxy is currently available.

Chikungunya vaccine

Valneva: IXCHIQ®▼ is available. Please read the important MHRA Drug Safety update on IXCHIQ® powder and solvent for solution for injection Chikungunya vaccine (live).

Bavarian Nordic: Vimkunya®▼ is available.