Official Statistics

National flu and COVID-19 surveillance report: 23 October 2025 (week 43)

Updated 23 October 2025

Applies to England

This report summarises the information from the surveillance systems which are used to monitor COVID-19 (caused by severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2)), influenza,respiratory syncytial virus (RSV) and diseases caused by other seasonal respiratory viruses in England. The report is based on data up to week 42 of 2025 (between 13 October and 19 October 2025).

Main points

The main messages of this report are:

• influenza activity increased, particularly among children, and is now above baseline in some indicators
• COVID-19 showed decreasing activity, circulating at low levels
• respiratory syncytial virus (RSV) showed increasing activity across some indicators and was circulating at baseline levels

Summary of all respiratory virus activity

Influenza activity

Influenza activity increased, particularly among children, and is now above baseline in some indicators. Higher circulation was seen in children and remained high in young adults. Emergency department (ED) attendances for influenza-like-illness (ILI) increased. The number of influenza-confirmed acute respiratory infection (ARI) incidents remained low. Of influenza viruses typed/subtyped at the UKHSA Respiratory Virus Unit since week 35, the majority were A(H3N2).

Weekly influenza vaccine uptake for the 2025 to 2026 season is reported for week 42 (data up to 19 October 2025). Compared with the equivalent week last season (2024 to 2025), vaccine uptake is higher for those aged 65 years and over, those aged under 65 years in clinical risk groups and pregnant women. For those aged 2 and 3 years data is comparable.

Indicator	Trend	Level [note 1]	Comments
Laboratory surveillance	Increasing	Low	Influenza positivity increased with a weekly mean positivity rate of 6.1% compared with 5% in the previous week
ILI general practice (GP) consultations	Stable	Baseline	The weekly ILI consultation rate remained stable at 5.6 per 100,000 registered population in participating GP practices compared with 5.4 per 100,000 in the previous week
GP swabbing positivity	Decreasing	Baseline	In week 42, among all tested samples, 0% were positive for influenza, compared with 6.6% in the previous week
Hospital admissions	Increasing	Baseline	The overall weekly hospital admission rate for influenza hospitalisations was increasing at 1.73 per 100,000 compared with 1.29 per 100,000 in the previous week
Intensive care units (ICU)/High-dependency unit (HDU) admissions	Remained low	Baseline	The overall weekly hospital admission rate for influenza ICU-HDU remained low at 0.05 per 100,000 compared with 0.04 per 100,000 in the previous week

COVID-19 activity

COVID-19 showed decreasing activity across indicators and was circulating at low levels. ED attendances for COVID-19-like illness decreased. The number of reported SARS-CoV-2 confirmed acute respiratory infections (ARI) incidents in week 42 decreased compared with the previous week.

By the end of week 42 2025 (week ending 19 October 2025) 41.0% of all people aged 75 years and over, and 18.9% of all people aged under 75 years with a weakened immune system had been vaccinated with an autumn 2025 dose since 1 October 2025.

Indicator	Trend	Level [note 1]	Comments
Laboratory surveillance	Decreasing	Low	COVID-19 PCR (polymerase chain reaction) positivity in hospital settings decreased with a weekly mean positivity rate of 10.3% compared with 11.9% in the previous week
GP swabbing positivity	Decreasing	Baseline	In week 42, among all tested samples, 3.6% were positive for SARS-CoV-2, compared with 7.7% in the previous week
Hospital admissions	Decreasing	Low	The overall weekly hospital admission rate for COVID-19 was decreasing at 3.43 per 100,000 compared with 4.22 per 100,000 in the previous week
ICU/HDU admissions	Remained low	Low	The overall weekly ICU or HDU admission rate for COVID-19 remained low at 0.10 per 100,000 compared with 0.10 per 100,000 in the previous week

Respiratory syncytial virus activity

RSV activity showed increasing activity across some indicators and was circulating at baseline levels. ED attendances for acute bronchiolitis remained stable.

Reporting of weekly RSV hospital admissions for the 2025 to 2026 season has begun.

Indicator	Trend	Level [note 1]	Comments
Laboratory surveillance	Increasing	Baseline	RSV positivity increased to 1.3% compared with 1.1% in the previous week.
GP swabbing positivity	Decreasing	Baseline	In week 42, among all tested samples, 0% were positive for RSV compared with 0.4% in the previous week
Hospital admissions	Increasing	Baseline	The overall weekly hospital (excl ICU-HDU) admission rate for RSV was increasing at 0.46 per 100,000 compared with 0.15 per 100,000 in the previous week

Other viruses

Indicator	Trend	Level [note 1]	Comments
Adenovirus	Increasing slightly	Baseline	Adenovirus positivity (laboratory surveillance) increased slightly to 1.7% compared with 1.4% in the previous week
Human metapneumovirus (hMPV)	Increasing	Baseline	hMPV positivity (laboratory surveillance) increased to 1% compared with 0.1% in the previous week
Parainfluenza	Increasing slightly	Baseline	Parainfluenza positivity (laboratory surveillance) increased slightly to 1.7% compared with 1.5% in the previous week
Rhinovirus	Decreasing slightly	Low	Rhinovirus positivity (laboratory surveillance) decreased slightly to 15.6%18.1% in the previous week

Note 1: these indicators use the moving epidemic method (MEM) and the mean standard deviation method (MSD) to define thresholds to determine their respective levels of activity. Further information on these methods can be found in Influenza surveillance in Europe: establishing epidemic thresholds by the Moving Epidemic Method and Setting thresholds to determine COVID-19 activity levels using the mean standard deviation (MSD) method, England, 2022 to 2024. The MEM approach is well-established for some influenza surveillance indicators, however, for other indicators both the MEM and MSD are experimental and may be subject to future revision. Influenza laboratory surveillance (from week 1) and GP swabbing positivity (from week 2) have transitioned from using MEM to using MSD. These approaches will be considered alongside expert opinion and triangulation of other data sources.

Laboratory surveillance

Laboratory-confirmed cases

The Second Generation Surveillance System (SGSS) captures test result information for notifiable infectious diseases, including COVID-19 and influenza, from laboratories in England. The unified sample dataset (USD), used to calculate the percentage tests positive for SARS-CoV-2 among all SARS-CoV-2 tests, stores all SARS-CoV-2 test results reported to SGSS, Respiratory DataMart, and UKHSA laboratories.

COVID-19 cases

As of 21 October 2025, there were a total of 1,935 COVID-19 cases identified in hospital settings in week 42, decreasing from 2,570 cases in the previous week. SARS-CoV-2 (COVID-19) PCR positivity in hospital settings decreased in week 42, with a weekly average positivity rate of 10.3% compared with 11.9% in the previous week. Positivity rates were highest in those aged 85 years and over at a weekly average positivity rate of 15.8%. This decreased when compared with week 41, when positivity rates were at 19.1% among those aged 85 years and over.

Figure 1. Weekly confirmed COVID-19 episodes tested in hospital settings, England.

Figure 2. Daily percentage of tests positive for SARS-CoV-2 among all reported SARS-CoV-2 tests (7-day rolling average), England 2022 to present [note 2] [note 3]

Note 2: data from previous seasons is aligned by day.

Note 3: testing policy and practice may change over time which can impact positivity rates, therefore comparisons over time should be interpreted with caution. Notable changes in testing policy occurred during 2022 to 2023, which are outlined in the data quality report.

Figure 3. Daily percentage of tests positive for SARS-CoV-2 among all reported SARS-CoV-2 tests by age group (7-day rolling average), England [note 4]

Note 4: the highlighted line corresponds to the age group in the subplot title, grey lines correspond to all other age groups.

Influenza cases

As of 21 October 2025, influenza positivity in week 42 increased with a weekly average positivity rate of 6.1% compared with 5% in the previous week. Influenza positivity rates were highest in those aged between 5 and 14 years at a weekly average positivity rate of 20%. This has increased from 13.2% among those aged between 5 and 14 years in week 41.

Figure 4. Daily percentage of tests positive for influenza among all reported influenza tests (7-day rolling average), England [note 2]

Note 2: data from previous seasons is aligned by day.

Figure 5. Daily percentage of tests positive for influenza among all reported influenza tests by age group (7-day rolling average), England [note 4]

Note 4: the highlighted line corresponds to the age group in the subplot title, grey lines correspond to all other age groups.

Respiratory DataMart System

Respiratory DataMart is a sentinel laboratory-based surveillance system where participating laboratories report positive and negative test results for a number of respiratory viruses from samples primarily taken in hospital. A small proportion of primary care samples are also included in this reporting.

In week 42, data is based on reporting from 9 out of the 14 sentinel laboratories.

In week 42, 4,656 respiratory specimens reported through the Respiratory DataMart System were tested for influenza. There were 324 positive samples for influenza: 118 influenza A (not subtyped), 172 influenza A (H3N2), 30 influenza A (H1N1)pdm09, and 9 influenza B. Overall, influenza positivity remained stable at 7% in week 42 compared with 6.7% in the previous week.

In week 42, 4,897 respiratory specimens reported through the Respiratory DataMart System were tested for SARS-CoV-2. There were 364 positive samples for SARS-CoV-2. SARS-CoV-2 positivity decreased slightly to 7.4% compared with 8.4% in the previous week, with the highest positivity in those aged 80 years and over at 12.3%.

RSV positivity increased to 1.3%, with the highest positivity in those aged under 5 years at 6.8%.

Adenovirus positivity increased slightly to 1.7%, with the highest positivity in those aged between 5 and 14 years at 6.9%.

Human metapneumovirus (hMPV) positivity increased to 1%, with the highest positivity in those aged under 5 years at 3.9%.

Parainfluenza positivity increased slightly to 1.7%, with the highest positivity in those aged between 5 and 14 years at 5.7%.

Rhinovirus positivity decreased slightly to 15.6%, with the highest positivity in those aged under 5 years at 33.9%.

DataMart data is provisional and subject to retrospective updates.

Figure 6a. Respiratory DataMart weekly percentage of tests positive for influenza, SARS-CoV-2, RSV and rhinovirus, England [note 5]

Note 5: shading represents 95% confidence intervals.

Figure 6b. Respiratory DataMart weekly percentage of tests positive for adenovirus, hMPV and parainfluenza, England [note 5]

Note 5: shading represents 95% confidence intervals.

Figure 7. Respiratory DataMart weekly cases by influenza subtype, England

Figure 8. Respiratory DataMart weekly percentage testing positive for RSV by season, England

Figure 9. Respiratory DataMart weekly percentage testing positive for RSV by age, England [note 4]

Note 4: the highlighted line corresponds to the age group in the subplot title, grey lines correspond to all other age groups.

SARS-CoV-2 lineages

UKHSA conducts genomic surveillance of SARS-CoV-2 lineages.

This section provides an overview of circulating lineages in England, derived from data on sequenced PCR-positive SARS-CoV-2 samples in SGSS.

The prevalence of UKHSA-designated lineages among sequenced cases is presented in Figure 10.

To account for reporting delays, we report the proportion of lineages within COVID-19 cases that have had a sequenced positive sample between 15 September 2025 and 28 September 2025. Of those sequenced in this period 33.01% were classified as XFG, 29.81% were classified as XFG.3, 13.78% were classified as NB.1.8.1, 5.13% were classified as XFG.5.1, 4.17% were classified as JN.1, 4.17% were classified as XFG.3.4.1 and 1.92% were classified as JN.1.11.1. Note that low sequencing numbers will impact the accuracy of the prevalence estimates.

Please note that lineages will be grouped independently from their parent lineage once they reach sufficient prevalence, and may be re-grouped into their parent lineage if their prevalence subsequently falls. The data quality report contains more information on lineage groupings.

Figure 10. Prevalence of SARS-CoV-2 lineages amongst available sequenced cases for England from 14 October 2024 to 5 October 2025

Influenza virus characterisation

Between week 35 2025 (week ending 31 August 2025) and week 42 2025 (week ending 19 October 2025), the UKHSA respiratory virus unit (RVU) has genetically characterised 95 seasonal influenza viruses, and identified 70 influenza A(H3N2) viruses, 20 influenza A(H1N1)pdm09 viruses, and 5 influenza B viruses. Details of the characterised viruses by subtype are shown in tables 1, 2 and 3. The RVU has confirmed by genome sequencing the detection of live attenuated influenza vaccine (LAIV) viruses in two influenza A positive samples collected from children aged between 2 and 16 years of age.

Table 1. Number of influenza A H1N1(pdm09) viruses characterised by genetic and antigenic analysis at the UKHSA Respiratory Virus Unit since week 35 2025

Clade	Subclade	Detections
5a.2a	C.1.9.3	2
5a.2a.1	D.3.1	18

Table 2. Number of influenza A(H3N2) viruses characterised by genetic and antigenic analysis at the UKHSA Respiratory Virus Unit since week 35 2025

Clade	Subclade	Detections
2a.3a.1	J.2	6
2a.3a.1	J.2.4	64

Table 3. Number of influenza B viruses characterised by genetic and antigenic analysis at the UKHSA Respiratory Virus Unit since week 35 2025

Clade	Subclade	Detections
V1A.3a.2	C.5.1	2
V1A.3a.2	C.5.6.1	1
V1A.3a.2	C.5.7	2

Influenza virus antiviral susceptibility surveillance

Influenza positive samples are screened for mutations in the virus neuraminidase (NA) and the cap-dependent endonuclease of the polymerase acidic protein (PA) genes known to confer neuraminidase inhibitor (Oseltamivir and Zanamivir) or Baloxavir resistance, respectively. Results from this surveillance are given in Tables 4 and 5.

Table 4. Number of influenza viruses tested for inhibition by Oseltamivir and Zanamivir since week 35 of 2025 using whole genome sequencing

Subtype	Antiviral	Normal inhibition	Reduced inhibition	Highly reduced inhibition
H1N1pdm09	Oseltamivir	20	0	0
H1N1pdm09	Zanamivir	20	0	0
H3N2	Oseltamivir	70	0	0
H3N2	Zanamivir	70	0	0
BVic	Oseltamivir	5	0	0
BVic	Zanamivir	5	0	0

Table 5. Number of influenza viruses tested for inhibition by Baloxavir marboxil since week 35 2025 using whole genome sequencing

Subtype	Normal susceptibility	Reduced susceptibility	Highly reduced inhibition
H1N1pdm09	20	0	0
H3N2	67	0	0
BVic	5	0	0

Community surveillance

Acute respiratory infection incidents (ARI)

Data is presented on viral ARI incidents in different settings that are reported to UKHSA health protection teams (HPTs).

Please note that reporting practices are known to vary between seasons and between regions. Any interpretation of temporal and regional trends should consider the likelihood of differences in reporting of ARI incidents over time and between regions.

There were 109 new ARI incidents reported in week 42 in England. These included:

• 96 incidents from care homes, of which 32 were due to SARS-CoV-2, 7 were due to influenza A, 5 were due to other pathogens, 3 were due to multiple pathogens, 2 were due to influenza (no type information available) and 1 was due to RSV

• 6 incidents from hospitals, of which 5 were due to SARS-CoV-2 and 1 was due to influenza (no type information available)

• 5 incidents from educational settings, of which 1 was due to RSV

• 1 incident from prisons for which no tests were available

• 1 incident from other settings, of which 1 was due to influenza A

Figure 11. Number of ARI incidents by setting, England

Figure 12. Number of ARI incidents in all settings by virus type, England

Syndromic surveillance

Syndromic surveillance collects data from various healthcare sources where presentations are classified by patterns of symptoms compatible with specific infections. In some settings, the syndromic diagnosis can be supplemented by (rapid) testing. In this report, ED attendances are displayed. Further details and data from other syndromic surveillance systems can be found in the syndromic surveillance weekly summaries.

During the week ending on 19 October 2025, ED attendances for acute respiratory infection increased and were similar to seasonally expected levels. ED attendances for influenza-like illness increased and were above seasonally expected levels. ED attendances for COVID-19-like illness decreased. ED attendances for acute bronchiolitis, a syndrome related to RSV infection, remained stable and were below seasonally expected levels.

Daily NHS 111 calls for acute respiratory continued to increase slightly, mainly in children aged between 1 and 14 years with other age groups remaining stable. GP out-of-hours contacts for acute respiratory infections increased slightly, particularly in children aged between 1 and 14 years. Contacts for influenza-like illness remained stable.

Figure 13a. Daily emergency department attendances for acute respiratory infection nationally, England [note 6]

Note 6: 7-day moving average is adjusted for bank holidays. Grey columns show weekends and bank holidays.

Figure 13b. Daily emergency department attendances for acute respiratory infection by age group, England [note 7]

Note 7: scales vary in each graph to enable trend comparisons. The black line is the 7-day moving average adjusted for bank holidays.

Figure 14a. Daily emergency department attendances for COVID-19-like illness nationally, England [note 6]

Note 6: 7-day moving average is adjusted for bank holidays. Grey columns show weekends and bank holidays.

Figure 14b. Daily emergency department attendances for COVID-19-like illness by age group, England [note 7]

Note 7: scales vary in each graph to enable trend comparisons. The black line is the 7-day moving average adjusted for bank holidays.

Figure 15a. Daily emergency department attendances for ILI nationally, England [note 6]

Note 6: 7-day moving average is adjusted for bank holidays. Grey columns show weekends and bank holidays.

Figure 15b. Daily emergency department attendances for ILI by age group, England [note 7]

Note 7: scales vary in each graph to enable trend comparisons. The black line is the 7-day moving average adjusted for bank holidays.

Figure 16a. Daily emergency department attendances for acute bronchiolitis nationally, England [note 6]

Note 6: 7-day moving average is adjusted for bank holidays. Grey columns show weekends and bank holidays.

Figure 16b. Daily emergency department attendances for acute bronchiolitis by age group, England [note 7]

Note 7: scales vary in each graph to enable trend comparisons. The black line is the 7-day moving average adjusted for bank holidays.

Primary care surveillance

Primary care surveillance is undertaken in collaboration with the Royal College of General Practitioners (RCGP) Research and Surveillance Centre (RSC), using a national sentinel surveillance system of around 2,000 GP practices covering over 20 million registered patients of all ages across England. More information on the methodology can be found in the data quality report.

RCGP clinical indicators (England)

The weekly ILI consultation rate through the RCGP surveillance remained stable at 5.6 per 100,000 registered population in participating GP practices in week 42 compared with 5.4 per 100,000 in the previous week. This rate is in the baseline activity level (Figure 17). By age group, the highest rates were seen in those aged between 1 and 4 years (7.2 per 100,000), and those aged under 1 year (6.6 per 100,000).

The lower respiratory tract infections (LRTI) consultation rate remained stable at 82.3 per 100,000 in week 42 compared with 79.6 per 100,000 in the previous week.

Further details are available in the weekly RSC communicable and respiratory disease report for England.

Figure 17. RCGP ILI consultation rates per 100,000, all ages, England

MEM thresholds are based on data from the 2017 to 2018 season to the 2024 to 2025 season. Please note the 2019 to 2020, 2020 to 2021 and 2021 to 2022 seasons have been removed.

RCGP sentinel swabbing scheme in England

283 samples were taken in week 42 through the GP sentinel swabbing, and 16 tested positive (Figure 18). As of week 4 2024, contemporaneous enterovirus differentiation has stopped. Starting from week 44 2024, reporting of rhinovirus and enterovirus has been grouped into rhinovirus/enterovirus. Starting from week 48 2024, samples with more than 10 days between the sample collection date and the symptom onset date have been excluded.

Among 56 tested samples in week 42, 3.6% were positive for SARS-CoV-2, 0% for influenza, 0% for RSV, 1.8% for adenovirus, 0% for hMPV, 0% for seasonal coronavirus, and 23.2% for enterovirus and rhinovirus (Figure 19). Due to the number of samples which have not yet been categorised, data should be interpreted with caution when compared with previous weeks. The proportion of detections among all tested samples is not calculated when the number of samples with a result is fewer than 50.

Figure 18. Number of samples tested for respiratory viruses in England by week, GP sentinel swabbing scheme [note 8] [note 9]

Note 8: unknown category corresponds to samples with no result yet.

Note 9: reporting of rhinovirus and enterovirus follows a greater lag than for other respiratory pathogens.

Figure 19. Percentage of detected respiratory virus among all samples with completed testing in England by week, GP sentinel swabbing scheme [note 9]

Note 9: reporting of rhinovirus and enterovirus follows a greater lag than for other respiratory pathogens.

Figure 20. Percentage of detected respiratory viruses among all samples with completed testing in England by age group, GP sentinel swabbing scheme, week 39 to week 42 [note 9]

Note 9: reporting of rhinovirus and enterovirus follows a greater lag than for other respiratory pathogens.

Figure 21. Weekly positivity for SARS-CoV-2, influenza and RSV in England, GP sentinel swabbing scheme

Secondary care surveillance

COVID-19 hospital and ICU or HDU admissions

Surveillance of COVID-19 hospitalisations to all levels of care and admissions to intensive care units (ICU) or high dependency units (HDU) are both mandatory, with data required from all acute NHS trusts in England.

Please note that SARI Watch data is provisional and subject to retrospective updates. ICU or HDU admission rates may also be affected by lags from admission to hospital to an ICU or HDU ward. Rates are presented per 100,000 trust catchment population.

COVID-19 hospitalisations for all levels of care in week 42 2025 based on 86 NHS trusts in England were as follows:

• the overall weekly hospital admission rate for COVID-19 decreased to 3.43 (compared with 4.22 per 100,000 in the previous week)

• hospital admission rates for COVID-19 were highest in the West Midlands region (decreasing to 4.28 per 100,000 compared with 6.39 in the previous week). Please refer to the supplementary graphs and data file for regional breakdowns

• the highest hospital admission rate for COVID-19 was in those aged 85 years and over (decreasing to 33.24 per 100,000 compared with 46.99 in the previous week)

COVID-19 ICU-HDU admissions in week 42 2025 based on 79 NHS trusts in England were as follows:

• the overall ICU or HDU rate for COVID-19 remained low at 0.10 per 100,000 (compared with 0.10 per 100,000 in the previous week). Note that with low rates in critical care, small random fluctuations may occur

• ICU or HDU admission rates for COVID-19 were highest in the North West region (decreasing to 0.22 per 100,000 compared with 0.25 in the previous week). Please refer to the supplementary graphs and data file for regional breakdowns

• the highest ICU or HDU admission rate for COVID-19 was in those aged between 75 and 84 years (slightly increasing to 0.47 per 100,000 compared with 0.44 in the previous week)

Figure 22. Weekly overall COVID-19 hospital admission rates per 100,000 trust catchment population reported through SARI Watch mandatory surveillance, England

Figure 23. Weekly hospital admission rate by age group for new COVID-19 positive cases reported through SARI Watch mandatory surveillance, England [note 10]

Note 10: the highlighted line corresponds to the most recent 2025 to 2026 season, grey lines correspond to the previous 2024 to 2025 season.

Figure 24. Weekly overall COVID-19 ICU or HDU admission rates per 100,000 trust catchment population reported through SARI Watch mandatory surveillance, England

Figure 25. Weekly ICU or HDU admission rate by age group for new COVID-19 positive cases reported through SARI Watch mandatory surveillance, England [note 10]

Note 10: the highlighted line corresponds to the most recent 2025 to 2026 season, grey lines correspond to the previous 2024 to 2025 season.

Influenza hospital and ICU or HDU admissions

Surveillance of influenza hospitalisations to all levels of care is based on data from a small sentinel network of acute NHS trusts in England. Surveillance of admissions to ICU or HDU for influenza is mandatory with data required from all acute NHS trusts in England.

Please note that SARI Watch data is provisional and subject to retrospective updates. Rates are presented per 100,000 trust catchment population.

Influenza hospitalisations to all levels of care in week 42 2025 based on 23 sentinel NHS trusts in England were as follows:

• the overall weekly hospital admission rate for influenza hospitalisations was increasing at 1.73 per 100,000 compared with 1.29 per 100,000 in the previous week

• this rate is in the baseline impact range (less than 1.95 per 100,000)

• hospital admission rates for influenza were highest in those aged 85 years and over (7.44 per 100,000). Please refer to the respiratory virus section of the data dashboard for regional breakdowns

• there were 174 new hospital admissions for influenza (141 influenza A(not subtyped), 6 influenza A(H1N1)pdm09, 20 influenza A(H3N2), and 7 influenza B)

Influenza ICU-HDU admissions in week 42 2025 based on 90 NHS trusts in England were as follows:

• the overall weekly hospital admission rate for influenza ICU-HDU remained low at 0.05 per 100,000 compared with 0.04 per 100,000 in the previous week

• this rate is in the baseline impact range (less than 0.1 per 100,000)

• please refer to the respiratory virus section of the data dashboard for regional breakdowns

• there were 19 new ICU or HDU admissions for influenza (12 influenza A(not subtyped), 4 influenza A(H1N1)pdm09, 1 influenza A(H3N2), and 2 influenza B)

Figure 26. Weekly overall influenza hospital admission rates per 100,000 trust catchment population with MEM thresholds, reported through SARI Watch sentinel surveillance, England

Figure 27. Weekly influenza hospital admissions by influenza type, reported through SARI Watch sentinel surveillance, England

Figure 28. Weekly hospital admission rate by age group for new influenza reported through SARI Watch sentinel surveillance, England [note 10]

Note 10: the highlighted line corresponds to the most recent 2025 to 2026 season, grey lines correspond to the previous 2024 to 2025 season.

Figure 29. Weekly overall influenza ICU or HDU admission rates per 100,000 trust catchment population with MEM thresholds, reported through SARI Watch mandatory surveillance, England

Figure 30. Weekly influenza ICU or HDU admissions by influenza type, reported through SARI Watch mandatory surveillance, England

Figure 31. Weekly ICU or HDU admission rate by age group for new influenza cases, reported through SARI Watch mandatory surveillance, England [note 10]

Note 10: the highlighted line corresponds to the most recent 2025 to 2026 season, grey lines correspond to the previous 2024 to 2025 season.

RSV hospital admissions

Surveillance of respiratory syncytial virus (RSV) hospitalisations (excluding ICU or HDU admissions) is based on data from a small sentinel network of acute NHS trusts in England submitting data volunatrily. Trusts submit weekly aggregate counts of new RSV admissions and these are summed and converted to rates by linking to catchment populations of participating trusts in that week. Please see the data quality report for additional details on SARI-Watch RSV data and other SARI-Watch collections.

Please note recent changes to the operational period of RSV surveillance. From the 2024 to 2025 season, surveillance of RSV commenced earlier (starting week 36) to routinely capture earlier activity, pausing earlier at week 14 due to substantial decreases in activity that typically occur by this time. In prior seasons, RSV surveillance operated routinely between week 40 and week 20 in the following year (except in 2023 to 2024 where surveillance paused at week 16). In order to view activity from week 36, the current season 2025-2026 is compared to 2024-2025 only. Where comparisons involve more seasons, data from week 40 to week 14 are presented.

SARI Watch data is provisional and subject to retrospective updates. Rates are presented per 100,000 trust catchment population.

RSV hospitalisations, excluding ICU or HDU admissions, in week 42 2025 were based on 15 sentinel NHS trusts in England:

• the overall weekly hospital admission rate for RSV increased to 0.46 per 100,000 (compared with 0.15 per 100,000 in the previous week)

• in children aged under 5 years, the hospitalisation rate for RSV increased to 5.33 per 100,000 (compared with 2.31 per 100,000 in the previous week)

• in adults aged 75 years and over, the hospitalisation rate for RSV increased to 0.38 per 100,000 (compared with 0.00 per 100,000 in the previous week). Broken down further, rates were 0.26 per 100,000 in those aged between 75 and 84 years, and 0.69 per 100,000 in those aged 85 years and over in week 42

RSV ICU-HDU admissions in week 42 2025 were based on 15 sentinel NHS trusts in England:

• the overall weekly ICU-HDU admission rate for RSV remained low at 0.01 per 100,000 (compared with 0.01 per 100,000 in the previous week)

Figure 32. Weekly overall hospital admission rates (excluding ICU or HDU) of RSV positive cases per 100,000 population reported through SARI Watch sentinel surveillance, England

Figure 33. Weekly hospital admission rates (excluding ICU or HDU) of RSV positive cases per 100,000 population in those aged under 5 years and aged over 75 years reported through SARI Watch sentinel surveillance, England

Figure 34. Weekly hospital admission rates (excluding ICU or HDU) by age group for RSV cases reported through SARI Watch sentinel surveillance, England [note 10]

Note 10: the highlighted line corresponds to the most recent 2025 to 2026 season, grey lines correspond to the previous 2024 to 2025 season.

ECMO admissions

Surveillance of extra corporeal membrane oxygenation (ECMO) admissions is based on data from severe respiratory failure (SRF) centres in the UK. Please refer to the data quality report for additional information.

Please note that SARI Watch data is provisional and subject to retrospective updates.

There was 1 new ECMO admission reported in week 42 2025 in adults:

• all admissions were due to a suspected ARI

Please note that the other group includes other viral, bacterial or fungal ARI, suspected ARI, non-infection (such as asthma, primary cardiac and trauma) and sepsis of non-respiratory origin.

Figure 35. Laboratory confirmed ECMO admissions in adults (COVID-19, influenza and non-COVID-19 confirmed) to severe respiratory failure centres in the UK

Vaccine coverage

COVID-19 vaccine uptake in England

Cumulative data up to the end of week 42 2025 (Sunday 19 October 2025) was extracted from the Immunisation Information System (IIS), formerly the National Immunisation Management Service (NIMS). Data is extracted on the next working day following the end of reporting week (Monday 20 October 2025). Age is calculated as age on date of extraction.

Data is provisional and subject to change following further validation checks. Any changes to historic figures will be reflected in the most recent publication.

Autumn 2025 campaign

The autumn 2025 data reported below covers any dose administered from 1 October 2025 (ISO Week 40) provided there is at least 20 days from the previous dose. Eligible groups for the campaign are defined in Green Book chapter on COVID-19. By the end of week 42 2025 (week ending 19 October 2025) 41% of all people aged 75 years and over, and 18.9% of all people aged under 75 years with a weakened immune system, who are living and resident in England had been vaccinated with a autumn 2025 dose since 1 October 2025 (Figure 36).

Figure 36. Cumulative weekly COVID-19 vaccine uptake by target group in England [note 11]

Note 11: the month is taken from the Monday of an international organisation for standardisation (ISO) week.

Please note that an error was identified on 21 October 2025 that affected the data within the “National flu and COVID-19 surveillance: COVID-19 vaccine uptake coverage report” for ISO weeks 41 and 42. The error was due to a coding issue in the algorithm used to calculate these statistics, which created multiple erroneous statistics for the “Under 75 years of age clinical risk group, immunosuppressed” eligible group when stratified by ethnicity and into different regions. This issue has been fixed for this week and future publications, and corrections have been made to week 41 and 42’s data. Please be aware that, as part of correcting the data for publication week 42, updates to the data that occurred after publication on the 16 October 2025 may be included. Previous versions of this data, downloaded before 23 October 2025, should not be used.

For data on the real-world effectiveness of the COVID-19 vaccines, please see the epidemiology of COVID-19 in England reports.

For COVID-19 management information on the number of COVID-19 vaccinations provided by the NHS in England, please see the COVID-19 vaccinations webpage.

For UK COVID-19 daily vaccination figures and definitions, please see the Vaccinations section of the UK COVID-19 dashboard.

Since the 19 December 2024, monthly data for frontline healthcare workers has been published. This covers vaccinations that were given between 1 September 2024 and 28 February 2025 and is available under the joint flu and COVID-19 vaccine uptake report.

Influenza vaccination

Influenza vaccine uptake in GP patients

Weekly vaccine uptake data is provisional.

Influenza vaccination is reported by GP practice through the ImmForm website. ImmForm provides a secure online platform for vaccine uptake data collection for several immunisation surveys, including the seasonal influenza vaccine uptake collection. Details can be found at the data quality report.

For the 2025 to 2026 season’s vaccination programme, as in previous seasons children and pregnant women have been eligible since 1 September. For this current season and the previous season (2025 to 2026 and 2024 to 2025 seasons respectively), adult groups (excluding pregnant women) were eligible from the start of October (01/10/2025 and 03/10/2024 respectively), rather than 1 September as in previous seasons. See the Timing section of the annual flu letter for more information.

Up to the end of week 42 of 2025 (Sunday 19 October 2025), the provisional proportion of people in England who had received an influenza vaccine this season in targeted groups was as follows:

Adults (99.1% of GP practices reporting through Immform):

• 22.1% in those aged under 65 years in a clinical risk group

• 25.1% in all pregnant women

• 49.3% in all those aged over 65 years

Children (98.9% of GP practices reporting):

• 26.9% in children aged 2 years

• 26.8% in children aged 3 years

Figure 37. Cumulative weekly influenza vaccine uptake by target group in England

On 27 November 2025, monthly vaccine uptake data will be published for the first time this season, which covers influenza vaccinations given between 1 September and 31 October 2025 for GP patients, school-aged-children and frontline healthcare workers.

Data sources and methodology

For additional information regarding data sources please refer to the data quality report.

Background information

Related statistics

Annual epidemiological reports for the 2024 to 2025 season:

• Influenza in the UK, annual epidemiological report: winter 2024 to 2025 includes modelled influenza-attributable mortality, influenza vaccine effectiveness and influenza hospitalisations averted due to vaccination
• Epidemiology of COVID-19 in England includes COVID-19 vaccine uptake, COVID-19 vaccine effectiveness and COVID-19 seroprevalence
• RSV Surveillance winter 2024 to 2025 includes RSV related deaths in children, RSV vaccine uptake and RSV vaccine impact Annual influenza vaccine uptake reports for the 2024 to 2025 season:
• Seasonal influenza vaccine uptake for all GP patients: annual report 2024 to 2025
• Seasonal influenza vaccine uptake for school-aged children: annual report 2024 to 2025
• Seasonal influenza vaccine uptake for frontline healthcare workers: annual report 2024 to 2025

COVID-19 deaths

For further information on COVID-19 related deaths in England please see the COVID-19 dashboard for death.

All-cause mortality assessment (England)

For further information on all-cause mortality in England please see the:

• excess mortality within England post-pandemic method report, which uses Office for National Statistics (ONS) death registration data

• the all-cause mortality surveillance report, which uses the European mortality monitoring (EuroMOMO) model to identify weeks with higher than expected mortality

• the ONS all-cause excess mortality report

Syndromic surveillance

For further information on syndromic surveillance please see the syndromic surveillance weekly summaries.

Further information and contact details

Feedback and contact information

To provide feedback and for all queries relating to this document, please contact respdsr.enquiries@ukhsa.gov.uk

Official statistics

Our statistical practice is regulated by the Office for Statistics Regulation (OSR). OSR sets the standards of trustworthiness, quality and value in the Code of Practice for Statistics that all producers of official statistics should adhere to.

You are welcome to contact us directly by emailing respdsr.enquiries@ukhsa.gov.uk with any comments about how we meet these standards.

Alternatively, you can contact OSR by emailing regulation@statistics.gov.uk or via the OSR website.

UKHSA is committed to ensuring that these statistics comply with the Code of Practice for Statistics. This means users can have confidence in the people who produce UKHSA statistics because our statistics are robust, reliable and accurate. Our statistics are regularly reviewed to ensure they support the needs of society for information.