Official Statistics

Seasonal influenza vaccine uptake in frontline healthcare workers in England: winter season 2024 to 2025

Published 22 May 2025

Applies to England

Main points

In the 2024 to 2025 season:

• the data in this report is cumulative, covering seasonal influenza vaccinations administered to frontline healthcare workers (HCWs) with direct patient care from 1 September 2024 to 28 February 2025 inclusive in England
• the tripartite annual flu letter advised that vaccination of frontline HCWs start from 3 October, rather than 1 September as in previous seasons. Data is therefore not comparable with previous seasons due to the later start date of the vaccination campaign this season. However, for reference, previous seasons data is given in this report
• the response rate for the final survey was 92.3% (215 out of 233) for NHS trusts and 9.6% (621 out of 6,459) for GP practices, a lower response rate than the previous season (2023 to 2024) for NHS trusts (93.6% last season) and comparable for GP practices (9.9% last season)
• this season (2024 to 2025), based on these response rates the combined total of all frontline HCWs (in NHS trusts and GP practices) who received a vaccine was 37.8% (458,097 out of 1,212,471) a decrease of 5.4% compared with the previous season (43.1%)
• of frontline HCWs in GP practices, 51.5% (12,063 of 23,401) received a vaccine, a decrease of 10.3 percentage points compared with the previous season (61.8%)
• of frontline HCWs in NHS trusts, 37.5% (446,034 out of 1,189,070) received a vaccine, a decrease of 5.3 percentage points compared with the previous season (42.8%)
• this season vaccine uptake in NHS trusts ranged from 75.4%, with the lowest reported as 0.6%
• this season the proportion of NHS trusts that achieved vaccine uptake of 75% or more was 0.4% (1 out of 233 organisations submitting data)
• in NHS trusts, the highest vaccine uptake by staff group was achieved among doctors with an uptake of 42.2%. The lowest uptake was 33.2% in support staff
• although not comparable to previous seasons due to the later start date of the vaccination campaign this season, this is the fourth consecutive season to show a decrease in vaccination of frontline HCWs and is the lowest uptake since the 2010 to 2011 season

Response rate

The data was collected alongside COVID-19 returns for the third consecutive year to reduce data burden on data providers. For this season, a total of 215 out of 233 NHS trusts (response rate of 92.3%) and 621 out of 6,459 GP practices (response rate of 9.6%) submitted data on seasonal influenza vaccinations administered up to 28 February 2025. In comparison, for the previous season a total of 218 out of 233 NHS trusts (response rates of 93.6%) and 642 out of 6,459 GP practices (response rate of 9.9%) submitted data. The response rate to the frontline HCW influenza vaccination survey was lower than the previous season for NHS trusts and comparable for GP practices.

Throughout this season, provisional uptake data was published on a cumulative monthly basis. The final, end of season response rate for this annual report (92.3% for trusts and 9.6% for GP practices) was higher than that observed in the provisional monthly surveys (Table 1). Caution should be used when interpreting provisional monthly data as the vaccine uptake percentages are based on denominators of those trusts returning data each month.

Table 1. NHS trust and GP collection response rate (%) in each provisional monthly survey for the 2024 to 2025 season

Month	NHS trust response rate (%)	GP response rate (%)
October	77.7	3.0
November	79.8	3.5
December	83.3	5.0
January	82.8	5.6
February	86.3	6.7

National vaccine uptake

Overall, based on submitted data, the combined total for NHS trusts and GP practices was 37.8% (458,097 of 1,212,471) of all frontline HCWs who have received a seasonal influenza vaccine during this season, compared with 43.1% in the previous season. Of frontline HCWs in NHS trusts, 37.5% (446,034 out of 1,189,070) received a vaccine during this season compared with 42.8%  in the previous season. This was a decrease of 5.3 percentage points (Figure 1). Of frontline HCWs in GP practices, 51.5% (12,063 of 23,401) received a vaccine during this season, compared with 61.8% in the previous season. This was a decrease of 10.3 percentage points. Approximately 62.2% (754,374) of frontline HCWs in organisations responding to the survey did not receive a vaccine this season. Although not comparable to previous seasons due to the later start date of the vaccination campaign this season, this is the fourth consecutive season to show a decrease in the vaccination of frontline HCWs, and uptake is lower than that observed in the previous 13 seasons (the 2010 to 2011 season saw an uptake of 34.7% and the 2011 to 2012 season saw an uptake of 44.6%) (Figure 1).

Figure 1. Seasonal influenza vaccine uptake in frontline healthcare workers in NHS trusts in England for the 2024 to 2025 season compared with the 19 previous seasons [note 1][note 2][note3][note 4][note 5][note 6]

Note 1: the influenza vaccination of frontline HCW scheme was introduced in 2000 to 2001 season. Data on seasonal flu vaccine uptake in HCWs for earlier seasons is also available.

Note 2: the 2009 to 2010 was the influenza pandemic year in which the HCWs vaccine uptake survey expanded from acute trust only to include other trusts, such as ambulance, mental health, and primary care trusts.

Note 3: in the 2016 to 2017 season, the commissioning for quality and innovation (CQUIN) payment incentive scheme for trusts to reach specified vaccine uptake targets was introduced and continued until the 2019 to 2020 season.

Note 4: CQUIN payments were suspended in the 2020 to 2021 and 2021 to 2022 seasons due to the COVID-19 pandemic.

Note 5: CQUIN scheme was continued in the 2023 to 2024 season, but was no longer linked to the ImmForm surveys, which are used to generate the data for the government official statistics used in this report. The CQUIN scheme was paused for the 2024 to 2025 season.

Note 6: in 2024 to 2025, seasonal flu vaccination of adults was advised from 3 October onwards, rather than from 1 September as in previous seasons. Data is therefore not comparable with previous seasons due to the later start date of the vaccination campaign this season.

During this season, vaccine uptake increased during the first 3 months of the vaccination campaign and then began to plateau from December onwards. At all points in the season, vaccine uptake was lower than corresponding times in previous seasons (Figure 2). Historic data for September is only available for the 2021 to 2022 and the 2022 to 2023 seasons as this was the second year of the COVD-19 pandemic and the first year of living with COVID-19. The seasonal influenza vaccination campaign in frontline HCWs was also of additional interest during this time. Data was not collected at this time point for any other season.

Figure 2. Seasonal influenza vaccine uptake in frontline healthcare workers in NHS trusts in England by month during the 2024 to 2025 season compared with the previous 4 seasons

Vaccine uptake rates by organisation type

Vaccine uptake by trust type ranged from 13.8% for staff in independent sector health care providers (ISHCPs) compared with 51.5% in those working in GP (Figure 3). This season, vaccine uptake decreased in all trust types apart from ambulance trusts (49.0% compared with 47.3% the previous season), an increase of 1.7 percentage points from last season (Figure 3). For trust types with a decrease in vaccine uptake, this ranged from 4.4 percentage points for mental health trusts to 11.0 percentage points for ISHCPs.

Figure 3. Seasonal influenza vaccine uptake in frontline healthcare workers in England by organisation type in the 2024 to 2025 season compared with 2023 to 2024 season

Vaccine uptake for all trusts

For this season, vaccine uptake in frontline HCWs in trusts was 37.5% compared with 42.8% in the previous season. This was a decrease of 5.3 percentage points, but data is not comparable with previous seasons due to the later start date of the vaccination campaign this season. Vaccine uptake by commissioning region ranged from 31.0% in the North West to 44.6% in the South East, with none of the commissioning regions achieving vaccine uptake of 70% or more (Figure 4).

Figure 4. Seasonal influenza vaccine uptake in frontline healthcare workers in England in NHS trusts by commissioning region in the 2024 to 2025 season compared with 2023 to 2024 season

This season, the median vaccine uptake for trusts was 38.2% among those submitting data. The highest vaccine uptake reported by a trust was 75.4%, with the lowest reported as 0.6%. This season, 0.4% of all trusts (1 out of 233) achieved the goal of 70% or more. For comparison, in the previous season 8.8% (20 out of 228) achieved 70% or more. Vaccination data by trust is available in the data tables that accompany this report.

Figure 5 is a histogram that shows the spread in the number of NHS trusts who achieved vaccine uptake in each 5-percentage category. Four categories (30 to 34%, 35 to 39%, 40 to 44% and 45 to 49%) had over 25 trusts falling within them, with 30 to 34% being the most frequent category (with 39 trusts).

Figure 5. Seasonal influenza vaccine uptake in frontline healthcare workers in NHS trusts  in England for the 2024 to 2025 season, histogram of uptake in trusts by vaccine uptake (%) categories [note 7]

Note 7: the vaccine uptake (%) categories in this histogram represent number ranges from the lower number to less than the greater number. ‘Less than’ is not written in the figure due to space constraints. For example, the first category (0 to 5) represents 0% to less than 5%. The second category (5 to 10) represents 5% to less than 10%

National vaccine uptake by staff group

Vaccine uptake in frontline HCWs varies by staff group and across trusts and GP practices Figure 6.

Figure 6. Seasonal influenza vaccine uptake in frontline healthcare workers in NHS trusts and GP practices (combined) in England by staff group for the 2024 to 2025 season compared with the 2023 to 2024 season

Of all frontline HCWs, vaccination in GP practices (51.5%) is higher than those in trusts (37.5%), and this trend is consistent across all staff groups (Figure 7 and Figure 8). Vaccine uptake by staff groups varies more in GP practices compared with trust settings. The highest vaccine uptake in NHS trusts by staff group was 42.2% in all doctors, and the lowest vaccine uptake was 33.2% in total support staff (Figure 7). In GP practices, the highest vaccine uptake was 59.6% in all nurses, and the lowest uptake was 43.7% in all other professionally qualified clinical staff (Figure 8).

Figure 7. Seasonal influenza vaccine uptake in NHS trust-based frontline healthcare workers in England by staff group for the 2024 to 2025 season compared with the 2023 to 2024 season

Figure 8. Seasonal influenza vaccine uptake in GP practice frontline healthcare workers in England by staff group for the 2024 to 2025 season compared with the 2023 to 2024 season

Glossary

Green Book

The Green Book is ‘Immunisation against infectious disease’, a UK Health Security Agency (UKHSA) publication on vaccines, vaccine-preventable infectious diseases and vaccination procedures. Chapter 19 refers to influenza.  

ImmForm

ImmForm is a website that provides a secure online platform for vaccine uptake data collection for several immunisation surveys, including the seasonal influenza vaccine uptake collection.

Data sources and methodology

Cumulative data on seasonal influenza vaccine uptake was collected from all NHS trusts (including ISHCPs  acute, ambulance, care, community, mental health and other NHS trusts, and primary care) and GP practices in England, using the ImmForm website. Monthly data was collected on frontline HCWs involved with direct patient care for vaccinations administered between 1 September 2024 to 28 February 2025 (inclusive). This included doctors, qualified nurses, other professionally qualified clinical staff, and clinical support staff; and are the same groups that were monitored in previous seasons. Trusts identify frontline HCWs eligible to receive seasonal influenza vaccine (the denominator) and record all those that are vaccinated (the numerator) to calculate their overall vaccine uptake.

Each monthly survey on the ImmForm website was opened for data submission over the first 9 working days of each survey month (with adjustments and extensions made to allow for public holidays in some weeks). The 2024 to 2025 monthly data collection schedule with original survey deadlines is provided in Appendix A in the supplementary data set. Trusts had 7 working days to submit data manually onto the ImmForm website. Additional follow-up was undertaken by UKHSA of non-responding trusts or for data validation, as required. Since the 2021 to 2022 season, data collections have combined influenza and COVID-19 vaccinations with the aim of reducing data burden where it was possible for organisations to submit data for either vaccination programme with the same denominator of frontline HCWs with direct care.

The data in this report is as submitted by the above organisations and has not been altered except by specific request from data providers.

ImmForm website

One of the functions of the ImmForm website is to provide a secure online platform for vaccine uptake data collection for several immunisation surveys, including this seasonal influenza vaccine uptake collection. It allows data providers to:

• provide information on the trust type, trust status and survey coverage
• view vaccine uptake rates by staff group allowing data providers to review and assess progress for their own organisation
• allow local NHS England and Screening and Immunisation teams to view a ‘non-responder’ report that highlights trusts and primary care providers in their region that have not yet submitted data, thus allowing follow-up

Data limitations

Reported uptake is based on responses from organisations. Non-responding organisations are not included in uptake figures.

All the data needed to calculate vaccine uptake was entered manually, directly onto the ImmForm website by trusts (including ISHCPs) and GP practices. The number of ISHCPs included is 9 as ISHCPs have historically had to self-declare and register with ImmForm to be included. This number is less than the number of ISHCPs licensed. All trusts were asked to submit cumulative influenza vaccine uptake data monthly over 5 months. This manual element means there is the possibility of human error or misinterpretation. The ImmForm survey form has basic automated validation checks to ensure logical consistency. For example, ensuring that the sum of the figures for individual staff group match the total for all frontline HCWs, and that the number vaccinated must be less than or equal to the number of reported frontline HCWs. As part of an exercise to improve data quality and remove input errors, the submitted data was then manually checked and validated before publication.

Staff group definitions

All staff group definitions used in this report are the official NHS definitions. A full index of these can be found in the National Workforce Data Set guidance documents produced by NHS England.

Background information

Frontline HCWs involved in direct patient care are encouraged to receive a seasonal influenza vaccine annually, to protect themselves and their patients from influenza. Frontline HCWs themselves may be at increased risk of exposure to influenza compared with the general population and their patients may have a suboptimal response to their own vaccinations. Frontline HCW vaccination also protects healthcare services by reducing sickness absences.

To assess vaccine uptake for the 2024 to 2025 winter season among frontline HCWs, a seasonal influenza vaccine uptake survey of all 233 NHS trusts and 6,459 GP practices in England was undertaken. NHS trusts comprise acute, ambulance, care, mental health and other NHS trusts including ISHCP, and General Practice.

UKHSA co-ordinated and managed the data collection and produced monthly provisional data on vaccinations allowing the NHS and Department of Health and Social Care (DHSC) to track the progress of the programme during the 2024 to 2025 influenza season. This collection received approval as a mandatory collection from the Data Alliance Partnership Board (DAPB) under the reference ‘DAPB2204 Amd 37/2021 Influenza and COVID-19 vaccine uptake in Frontline Healthcare Workers (HCWs) survey’.

The aims and objectives of the 2024 to 2025 seasonal influenza vaccine uptake campaign amongst HCWs in England were to:

• monitor  vaccine uptake amongst frontline HCWs to inform and progress of the national vaccination programme
• allow DHSC, NHS England, Screening and Immunisation Teams, NHS trusts and integrated care boards to review national, regional, and local vaccine programme performance and identify staff groups and local or regional areas where coverage is high (to identify best practice to inform activities to increase uptake) and low (to increase uptake further)
• gather epidemiological data to support the evaluation and future planning of seasonal influenza vaccinations amongst frontline HCWs

For the 2024 to 2025 season, details on the inclusion and exclusion criteria of frontline healthcare workers continued to be included in the user guide . Alongside efforts by participating NHS trusts to ensure accuracy of provided data, UKHSA continued to carry out additional data validation to ensure the minimisation of double counting by contributing organisations (see staff group definitions).

The Health and Social Care Act 2008 code of practice on the prevention and control of infections and related guidance, emphasises the need to ensure, so far as is reasonably practicable, that HCWs are free of and are protected from exposure to infections that can be caught at work, and that all staff are suitably educated in the prevention and control of infection associated with the provision of health and social care. Registered providers should therefore ensure that policies and procedures are in place in relation to the prevention and control of infection such that:

• all staff can access occupational health services or appropriate occupational health advice
• occupational health policies on the prevention and management of communicable infections in care workers are in place
• decisions on offering immunisation should be made on the basis of a local risk assessment as described in Immunisation against infectious disease (The Green Book)
• employers should make vaccines available free of charge to employees
• if a risk assessment indicates that it is needed (COSHH Regulations 2002) there is a record of relevant immunisations

Further information on the Code of Practice can be found on the DHSC website.

Further information and contact details

Feedback and contact information

To provide feedback about this report and data, please email HCWvac@ukhsa.gov.uk.

Alternatively, you can contact OSR with any comments about how we meet these standards by emailing regulation@statistics.gov.uk or via the OSR website.

Acknowledgements

The authors would like to thank everyone that contributed to the data collection, specifically all the staff and data providers who participated in and supported the frontline HCWs seasonal influenza vaccine uptake data collection, the ImmForm team and the ImmForm support team.

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.

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.

UKHSA has conducted a formal review of these statistics. Following this review, an implementation plan has been developed to continue to improve the trustworthiness, quality, and value of these statistics. Key continuous improvements made will be highlighted within future releases of these statistics for transparency.