GPAtlas🧭 When to offer the seasonal flu vaccine
Seasonal influenza is an acute respiratory viral infection. It is usually self-limiting in healthy adults, but causes substantial morbidity and mortality at the extremes of age and in those with chronic disease, immunosuppression or pregnancy. The annual programme aims to protect those at highest risk and to reduce community transmission. Eligibility is set each year by the Joint Committee on Vaccination and Immunisation (JCVI).
Two tasks fall to primary care every autumn: identify and recall every eligible patient, and give the age-correct vaccine at the right time. For 2026/27 the adult programme starts on 1 October; pregnant women and children are offered vaccine from 1 September (or as soon as supply allows). The majority should be completed by the end of November, although vaccine can be given up to 31 March. There are no changes to eligible cohorts for 2026/27.
| Offered from 1 September 2026 | Offered from 1 October 2026 |
|---|---|
|
• Pregnant women (any stage) • All children aged 2 or 3 years on 31 August 2026 • All school-aged children (reception to year 11) • All children in a clinical risk group, aged 6 months to under 18 years |
• All adults aged 65 and over • Adults 18 to under 65 in a clinical risk group • Residents of long-stay residential care homes • Carers (carer's allowance, or main carer of an elderly/disabled person) • Close contacts of immunocompromised people • Frontline health and social care workers (NHS staff via their employer; eligible social-care staff without an occupational scheme via the NHS) • People experiencing homelessness aged 16 and over |
| Clinical risk group | Examples (not exhaustive – use clinical judgement) |
|---|---|
| Chronic respiratory disease | Asthma needing continuous/repeated inhaled or systemic steroids, or with prior hospital admission; chronic obstructive pulmonary disease (COPD), bronchiectasis, cystic fibrosis, interstitial lung fibrosis. Children previously admitted for lower respiratory tract disease. |
| Chronic heart & vascular disease | Congenital heart disease, hypertension with cardiac complications, chronic heart failure, ischaemic heart disease needing follow-up, atrial fibrillation, peripheral vascular disease, prior venous thromboembolism. |
| Chronic kidney disease | Chronic kidney disease stage 3–5, nephrotic syndrome, kidney transplant. |
| Chronic liver disease | Cirrhosis, biliary atresia, chronic hepatitis. |
| Chronic neurological disease | Stroke or transient ischaemic attack (TIA); conditions compromising respiratory function; cerebral palsy, severe learning disability, Down's syndrome, multiple sclerosis, dementia, Parkinson's disease, motor neurone disease. |
| Diabetes & adrenal insufficiency | Type 1 diabetes; type 2 diabetes on medication or diet-controlled; Addison's disease and other adrenal insufficiency needing steroid replacement. |
| Immunosuppression | Disease or treatment-related – chemotherapy, radical radiotherapy, transplant, HIV (any stage), biologic therapy, systemic steroids ≥ 20 mg prednisolone/day for over a month (or ≥ 1 mg/kg/day in children under 20 kg), haematological malignancy. |
| Asplenia or splenic dysfunction | Sickle cell disease, hereditary spherocytosis, thalassaemia major, and coeliac disease (via hyposplenism). |
| Morbid (class III) obesity | Body mass index (BMI) ≥ 40. |
Source: UKHSA · National flu immunisation programme 2026/27 · Green Book chapter 19
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