Flu Vaccination Service
Published on: 22nd July 2015 | Updated on: 6th April 2025
Each year from the autumn through to March, the NHS runs a seasonal flu vaccination campaign aiming to vaccinate all patients who are at risk of developing more serious complications from the virus.
The accessibility of pharmacies, their extended opening hours and the option to walk in without an appointment have proved popular with patients seeking vaccinations.
Update: Annual flu letter for 2025/26 published
The Department of Health and Social Care, the UK Health Security Agency and NHS England have jointly published the national flu vaccination programme letter for the 2025/26 season.
Key highlights from the letter are:
Key highlights from the letter are:
- There are no changes to the eligible cohorts for the 2025/26 season;
- From 1st September 2025 and in line with the 2024/25 season, pharmacies will only be able to vaccinate pregnant women. Then, from October 2025, vaccination of the other adult cohorts will commence, with the exact starting date to be confirmed by NHS England in due course;
- There are changes to the Joint Committee on Vaccination and Immunisation recommended adult flu vaccines for the 2025/26 season; and
- Reinforced advice regarding the restriction on the use of second line vaccines and to place orders with more than one manufacturer to ensure receipt of sufficient stock.
Read the annual flu vaccination programme letter for the 2025/26 season
Click on a heading below for more information
Background and aims of the service
Service description
Before providing the service
Training requirements and resources
Training providers
Providing the service
Communicating and working with GP practices
Vaccinating outside the consultation room & off site
Promoting the service to patients
Frequently Asked Questions
Service digital guide
Information and resources for LPCs
Flu Vaccination Service statistics
Resources
Only a small number of amendments have been made to the service specification this season. The key changes are:
Based on evidence that flu vaccine’s effectiveness can wane over time in adults, the Joint Committee on Vaccination and Immunisation (JCVI) advised moving the start of the programme for most adults to the beginning of October. This is on the understanding, that the majority of the vaccinations will be completed by the end of November, closer to the time that the flu season commonly starts. As a result, the annual flu letter confirmed, from 1st September 2024, pharmacies will only be able to vaccinate pregnant women, as they are the exception to the advice. From October 2024, vaccination of the other adult cohorts will commence, with the exact starting date to be confirmed by NHS England in due course. Following the service commencement date, the specification notes that pharmacy owners should maximise administration of vaccine by 30th November 2024. Read more about this change to the service requirements The annual flu vaccination programme letter for the 2024/25 season confirms the eligible cohorts for the 2024/25 season and the vaccines which will be reimbursable under the Community Pharmacy Seasonal Influenza Vaccination Advanced Service. Although there has been no change to the recommended vaccines that will be reimbursed for adults in the 2024/25 programme, the advice regarding when second line vaccines can be used has been strengthen. The annual flu vaccination programme letter for the 2024/25 season states that use of second line vaccines should only be considered when every attempt to use first line recommended vaccines has been exhausted – evidence of this may be requested by NHS England before reimbursement is agreed. Where supplies of the Recombinant quadrivalent influenza vaccine (QIVr) are available, preliminary UKHSA evidence in the UK from the 2022 to 2023 season and international evidence suggests that the potential additional benefit may be greatest in adults aged 65 years and older (compared to those aged 18 to 64 years). Therefore, the clinical recommendation would be to prioritise the use of any QIVr for use in the 65 years and over age group. For those aged 18 to 64 years in eligible clinical risk groups, the letter advises that while egg-grown quadrivalent influenza vaccine (QIVe) remains a second line vaccine, there is a potential advantage to using flu vaccines which do not use eggs in the manufacturing process (cell-culture or recombinant). Due to this, the recommended first line vaccines avoid the possible impact of “egg-adaptation” on the effectiveness of flu vaccines, particularly against A(H3N2) strains. The evidence on additional benefit is available for only a few seasons but the issue of egg adaptation remains a real concern, particularly for the A(H3N2) virus which is the more virulent influenza subtype in terms of morbidity and mortality. Service specification for the flu vaccination Advanced Service 2024/25 (published 22nd March 2024) National Patient Group Direction 2024/25 (awaiting publication) National protocol for inactivated influenza vaccine 2024/25 (awaiting publication) The protocol allows provision of flu vaccinations to people aged from 6 months to under 65 years in a clinical risk group, but the pharmacy service is only for eligible patients aged 18 years and older. Community Pharmacy England Briefing: Guidance on the 2024/25 Seasonal Influenza Vaccination Advanced Service (will be published in due course)Start date of the service
Eligible cohorts
Reimbursed vaccines
Key documents
The service specification describes the requirements for provision of the service and it is essential reading for all pharmacists providing the service.
The national Patient Group Direction (PGD) provides one legal mechanism for administration of flu vaccine under the service. Email ENGLAND.communitypharmacy@nhs.net if you have questions about the PGD.
This protocol provides another legal mechanism for administration of flu vaccine under the service by appropriately trained persons in accordance with regulation 247A of the Human Medicines Regulations 2012. Email immunisation@ukhsa.gov.uk if you have questions about the PGD.
Our Briefing provides guidance for pharmacy owners and their teams on the 2024/25 NHS Seasonal Influenza Vaccination Advanced Service.
This section contains additional information and resources to support pharmacy owners and their teams to provide the Flu Vaccination Service. This section will be updated as further resources are published by various bodies. National flu immunisation programme letter 2024/25 (updated 12th March 2024) UKHSA flu programme website hub Influenza vaccines marketed in the UK Influenza vaccines marketed in the UK for 2024/25, including ovalbumin content (21st March 2024) Protocol for ordering, storing and handling vaccines (2nd April 2014) Vaccine incident guidance: responding to errors in vaccine storage, handling and administration (7th July 2022) Flu vaccination programme: information for healthcare practitioners (awaiting publication) Flu vaccines poster: 2024 to 2025 flu season (awaiting publication) Flu immunisation for social care staff (awaiting publication) Immunisation against infectious disease: the green book Anaphylaxis action card – Personalise this card and keep it by the phone to guide staff on calling an ambulance if a patient has an anaphylactic reaction to a vaccine. Anaphylactic guidelines and algorithm poster (Resuscitation Council UK) (May 2021) NICE – Guideline 103, Flu vaccination: increasing uptake (August 2018) As has been the case for several years, in the Annual Flu letter, the Department of Health and Social Care, UKHSA and NHS England advise that all frontline health and social care workers should receive a flu vaccination this season. They state this should be provided by their employer, to meet their responsibility to protect their staff and patients and ensure the overall safe running of services.Joint guidance and briefing documents
UK Health Security Agency (UKHSA) guidance and briefing documents
Other resources
Flu vaccinations for pharmacy staff
All pharmacy staff involved in the provision of the service should receive appropriate training relevant to the role they will undertake and pharmacy owners are required to demonstrate that all staff providing the service in their pharmacy have the skills needed to do so.
The content of vaccination training
The National Minimum Standards and Core Curriculum for Immunisation Training for Registered Healthcare Practitioners sets the standards and lists the essential topics which should be incorporated into immunisation training for registered healthcare practitioners.
Pharmacists and other vaccinators who will administer flu vaccines must have completed practical training in vaccination that meets these requirements.
There are several organisations offering training and support for the provision of flu vaccination services and contact details can be found below.
The frequency of training
Pharmacists and other vaccinators providing the service need to attend face-to-face training for both injection technique and basic life support training periodically.
Pharmacy owners and vaccinators will need to consider when it would be appropriate to attend refresher training or if ongoing competence of an individual vaccinator can be evidenced, without the need for face-to-face training.
An individual’s continued competence may be influenced by their prior experience vaccinating patients, including the overall number of vaccines administered and the regularity with which they administer vaccines.
The National Minimum Standards and Core Curriculum for Immunisation Training for Registered Healthcare Practitioners recommend that immunisers should keep a portfolio of completed competency checklists, knowledge test score sheets, reflective logs, completion of e-learning course certificates and certificates of attendance at immunisation training courses and updates.
This will provide vaccinators with a means to be able to show evidence of completion of training and achievement of competence to both current and future employers. It will also provide useful evidence of continuing professional development for professional revalidation.