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Flu vaccination: The main things to know about the 2019 programme

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Please note we cannot answer any questions that relate to individual health concerns. You should consult your GP or specialist consultant.

Flu is now circulating and is starting to increase in the community. Delays in the delivery the childhood nasal vaccine have now been resolved. The primary school programme has resumed following a temporary pause and GPs have sufficient stocks to vaccinate high-risk children and toddlers. The main circulating strain of flu is well matched to this year’s vaccine. It’s not too late to get vaccinated. If you are eligible, get your vaccine from GP or Pharmacist to ensure you are protected.

What is flu?

Flu is an acute viral infection of the respiratory tract, usually characterised by a fever, chills, headache, aching muscles, joint pain and fatigue. It is a highly infectious virus different to the common cold, and spreads rapidly in closed communities and even people with mild or no symptoms can infect others.

Flu kills an average of 8,000 people every year, and it can be particularly serious in older adults, very young children, and people with underlying health conditions.

Why get the vaccine and who is eligible?

The flu vaccine remains the best defence we have against flu and protects those people who are most vulnerable.

Certain groups of people are at higher risk from flu, including adults aged 65 and over, those with underlying health conditions, pregnant women, and frontline health and social care workers.

In 2019/20, the flu vaccination will be offered to:

  • those aged 65 years and over
  • those aged 6 months to under 65 years in clinical risk groups
  • pregnant women
  • those living in a residential or nursing home
  • the main carer of an older or disabled person
  • children aged 2-3 (on 31 August 2019) and all primary school aged children

Employers of frontline health and social care workers also have a responsibility to ensure their staff can get the free vaccine.

What’s new for 2019?

More people than ever are now eligible for the flu vaccine and 25 million people in England will be offered it for free by the NHS. For the first time, the nasal spray vaccine will be offered to all primary school aged children, which means an extra 600,000 children will be protected.

A brand new flu vaccination marketing campaign for health and social care workers has also launched, delivered by PHE, NHS England and NHS Improvement. “Time to get your flu jab” takes a new approach, emphasising the protective benefit of the flu vaccination of themselves, their family, and their patients.

A wider range of flu vaccines are now available which should offer better protection. This includes the ‘adjuvanted’ vaccine which was offered to those aged 65 years and over for the first-time last year and provided a higher level of protection compared to the standard non-adjuvanted vaccines in this age group.

In addition, a new cell-based vaccine which protects against four strains of flu (quadrivalent) will also be available for those aged 65 and over, and those under 65 with underlying medical conditions. As the vaccine virus is grown in cells, rather than eggs, this avoids the changes that can occur when using eggs in the manufacturing process. There is increasing evidence in recent seasons that egg adaptation may mean that vaccines do not work as well, particularly against the A(H3N2) virus strain.

This vaccine should offer better protection for older people against flu than standard-dose, non-adjuvanted vaccines that are grown in eggs. The cell-based vaccine is therefore considered equally suitable for older adults as the ‘adjuvated’ vaccine.  For under 65s with underlying health conditions and pregnant women , both the quadrivalent egg-based vaccine and quadrivalent cell-based vaccine are equally suitable We advise that you can accept any of the vaccines recommended for your age.

How do we know which strains should go into the flu vaccine?

The World Health Organization (WHO) reviews the global situation (once for the Northern Hemisphere vaccine and once for the Southern Hemisphere) each year and recommends which flu strains should go in the vaccine to be manufactured for the following season. This recommendation is based on the viruses circulating each season and epidemiological data from around the world.

The WHO has to make a decision on which strains of flu to protect against, before flu starts circulating several months later the following season. This year, the following strains have been used in vaccines:

  • an A/Brisbane/02/2018 (H1N1)pdm09-like virus;
  • an A/Kansas/14/2017 (H3N2)-like virus;
  • a B/Colorado/06/2017-like virus (B/Victoria/2/87 lineage); and
  • a B/Phuket/3073/2013-like virus (B/Yamagata/16/88 lineage).

What happened last year?

Last winter, 5,505 people were reported hospitalised because of confirmed flu in a network of 24 trusts in England. 3,157 people were admitted to an Intensive Care Unit or High Dependency Unit as a result of confirmed flu across all of the UK during the 2018/19 flu season, of whom 312 died.

In 2018/19, there were an estimated 1,692 deaths associated with flu.

The flu vaccine uptake rates in key eligible groups last season were:

  • adults aged 65 or older: 72.0%
  • adults in at-risk groups: 48.0%
  • pregnant women: 45.2%
  • children aged 2: 43.8%
  • children aged 3: 45.9%

There is clearly still room for improvement within the vaccination programme and we urge everyone who is eligible or responsible for an eligible person to think about protecting their health with the vaccine this winter.

How can I protect myself, my family and those around me from the flu?

Flu is very infectious and the virus can live on hands and hard surfaces for up to 24 hours. This is why it is important to “Catch it, Bin it, Kill it” - “Catch” any sneezes in a tissue, “Bin” any tissues immediately and “Kill” the virus by washing your hands with soap and warm water. Avoid contact with sick people and wash your hands often with soap and water or use an alcohol-based hand rub. If you are unwell, look after yourself, drink plenty of fluids and stay at home so you don’t spread flu to others.

The vaccine remains the best defence we have to protect against the spread of flu and we encourage everyone eligible to get it each year.

Should Aussie flu be a concern this season?

What happens in Australia is not a clear predictor of the UK’s flu season. Australia had an early start to the flu season than in recent years. It follows the previous season (2018) of very low activity, but overall numbers are likely to be lower than those seen in 2017.

Will EU Exit impact on the delivery of flu vaccines into the country?

Flu vaccines are generally delivered from September to November. This year the majority of flu vaccines are expected to be in the UK by the end of October.

Public Health England manages significant stockpiles of vaccine; including the supply and distribution of children’s flu vaccines.

We do not anticipate any delays to the vaccine for the children’s flu programme as a result of EU Exit. Phased deliveries throughout the season are usual and necessary as the vaccine has a very short shelf life.

Additional planning—working closely with vaccine suppliers—has and continues to take place to minimise the risk of supply disruption for all centrally supplied vaccines following EU Exit.

Get more information about flu by visiting the NHS website.


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  1. Comment by Elizabeth Barber posted on

    When will the children’s vaccine (youth) be available in GP practices in Northumberland? Currently there is no information about the lead time for this. Could you please explain why pharmacies have access to adult vaccination and GP surgeries currently do not.

    Many thanks

  2. Comment by Janet Allen posted on

    I am allergic to eggs and have never had the flu vaccine. As I am now 81 years old, how can I get immunised with the cell based flu vaccine? I live in Chadderton, Oldham, Greater Manchester

    • Replies to Janet Allen>

      Comment by colette green posted on

      I don't know if its the same for adults by my son had a severe egg allergy and had to have his flu vaccination done at the hospital. I do believe though if you speak to your gp surgery they should be able to order the non egg vaccine or at least tell you what your options are.

  3. Comment by Peter J posted on

    I would like to see everyone encouraged to receive the flu vaccine, not just selected groups. The benefits of 'herd vaccination' are well known and stand up to scrutiny from an evidence based medicine (EBM) approach . I would also like to see what % of the population actually receive the vaccine outside the groups reported above and compare this w/other countries. I do believe the NHS need to do more to tackle preventable disease w/a more proactive, preventative stance.

  4. Comment by Helen Moss posted on

    Of all of the people 5505 reported to have flu, and of those admitted into hospital 3157and including the deaths 312 from flu where all of these people not vaccinated with the flu virus?

  5. Comment by Mona posted on

    Why is the nasal vaccine for kids still not available !! It’s almost almost November and my GP still didn’t receive them!

  6. Comment by Alison jones posted on

    Can someone explain why, despite receiving and completing consent forms for children to receive nasal flu spray in school after half term, we subsequently received a message informing us that our children would NOT be receiving the flu spray, as there are NONE LEFT in the U.K?

    • Replies to Alison jones>

      Comment by Blog editor posted on

      Hi Alison. This year, a delay in the World Health Organisation (WHO) announcing the strain means that we have received vaccine for children slightly later than usual. However, vaccinations started in schools earlier in the month and a significant amount of vaccine has already been distributed.

      In most years, flu does not start circulating before December, so parents of healthy children do not need to worry if they haven’t received their appointment already. We expect vaccinations to be well advanced by early December. If you have not got a date for your child’s vaccination by late November, please check with your school.

  7. Comment by ELAINE WILSON posted on

    Is the flu vaccine now safe to be given to those who have previously suffered from Guillain-Barré syndrome. As this can be triggered by Flu vaccine

    • Replies to ELAINE WILSON>

      Comment by Blog editor posted on

      Hi Elaine, although one US study in 1998 stated that Guillain-Barré Syndrome (GBS) had been very rarely reported after flu vaccination (at a rate of 1 in a million people vaccinated), other studies, including a large study in the UK carried out in 2009 have not found this association. The UK study found a strong association between flu and GBS (that is, people who acquired flu naturally were at increased risk of developing GBS). So if developing flu increases the risk of GBS, having the flu vaccine should protect against GBS. People who have had GBS previously can receive flu vaccine since the vaccine has not been shown to cause GBS.