Annual Flu Letter for 2025/26

The Department of Health and Social Care, the UK Health Security Agency and NHS England have published the national flu vaccination programme letter for the 2025/26 season.

Eligible cohorts

There are no changes to the eligible cohorts for the 2025/26 season.

Timing

From 1st September 2025, pharmacies will only be able to vaccinate pregnant women.

From October 2025, vaccination of all other adult cohorts will commence, with the exact starting date still to be confirmed by NHS England.

Reimbursed vaccines

JCVI advice for 2025/26 noted that the World Health Organization advised that one of the antigens is no longer warranted. As a result, manufacturers have either already received or applied for approval to produce a trivalent formulation for the 25/26 season.

The adjuvanted trivalent influenza vaccine (aTIV) is now licensed from age 50 years and over.

When ordering flu vaccines, pharmacies should order the first line vaccines irrespective of whether they are currently described as quadrivalent (Q) or trivalent (T) formulations in the table below.

Aged 18 to 64 years in clinical risk group (including pregnant women)	Aged 65 years and over
First line (listed alphabetically) adjuvanted (aTIV) (in those from 50 years of age) or cell-culture (TIVc) or high dose (TIV-HD/QIV-HD) (in those from 60 years of age) or recombinant (TIVr/QIVr) Second line egg-culture (TIVe/QIVe) (only reimbursed as set out in the letter)	First line (listed alphabetically) adjuvanted (aTIV) or high dose (TIV-HD/QIV-HD) or recombinant (TIVr/QIVr)     Second line cell-culture (TIVc) (only reimbursed as set out in the flu letter)

 

The letter provides a reminder that contractual requirements for all commissioned NHS flu vaccination providers will state that to receive payment for flu vaccination and reimbursement of flu vaccine they will need to use the specific flu vaccines outlined above for the appropriate cohort and administer vaccines in line with the announced and authorised cohorts. Commissioners will actively recover any payments made for the incorrect vaccine administered.

Once the vaccination campaign has started, if providers need additional stock, second line vaccines should only be ordered if first line options are not available to order. Where a provider does not have a first line vaccine in stock, patients should be directed to an alternative provider who has stock of a first line vaccine or told to rebook when the new stock is available.

Vaccination with a second line vaccine should only be considered on an exceptional basis where there is a valid reason why the patient may not return for a further appointment. Practices and Community Pharmacy should aim to minimise the need for this by procuring adequate stock before the campaign starts.

Read the annual flu vaccination programme letter for the 2025/26 season