Over 5 million under 65s with a long-term health condition could miss out flu vaccine

Latest figures show less than a third (28.9%) of people with one or more long-term health conditions (LTHCs) have had a flu vaccine.

9 million aged under 65's in clinical risk groups are eligible but just 40% vaccinated last year (2024 to 25) - leaving over 5 million missing out and unprotected.

Uptake of the flu vaccine in older adults, aged 65 and over, is higher - 61.5% this year to date; and 74.9% overall for last year - but many over 65s with LTHCs will be missing out.

For some clinical groups the risk of influenza-related mortality compared with the general population is much higher (1):

• 48 times more likely for those with chronic liver disease
• 47 times more likely for those with immunosuppression
• 40 times more likely for those with a chronic neurological disease

Last year (2024 to 25), uptake of the flu vaccine among the 9 million individuals aged under 65 with certain LTHCs and therefore in a clinical risk group was just 40% - leaving over 5 million missing out and unprotected. The highest flu vaccine uptake among people with a certain LTHC over the past 2 decades was in 2020 to 21 at 53%.

As the flu virus mutates and changes from year to year, it is important those eligible ensure they get vaccinated every year ahead of winter. And with an early flu season starting this year, getting vaccinated as soon as possible is important before the virus starts circulating more widely.

For some clinical groups the risk of influenza-related mortality compared with the general population is much higher:

• 48 times more likely for those with chronic liver disease
• 47 times more likely for those with immunosuppression
• 40 times more likely for those with a chronic neurological disease

Last year less than 34% of people with chronic liver disease got a flu vaccine, leaving over 600,000 in this clinical risk group missing out on potentially life-saving protection.

Similarly, for those with immunosuppression, which may be due to a particular health condition or caused by medication, only 47% were vaccinated, with almost 400,000 missing out; and for those with a chronic neurological disease, less than 45% received a vaccine leaving over half a million unprotected.

Dr Gayatri Amirthalingam, Deputy Director for Immunisation at UKHSA:

Every year we see many thousands of people with a long-term health condition being seriously ill in hospital from flu and tragically too many dying, when for many this could be potentially prevented by vaccination.

We are concerned that many people at risk may not know they are eligible. Do not wait or delay, book your vaccine appointment today, because flu is spreading now. If you have a long-term health condition speak with your doctor's surgery to find out more. With flu hitting earlier this year I can't stress enough how important it is to get yourself protected as soon as possible.

And for all other groups at increased risk of severe illness and who are also eligible – people aged 65 and over, pregnant women and 2-and-3 year olds – if you've not had the flu vaccine, please do not put if off and regret it later.

Estimates every year of excess winter deaths potentially attributable to influenza in England are published in the annual national flu reports and range from less than 1,000 (2013 to 2014) to greater than 20,000 (2014 to 2015 and 2017 to 2018). More recently, over 15,000 deaths from flu were seen in England during the 2022 to 2023 season.

The risk of serious illness from flu is higher amongst children under 5 years of age, older people, those with certain LTHCs and also in pregnant women. People with one or more certain LTHCs in a clinical risk group who are eligible for flu vaccine include:

1. chronic respiratory disease
2. chronic heart disease and vascular disease
3. chronic kidney disease
4. chronic liver disease including chronic hepatitis
5. chronic neurological disease:
   • including stroke, transient ischaemic attack and conditions in which respiratory function may be compromised due to neurological or neuromuscular disease
6. diabetes and adrenal insufficiency
7. immunosuppression due to disease or treatment:
   • including patients undergoing chemotherapy, radical radiotherapy, solid organ transplant recipients, bone marrow or stem cell transplant recipients, people living with HIV, multiple myeloma or genetic disorders affecting the immune system
8. asplenia or dysfunction of the spleen, including sickle cell disease
9. morbid obesity (class III obesity)

The list above is not exhaustive, and doctors should apply clinical judgment to take into account the risk of flu exacerbating any underlying disease that a patient may have, as well as the risk of serious illness from flu itself. A vaccine should be offered in such cases even if the individual is not in the clinical risk groups specified above.

Dr Claire Fuller, NHS National Medical Director, said:

We are urging people with long-term health conditions to book their flu jabs now and make sure they get protected, as they are vulnerable to the virus and it can make them seriously ill.

NHS teams across the country have been ramping up efforts to make it as easy as possible for the public to get vaccinated at a range of locations including local GP practices, pharmacies, schools, and other community clinics.

More than 12 million people have had their flu vaccinations providing crucial protection as winter rapidly approaches and cases of flu rise - but it is vital that more people with long-term health conditions come forward.

You can book quickly and easily on the NHS website, NHS App or by calling 119, and the ‘walk in flu finder' on the NHS app allows you to find a pharmacy where you can walk in for a vaccine without an appointment.

The Department of Health and Social Care, with UKHSA and NHS England, has launched a new campaign urging people to protect themselves against flu this winter. Campaign activity prioritises audiences who are eligible for the flu vaccine, including pregnant women, parents of children aged 2 to 16 years, and people living with certain long-term health conditions. The campaign message is simple and calls on eligible groups to ‘Stay strong. Get vaccinated' for flu this winter. The campaign uses protective imagery like bubble wrap and armour to illustrate the protection that vaccinations offer.

The marketing will run across TV, video on demand, radio, outdoor advertising and social channels. This is supported by media outreach, partnership activity, social media, and more.

UK Health Charity statements

Pamela Healy, Chief Executive at the British Liver Trust:   

People living with liver disease, particularly those with cirrhosis or a suppressed immune system, are at greater risk from infections like flu. Getting vaccinated offers the best protection, and we urge all eligible patients to take up the vaccine.

Fiona Loud, Policy Director at Kidney Care UK:   

Many people still often think that flu isn't a serious illness; comparable to the common cold, but for people with chronic kidney disease illnesses like flu can have a devastating impact. Data shows that people with chronic kidney disease are 19 times more likely to die from flu and whilst some people can recover within a week, people who are more vulnerable with long term health conditions, can find themselves still unwell for many weeks and months. We urge anyone with a diagnosis of chronic kidney disease to book in for their flu vaccine if they have been invited to do so.

Danni Manzi, Assoc. Director of Policy & Strategy at Parkinson's UK:  

People with Parkinson's can be more susceptible to chest infections. This is especially true for those with advanced Parkinson's. That's why, as flu season comes back around, we'd encourage anyone with Parkinson's to take up any vaccines that they are offered.

It's especially important to spread the message amongst those who have been newly diagnosed with the condition, or who are under 65 and may not realise that they are eligible for vaccinations. Giving yourself and your loved ones added protection from flu will allow you to continue to live well with Parkinson's.

Ailsa Bosworth, National Patient Champion for National Rheumatoid Arthritis Society:

I've lived with sero negative rheumatoid disease for over 45 years and to treat my condition I have been taking immunosuppressive medication long-term. This makes me more susceptible to severe illness, especially in the winter months when flu is more prevalent. This is why I always make sure I have my vaccinations, including the flu vaccine, when they are due.

We have provided support to researchers in this area and are familiar with the data and overwhelmingly positive evidence to keep your vaccinations up to date, especially if you are taking long-term immunosuppressive medication for a condition such as rheumatoid arthritis.

References

1. Table 19.1 Influenza-related population mortality rates and relative risk of death among those aged 6 months to under 65 years by clinical risk group in England, September 2010 to May 2011. Published in The Green Book Chapter 19 Influenza.