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Flu planning: cases may be high this winter

25 April 2022

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Flu cases may rise to higher levels than before the Covid pandemic next season, the Government has warned in annual guidance.

It said that flu levels were ‘extremely low’ globally in 2020 to 2021 thanks to Covid measures such as mask-wearing and reduced social interactions and travel and ‘continue to be low’.

But the 2022/23 flu letter, published in April by the UK Health Security Agency (UKHSA), Department of Health and Social Care (DHSC) and NHS England, stressed that this may not continue to be the case.

It said: ‘A late increase in activity cannot be ruled out this season. As social contact returns to pre-pandemic norms there is likely to be a resurgence in influenza activity in winter 2022 to 2023 to levels similar to or higher than before the pandemic. 

‘The potential for co-circulation of influenza, Covid-19 and other respiratory viruses could add substantially to pressures in the NHS in 2022 to 2023, by addition, or by prolongation of the overall period for which respiratory viruses circulate in sequence.’

The letter added that the flu vaccine development process ‘has been far more difficult and potentially less precise since early 2020 due to far fewer influenza viruses isolated and analysed worldwide’.

It also confirmed that the annual flu vaccination campaign is to return to normal in England after two years of expanded cohorts.

This means secondary school pupils and those aged 50 to 64 will no longer be eligible for routine vaccination unless they fall into a clinical risk group.

Frontline health and social care workers are also still recommended for vaccination although this should be provided by employers.

Eligible cohorts for free flu vaccination in 2022/23

Those eligible for the NHS influenza programme are the cohorts offered vaccine prior to the pandemic:

  • all children aged 2 or 3 years on 31 August 2022
  • all primary school aged children (from reception to Year 6)
  • those aged 6 months to under 65 years in clinical risk groups
  • pregnant women
  • those aged 65 years and over
  • those in long-stay residential care homes
  • carers
  • close contacts of immunocompromised individuals
  • frontline staff employed by the following types of social care providers without employer led occupational health schemes:
    • a registered residential care or nursing home
    • registered domiciliary care provider
    • a voluntary managed hospice provider
    • Direct Payment (personal budgets) or Personal Health Budgets, such as Personal Assistants

Cohorts that were eligible in the 2021 to 2022 season but that are not included in the cohorts for 2022 to 2023 are:

  • those aged 50 to 64 years
  • secondary school children in Years 7 to 11 (between 11 and 15 years of age on 31 August 2022)

All frontline health care workers, including both clinical and non-clinical staff who have contact with patients, should be offered the influenza vaccine to protect themselves and those they care for. This should be provided by their employer as part of the organisation’s policy to prevent the transmission of infection. 

The complementary NHS influenza vaccination offer for primary care staff has not been extended for the 2022 to 2023 influenza season. Influenza vaccinations for primary care staff, like other frontline healthcare staff, revert to being an employer’s occupational health responsibility.

Source: 2022/23 flu letter

However, the letter suggested that both secondary school pupils up to year 11 and 50-64s could be reintroduced to the free programme.

It said that while 50-64s will not be offered a free jab next season, the Government ‘will continue to keep JCVI’s advice for the influenza vaccination programme under review’.

And although the prior expansion into school children up to year 11 ‘will not be taken forward’ for 2022/23, the JCVI has recommended that the programme includes all school children up to year 11 ‘as far as it is reasonably practical’.

The letter added: 

  • GP practices ‘must demonstrate a 100% offer this season by ensuring all eligible patients are offered the opportunity to be vaccinated by active call and recall mechanisms, supplemented with opportunistic offers where pragmatic’;
  • The programme aims to ‘achieve at least the uptake levels of 2021 to 2022 for each cohort, and ideally exceed them’;
  • NHS England is ‘considering’ the use of a national call and recall service for next season, but this is ‘intended to supplement not replace local call and recall mechanisms that are already in place contractually’.

It comes as the Welsh Government announced this month that it will extend its expanded flu vaccination programme for another year.

In England, the cohorts of those eligible for flu vaccination were expanded in 2020/21 and 2021/22 as part of the pandemic response, meaning 35 million people were eligible last season in the biggest ever flu programme.

This article was first published on our sister title Pulse.