Flu vaccinations

Not enough people get the flu vaccine. We need to improve take-up to protect more people from serious illness.

Flu can kill. People with lung disease are 7 times more likely to die if they catch flu than someone who is not in an at-risk group

This is why people with lung disease should get vaccinated. So should anyone who looks after someone with lung disease, whether that’s as a health care professional, or caring for a family member.

What this page tells you

This page provides evidence and information on flu vaccinations among health care workers. It will monitor the progress of the Taskforce recommendation to:  

Increase rate of flu vaccination among the clinical at-risk groups and front-line NHS and social care staff who have contact with patients

This will be measured through the following measure of success: 

Increase the uptake rate of the flu vaccine among health care workers from 68.7% (2017) to 100%

What’s the story so far?

We have seen significant progress in flu vaccination uptake in health care workers but there is still a long way to go

There has been a steady increase in vaccination rates among NHS health care workers between 2012 and 2019. Flu vaccination rates have increased by nearly 30 percentage points, from 45% to 74%. The most recent season showed a welcome uplift after improvements in vaccination uptake appeared to be slowing between 2017 – 2019.

However, we are still a long way from meeting the target of 100% and there are still large variations across the country. What's more, data and consistent funding for flu vaccinations in social care staff are lacking. At current rates of progress, it would take until 2026 to see uptake rates of 100% in health care workers. 

YearNational vaccination rateTarget
20120.4561.000
20130.5481.000
20140.5491.000
20150.5061.000
20160.6321.000
20170.6871.000
20180.7031.000
20190.7431.000
20201.000
20211.000

Vaccination uptake in health care workers varies across the country

Vaccination uptake in health care workers varies considerably across the country

NHS trusts across the country can have very different vaccination rates with uptake as low as 45% in some areas. We need to ensure overall vaccination rates are consistently high for all NHS trusts. Variations across the country mean that a person's potential exposure to the risk of flu in an NHS setting becomes a postcode lottery based on where they live.

See slides 1 and 2 below for more detail on trust level variations. 

On average, staff in GP surgeries have the lowest vaccine uptake of all NHS health care workers

All staff members must be vaccinated to reduce the risk of flu in NHS settings

Making sure that every staff group with patient contact is equally well vaccinated important to ensure that the public and NHS employees are protected. This applies to all people working in a health care setting including doctors, nurses, allied health professions, receptionists, admin staff, and ideally even volunteers.

If one group of staff are poorly vaccinated against flu it can jeopardise the beneficial effect of having other groups of staff vaccinated. This is because the poorly vaccinated group can still carry and spread the disease to patients and other staff. If we are to effectively reduce the risk of flu transmission within hospitals and healthcare facilities we need to ensure all health care workers are vaccinated.

Despite the importance of consistently high vaccine uptake, vaccination rates vary by 18 percentage points across different groups of health care workers. Worryingly, GP staff including, GP doctors, and support staff have the worst vaccination rates. Given the community-based nature of GPs and the regularity with which most patients visit their GP, in comparison to hospitals, it is vital that vaccination rates are high.

See slide 3 below for more detail on staff specific vaccination rates.

The range in vaccination rates across the country

Bar titleIcon filenameValueRange-minRange-maxTargetLeft is goodLine of peopleScale-minScale-maxUnitRange-min-labelRange-max-label
Range of overall vaccination rates between NHS Trusts4595100Yes0100%
Range of staff level vaccination rates between NHS Trusts37100100Yes0100%
Maximum range between staff level vaccination rates within the same NHS Trust3961100Yes0100%

Total vaccine uptake in health care workers can vary by as much as 50 percentage points between NHS trusts across the country. When drilling down further, vaccination rates for individual staff groups vary by 62 percentage points across NHS trusts. This staff specific figure is the comparison between the worst-performing staff group in the worst-performing trust, versus the best-performing staff group in the best-performing trust. These variations demonstrate the extent to which where you live can impact your exposure to the risks of flu.

Bar titleIcon filenameValueRange-minRange-maxTargetLeft is goodLine of peopleScale-minScale-maxUnitRange-min-labelRange-max-label
Range of overall vaccination rates between NHS Trusts4595100Yes0100%
Range of staff level vaccination rates between NHS Trusts37100100Yes0100%
Maximum range between staff level vaccination rates within the same NHS Trust3961100Yes0100%

Even within individual trusts, there can be large variations between staffing groups. The worst-case scenario saw a difference of 21 percentage points between the best and worst-performing staffing group within the same trust.

As mentioned, having one poorly vaccinated group of staff can jeopardise the beneficial effect of having other groups of staff vaccinated. Trusts with large variations in vaccine uptake between groups of staff leave staff and patients exposed to unnecessary additional risk, despite potentially high vaccination uptake among some groups. 

Bar titleIcon filenameValueRange-minRange-maxTargetLeft is goodLine of peopleScale-minScale-maxUnitRange-min-labelRange-max-label
Support to GP staff59.4100Yes0100%
GPs Only67100Yes0100%
GP practice nurses71.6100Yes0100%
Nurses (excl. GP practice Nurses)73.2100Yes0100%
Allied health professionals74.1100Yes0100%
All doctors (excl. GPs)76100Yes0100%
Support to clinical staff77.2100Yes0100%

Vaccination rates vary from 59% to 77% across different groups of health care workers. GP support staff have the lowest vaccine uptake at 59%. This group includes staff working in reception, the first port of call for patients. Having a high touch point staff group such as this with low vaccination rates presents a potential risk of spreading flu. What's more, GPs themselves only have a vaccination rate of 67%. Every patient-facing member of staff in a GP practice needs to be vaccinated to reduce the risk of spreading flu.

Vaccination rates among other staff groups including hospital staff, nurses, clinical support staff, and allied health professionals, are all at a good level at around 75%, but still a long way from the 100% target.

We need to ensure every staff group is well vaccinated if we are to effectively reduce the risk of flu transmission within hospitals and healthcare facilities.

Explore your area

The map below displays flu vaccination rates at both regional and trust levels for various healthcare worker staff groups. Use this to explore how your area is performing and understand the variation in healthcare worker vaccination uptake across the country. 

A map of regional and trust level vaccination uptake in health care workers

Click these filters to change the map

Why are flu vaccinations for health care staff important?

Flu is highly transmissible, can have significant health implications, and places a serious burden on the NHS

Why vaccinating health care workers is important
  • iconProtect health care workers: 1 in 4 healthcare workers become infected with flu each flu season.
  • Protect patients: Stops transmission from staff to patients
  • Reduce hospital bed days: Flu takes up around 75,000 hospital bed days each year
  • Improve patient vaccination rates: Health care workers are leading by example and have better knowledge and confidence when recommending vaccinations. 
  • Reduce sick days: NHS England lose 1.2 million working days due to cold, cough and flu

Frontline health and social care staff should be vaccinated to protect themselves, their patients, colleagues, and families. Health care staff are more likely to be exposed to flu than the general public. An estimated one in four workers become infected during a mild flu season. This increases the risk of flu for the people they are treating, some of whom may be vulnerable or in poor health. In fact, flu cases take up around 75,000 hospital bed days each year.

Vaccinating health care workers can also have a positive impact on increasing vaccination rates. The NHS considers patients more likely to get vaccinated when they know staff are vaccinated. Uptake of the vaccine among health care staff can also improve staff confidence and knowledge when advising patients about vaccination.

Flu is also a major cause of lost working days for health services due to staff sickness. Within NHS hospital and community health services, over 1.2 million working days are lost due to cold, cough, and flu.

Social care staff should receive the vaccine for the same reasons as frontline NHS staff. However, the independent care sector has previously been overlooked and vaccination is the responsibility of care provider employers.

Flu vaccinations in light of COVID-19

In light of COVID-19 it is more important than ever people get their flu vaccinations to reduce the risk of flu and help reduce the strain flu places on the NHS and social care system

We need national data on the relationship between COVID-19 and flu

We need national data on the relationship between COVID-19 and flu. We already know people with lung disease are at a heightened risk of the effects of flu, but we don’t understand the impact and relationship between contracting both COVID-19 and flu concurrently or consecutively.

What is the relationship between flu and COVID-19

Delivering flu vaccinations in a safe manner throughout the pandemic is crucial

Maintaining the national immunisation programme during the pandemic is crucial to provide protection to vulnerable groups and reduce preventable pressure on the NHS during any future ‘peaks.’ It is essential that healthcare settings can deliver the flu vaccine with minimal risk of COVID-19 infection, for example through the use of PPE. 

A detailed analysis

Health care worker staff groups have seen varying levels of improvement in vaccination uptake

Generally, staff groups that were performing best in 2012 have seen progress slow between 2012 and 2019. Many of the staff groups that had the highest vaccination rates in 2012 have been overtaken, causing the leaderboard to change dramatically. One reason for this could be that more resources have been invested in uplifting the lower-performing groups from 2012.

Since 2012, the range in vaccination uptake between the best and worst-performing staff groups has reduced from a 20.5 percentage point difference to a 17.8 percentage point difference. This is good as it means that the vaccination rate is becoming more consistent across all health care workers.  

Despite this, there are still large variations and a long way to go to ensure all groups are uplifted to reach 100%. We need to make sure each staff group receives the focus and resources it needs. 

Healthcare professional2012Uptake improvement (2019)
GP practice nurses0.6060.11
GPs Only0.5270.143
Support to Clinical Staff0.5080.264
Support to GP staff0.4910.103
Allied Health Professionals0.4630.278
Frontline healthcare workers0.4560.287
All doctors (excl. GPs)0.4240.336
Nurses (excl. GP practice Nurses)0.4010.331

On average, 35% of vaccinations in health care workers take place after the flu season could have already started

Flu vaccinations need to occur before the flu season to ensure that everyone at risk is protected before the virus begins to spread. Currently, the majority of vaccinations in health care workers take place before or during October. This is good as the earlier workers get vaccinated the longer they are protected and are able to protect their patients.

However, on average we still see 35% of vaccinations in health care workers take place beyond the first month of the flu vaccine season. In fact, last flu season saw the of the worst October vaccination rates since 2014, with 41% of vaccinations taking place after the first month of the flu vaccine season.

Being vaccinated later in the season is likely to be less impactful as it means that people are protected for a shorter period of time and are more likely to be at risk of the virus earlier on in the season. We want to see as many health care workers as possible being vaccinated by the end of October. To protect staff and patients, the distribution of the vaccine needs to shift to earlier in the season.

YearOctoberNovemberDecemberJanuaryFebruary
20140.67030965390.20765027320.080145719490.03642987250.005464480874
20150.63779527560.23031496060.06889763780.03740157480.02559055118
20160.63722397480.23974763410.097791798110.018927444790.006309148265
20170.66957787480.19359534210.066957787480.05385735080.01601164483
20180.65860597440.20910384070.068278805120.039829302990.02418207681
20190.58681022880.24091520860.094212651410.052489905790.02557200538

Data issues

  • Since 2012 the submission rate for flu vaccination data from NHS Trusts has been very good with an average of 99.31%. However, both 2018 and 2019 flu seasons have showcased the lowest rates since 2012 with response rates of 98.8% and 98.7% respectively. While these figures still represent a high level of engagement we need to maintain this so we can effectively monitor uptake.
  • The Commissioning for Quality and Innovation (CQUIN) scheme was introduced in 2016 with payment incentives for trusts who reach high uptake rates for flu vaccinations. The implementation of these schemes helps to improve uptake rates. However, the scheme only requires trusts to reach an uptake of 75% to receive full payment. Therefore the scheme may provide little incentive for trusts to push for uptake rates higher than 75%, necessary for achieving the Taskforce target of 100%.

Uptake data for social care staff is not currently collected

Uptake data for social care staff is not currently collected because of the challenges associated with establishing a data collection system across a mixed market of independent providers.

Data collection on social care staff uptake rates should coincide with the routine funding of frontline social care staff vaccination and a coverage tracker should form part of the programme. Data is only currently collected and included in frontline staff uptake rates in Northern Ireland.

Our asks

We need more health care workers to get the flu vaccine, to do this we need:

  • Near universal uptake of the flu jab: All frontline health and social care workers need to be vaccinated.
  • Funding for annual flu vaccination programmes: A commitment from the Government to routinely fund the vaccination programme for social care staff, as well as NHS health care workers.
  • Quality monitoring and tracking: A national data collection system to accompany the delivery and uptake of flu vaccinations so we can target interventions effectively. 
  • To tackle variations in vaccine uptake: Continued work and support by NHSE/I and NHS organisations to tackle regional and staff level variations in flu vaccine uptake.

Help and more info

If you have a lung condition, or you care for someone who does and want more information on getting your flu vaccination, please visit the BLF flu jab page, the NHS's page on who should have the flu vaccine or talk to your GP, midwife or local chemist.

Data sources

All data sources can be found on our data sources page