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.

Flu vaccinations in people with lung disease

What this page tells you

This page provides evidence and information on flu vaccinations in people with chronic lung disease. It checks progress against 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 measures of success:

  • An increase in the proportion of people with lung disease getting their flu vaccination from 50.8% to 75%.

What's the story so far?

Flu vaccination rates fell last season and 1.6 million people with a lung condition were not vaccinated

To hit our target, we need to increase the uptake of flu vaccinations from 2 in every 4 people with lung disease to 3 in every 4

Last flu season only 49.8% of the people with lung disease got the flu vaccine in England, down from 50.8% the year before and a long way from our 75% target.

These figures represent 1.6 million people at higher risk because they didn't get the flu vaccine.

That included 230,000 children and 1.33 million adults.

Progress is much too slow and inconsistent

It will take too long to reach our target unless things change. Use the walk-through below to find out more:

Flu vaccination rates in England (2015 – 2018)

Flu vaccination rates against our 75% target
Yearunder 65: flu vaccination ratetarget vaccination rate
201547.41%75%
201648.55%75%
201750.82%75%
201849.82%75%
201975%
202075%
202175%

Progress over the past 4 years has been slow and inconsistent. At the current rate of progress, it would be 2050 before we reached the target of 3 in 4 people with a lung condition getting the flu vaccine and the most recent data shows a downturn in vaccination rates.

This is simply not good enough. We need to make big changes if we’re going to meet our target.

Flu vaccination rates against our 75% target
Yearunder 65: flu vaccination ratetarget vaccination rate
201547.41%75%
201648.55%75%
201750.82%75%
201849.82%75%
201975%
202075%
202175%

The graph shows how the proportion of people with lung disease getting the flu vaccine rose from 2015 – 2017 but fell slightly last year. This put an extra 60,000 people at unnecessary risk compared to the previous year.

Flu vaccination rates against our 75% target
Yearunder 65: flu vaccination ratetarget vaccination rate
201547.41%75%
201648.55%75%
201750.82%75%
201849.82%75%
201975%
202075%
202175%

Vaccination rates are consistently well below target level and last season we were 666,000 people short of what we’re aiming for and 1.6 million short of all people with lung disease getting a vaccination.

Why are vaccinations so important?

Flu can be deadly

Last winter, 5,505 people were admitted to hospital with flu and 3,157 ended up in intensive care or on a high dependency unit.

273 people died.

Every year 1 in 10 people who are admitted to intensive care as a result of flu die.

Yearhospital admissionsintensive care admissionsdeaths
201855052924273

2018 hospital admissions for people with lung disease with flu

The best thing anyone with lung disease can do to protect themselves is get the flu vaccine.

The flu vaccine is free on the NHS for people with a chronic lung condition, for carers, children and for over 65s. It’s also free for people who work in health and social care.

Vaccinations can halve the number of hospital admissions and reduce deaths by two thirds

You can have your NHS flu vaccine at:

  • your GP surgery
  • a local chemist offering the service
  • your midwifery service if they offer it for pregnant women

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

Explore how your area is performing

Data on flu vaccinations is collected for the following age ranges:

Flu vaccination rates for people with chronic lung disease are measured using 4 age groups ranging from 6 months to 65 years.

Over 65s are included in the map below but vaccination rates for this group are not specific to people with chronic respiratory disease. The rate for this group instead represent all people over the age of 65. This is because they represent an at-risk group in and of themselves. While it is good that over 65s are a focus group for flu vaccinations, the way the data is captured is problematic as it is not possible to break out the numbers for different diseases. Older people make up a large proportion of the chronic lung disease population and currently we have no way of knowing how many people over 65 with chronic lung disease get their vaccination each year.

Having age-specific data is important as it allows decision-makers to understand who is most at risk. The needs of each group are different and we need to ensure everyone with a chronic lung disease gets vaccinated.

The map below shows vaccination rates by region for different age groups. Rates of vaccination uptake vary greatly by both these measures. Use the map to explore how your area is performing and read our detailed analysis below.

Flu vaccination rates across the country

nhsrlo17cdnhsrlo17nmDisplay nameStart YearOrg CodeOrg Name6 months to under 2 years old - % Vaccine UptakeLT Ranking2 years to under 5 years old - % Vaccine UptakeLT Ranking5 years old to under 16 years old - % Vaccine UptakeLT Ranking16 years old to under 65 years old % Vaccine UptakeLT RankingTotal under 65 years old - % Vaccine UptakeLT RankingTotal over 65 years old - % Vaccine UptakeLT RankingUpdated
E39000018NHS England LondonLondon2018Q71 Eng TeamNHS ENGLAND LONDON LT AND COMMISSIONING REGION16.71447.31433.61447.61345.61465.414December 2019
E39000029NHS England North (Yorkshire and Humber)Yorkshire and Humber2018Q72 Eng TeamYORKSHIRE AND HUMBER LT27.2556.5950.9550950.2873.27December 2019
E39000039NHS England North (Cumbria and North East)Cumbria and North East2018Q74 Eng TeamCUMBRIA AND NORTH EAST LT23.5856.51049.3950.7750.6773.46December 2019
E39000026NHS England North (Cheshire and Merseyside)Cheshire and Merseyside2018Q75 Eng TeamCHESHIRE AND MERSEYSIDE LT25649.51340.51352.4350.9674.24December 2019
E39000037NHS England North (Greater Manchester)Greater Manchester2018Q83 Eng TeamGREATER MANCHESTER LT21.21059.1850.5755.3154.6174.52December 2019
E39000040NHS England North (Lancashire and South Cumbria)Lancashire and South Cumbria2018Q84 Eng TeamLANCASHIRE AND SOUTH CUMBRIA LT19.11160.5651.9352.1452.2372.98December 2019
E39000032NHS England Midlands and East (North Midlands)North Midlands2018Q76 Eng TeamNORTH MIDLANDS LT23.5959.3750.6651.6551.6473.65December 2019
E39000033NHS England Midlands and East (West Midlands)West Midlands2018Q77 Eng TeamWEST MIDLANDS LT23.6753.11243.81250.7849.7970.813December 2019
E39000030NHS England Midlands and East (Central Midlands)Central Midlands2018Q78 Eng TeamCENTRAL MIDLANDS LT18.11261.8449.21047.712481271.810December 2019
E39000031NHS England Midlands and East (East)East2018Q79 Eng TeamEAST LT17.71363.3252246.61447.51371.111December 2019
E39000036NHS England South (South West)South West South2018Q85 Eng TeamSOUTH WEST SOUTH LT32.1261.4550.1848.91149.21172.29December 2019
E39000034NHS England South (South Central)South West North2018Q86 Eng TeamSOUTH WEST NORTH LT33.7162.8351.3451.5651.5575.11December 2019
E39000025NHS England South (Wessex)Hampshire, Isle of Wight and Thames Valley 2018Q87 Eng TeamHAMPSHIRE, ISLE OF WIGHT AND THAMES VALLEY LT29.8365.1153.7153.2253.4274.43December 2019
E39000035NHS England South (South East)Kent, Surrey and Sussex2018Q88 Eng TeamKENT, SURREY AND SUSSEX LT28.3455.61146.31149.81049.41071.112December 2019
TotalENGLAND2357.447.150.249.872.0December 2019

A detailed analysis

Under 65 vaccination rates vary by as much as 10% across the country

For vaccination rates in people under 65 and living with a lung condition, there are regional differences across England, ranging from 46% in London to 55% in Greater Manchester.

While vaccination rates in Greater Manchester are still too low, they are the highest across the country. If vaccination rates in Greater Manchester were matched across England, an additional 145,000 people would have been vaccinated last year.

Bar titleIcon filenameValueRange-minRange-maxTargetLeft is goodLine of peopleScale-minScale-maxUnitRange-min-labelRange-max-label
Range in overall vacciation uptake in under 65s45.654.675YesLondonGreater Manchester

Age also plays an important role in vaccination rates and different age groups vary by as much as 34%

The very youngest people with lung disease have the worst vaccination rates. Use the walk-through below to find out more. See the last slide for how vaccination rates differ across the country.

Vaccination rates for different age groups

Bar titleIcon filenameValueRange-minRange-maxTargetLeft is goodLine of peopleScale-minScale-maxUnitRange-min-labelRange-max-label
6 months to under 2 years oldage-6m-2y.png23.0%75%
2 years to under 5 years oldage-2y-5y.png57.4%75%
5 years old to under 16 years oldage-5y-16y.png47.1%75%
16 years old to under 65 years oldage-16y-65y.png50.2%75%
Over 65age-65y-plus.png72.0%75%

Age plays an important role in vaccination rates and some age groups are at greater risk than others.

Vaccination rates for different age groups vary from 23% up to over double that at 57.4% and as high as 72% if you consider over 65s.

We need to understand why some age groups have better vaccination uptake than others and what can be done to ensure everyone receives the same protection.

Bar titleIcon filenameValueRange-minRange-maxTargetLeft is goodLine of peopleScale-minScale-maxUnitRange-min-labelRange-max-label
6 months to under 2 years oldage-6m-2y.png23.0%75%

Children aged between 6 months and 2 years are less likely than any other age group to have the flu vaccine, at just 23%. Vaccination rates rose between 2015 and 2017 but last season fell below 2015 levels. 1,546 infants (out of 2,000) did not get a flu vaccine last season.

Bar titleIcon filenameValueRange-minRange-maxTargetLeft is goodLine of peopleScale-minScale-maxUnitRange-min-labelRange-max-label
2 years to under 5 years oldage-2y-5y.png57.4%75%

Children aged between 2 and 5 have the best vaccination rates at 57%. Take-up rose between 2015-2016, but the improvement has stalled. There are 31,000 children in this group and 13,000 did not get a flu vaccine last year.

Bar titleIcon filenameValueRange-minRange-maxTargetLeft is goodLine of peopleScale-minScale-maxUnitRange-min-labelRange-max-label
5 years old to under 16 years oldage-5y-16y.png47.1%75%

Children and teenagers aged 5 to 16 years have the second-lowest vaccination rates at 47%. This group is the second largest with 400,000 children, 207,000 of whom did not have a flu vaccine last year.

Bar titleIcon filenameValueRange-minRange-maxTargetLeft is goodLine of peopleScale-minScale-maxUnitRange-min-labelRange-max-label
16 years old to under 65 years oldage-16y-65y.png50.2%75%

People aged 16-65 have the second-best vaccination rates at 50%. Vaccination rates rose between 2015 and 2017 but fell last season. This group is the largest group, with 2.6 million adults, 1.3 million of whom did not get a flu vaccine last season.

Bar titleIcon filenameValueRange-minRange-maxTargetLeft is goodLine of peopleScale-minScale-maxUnitRange-min-labelRange-max-label
Over 65age-65y-plus.png72.0%75%

People aged over 65 have the best vaccination rates. However, this data is for all people over 65 not just those with chronic lung disease. People over 65 are considered an at-risk group for flu regardless of whether they have a lung disease. There are over 10.1 million people over 65 in England, 7.2 million of whom got their flu vaccination last season. Whilst these are impressive numbers, vaccination rates for this group are still short of the 75% target.

Over 65s make up a large proportion of the lung disease population. So we need to know how this translates to those with chronic lung conditions specifically. They are an especially vulnerable group of older people for whom flu can be very serious. We need to understand the problem in order to solve it.

Bar titleIcon filenameValueRange-minRange-maxTargetLeft is goodLine of peopleScale-minScale-maxUnitRange-min-labelRange-max-label
6 months to under 2 years oldage-6m-2y.png16.733.775Yes
2 years to under 5 years oldage-2y-5y.png47.365.175Yes
5 years old to under 16 years oldage-5y-16y.png33.653.775Yes
16 years old to under 65 years oldage-16y-65y.png46.655.375Yes
Over 65age-65y-plus.png65.475.175Yes
How age-specific vaccination rates vary across the country

Age-specific vaccination rates vary across the country by as much as 20% among 5 - 16 year olds. They are lowest in London at 34% and highest in Hampshire, Isle of Wight and Thames Valley at 54%. Other age groups also show large regional differences.

This level of variation is cause for concern. We need to understand why some areas are performing better than others and what areas can learn from each other.

The future of flu vaccination rates for people with lung disease looks very different for different age groups

As well as a variation in the proportion of those getting vaccinated, the future of flu vaccination rates for people with lung disease looks very different for different age groups.

Current rates of progress mean children aged between 6 months and 2 years will never reach the target. Other groups will take up to 29 years, so it would be nearly 2050 before all groups hit the target.

This is how long it will take each age group to reach the target at current rates.

How long it would take each age group to reach the target

Age specific vaccination rates against our 75% target
% Vaccine Uptake6mnths - 2yrs2yrs - 5yrs5yrs - 16yrs16yrs - 65yrstarget vaccination rates
201523.4%52.4%42.3%48.2%75.0%
201624.4%56.0%44.3%49.1%75.0%
201725.2%57.0%46.7%51.4%75.0%
201823.0%57.4%47.1%50.2%75.0%
201975.0%
202075.0%

Current rates of progress mean children aged between 6 months and 2 years will never reach the target vaccination rate. Other groups will take up to 29 years.

This is how long it will take each age group to reach the target at current rates:

  • 6 months to 2 years: will not reach the target
  • 2 to 5 years: 8 years
  • 5 to 16 years: 12 years
  • 16 years to 65: 29 years
Age specific vaccination rates against our 75% target
% Vaccine Uptake6mnths - 2yrstarget vaccination rates
201523.4%75.0%
201624.4%75.0%
201725.2%75.0%
201823.0%75.0%
201975.0%
202075.0%

Children aged between 6 months and 2 years are less likely than any other age group to have the flu vaccine, at just 23%. Vaccination rates rose between 2015 and 2017 but last season fell below 2015 levels. 1,546 infants (out of 2,000) did not get a flu vaccine last season.

Age specific vaccination rates against our 75% target
% Vaccine Uptake2yrs - 5yrstarget vaccination rates
201552.4%75.0%
201656.0%75.0%
201757.0%75.0%
201857.4%75.0%
201975.0%
202075.0%

Children aged between 2 and 5 have the best vaccination rates at 57%. Take-up rose between 2015-2016, but the improvement has stalled. There are 31,000 children in this group. 13,000 did not get a flu vaccine last year.

Age specific vaccination rates against our 75% target
% Vaccine Uptake5yrs - 16yrstarget vaccination rates
201542.3%75.0%
201644.3%75.0%
201746.7%75.0%
201847.1%75.0%
201975.0%
202075.0%

Children and teenagers aged 5 to 16 years have the second-lowest vaccination rates at 47%. This group is the second largest with 400,000 children, 207,000 of whom did not have a flu vaccine last year.

Age specific vaccination rates against our 75% target
% Vaccine Uptake16yrs - 65yrstarget vaccination rates
201548.2%75.0%
201649.1%75.0%
201751.4%75.0%
201850.2%75.0%
201975.0%
202075.0%

People aged 16-65 have the second best vaccination rates at 50%. Vaccination rates rose between 2015 and 2017 but fell last season. This group is the largest group, with 2.6 million adults, 1.3 million of whom did not get a flu vaccine last season.

Our asks

We need decision-makers to be asking?

  • Why are some areas performing better than others?
  • Why are some areas performing well in one age group and poorly in another?
  • What can different areas learn from each other?

We need more people with lung disease to get the flu vaccine, to do this we need:

  • Funding for the annual flu vaccination campaigns: These should target people with different respiratory conditions.
  • Everyone to work together: This means joined-up thinking between NHS England, community pharmacies and other health and social care services. We should think about offering the flu vaccine in different places, such as where people work.
  • Effective monitoring and tracking: of the delivery and uptake of flu vaccinations so we can target interventions in the right way.

Data issues

We need better data accuracy and better record keeping

Data collection  

We need data for people with lung disease to be broken out by lung condition as well as age. Currently, all lung diseases, including COPD, asthma, bronchiectasis, cystic fibrosis and interstitial lung disease, are recorded as one.

We need better data collection, including on over 65s with lung disease and on the differences between take up rates for people with asthma, COPD, and other lung disease.

Data accuracy 

  • Last year there were an estimated 103,917 people with lung disease whose vaccination status was un-recorded. We don’t know whether these people received a vaccine or not.

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