Flu season 2020/2021: essential information for patients
Pharmacy insights

12 facts you must know – FLU SEASON 2020/2021

With just one month to go, flu season 2020/2021 is just around the corner. It is expected to be that demand for flu vaccination service will be high this year. NHS England has an ambitious target for the uptake in eligible patients groups of at least 75%. Additionally, eligibility criteria will be extended, for example, phased-out eligibility for free flu vaccination of those aged 50-64. It is expected to be the busiest season, and community pharmacies will play a vital role in providing flu vaccination service. This post is a summary of essential information about flu season 2020 and flu vaccination 2020/2021. This post will be updated regularly with any significant facts, such as flu jab stock availability. Information provided is focused on the delivery of flu vaccination by community pharmacies. 

1. When will flu season 2020 start?

The official start day of the flu vaccination programme in the UK is usually at the beginning of September. This year the official start date for flu vaccination service is 01/09/2020. NHS flu vaccination programme runs each year for seven months, until the end of March. This year will not be any different with the end of flu season on 31/03/2021.  

2. When will flu vaccine be available?

Although the start of flu vaccination season is set for 01/09/20, flu vaccines are generally not available from day one. For example, last year, Flaud vaccine (for patients over 65 years of age) became available a week later, and egg-grown quadrivalent vaccine (for patients aged 64 and below, both private and NHS’ at-risk groups’) became available in October, a month after the start of the flu season.

AHH, one of the main pharmaceutical wholesalers in the UK announced, some flu jabs will be available for pharmacies to order from 14/09/2020.

There is no information on stock availability at this time. This post will be updated with any delays and stock availability information, should manufactures or Department of Health and Social Care (DHSC) announce supply problems. 

It is possible to book/pre-book flu vaccination service (private and NHS) with most pharmacy chains in the UK (see details below). At the moment some pharmacies cautiously set the starting date for flu vaccination service mid-September and even October, which is a very reasonable move in case there is a delay in the delivery of vaccinations during this year’s flu season.

3. What are the criteria for free NHS flu jab

The general eligibility for free NHS flu jab is as follows: 

  • All children aged two to ten. Community pharmacists do not vaccinate this group.
  • Patients aged six months to 64 years of age with certain medical conditions such as diabetes, considered as ‘at-risk’ group (see details below)
  • Pregnant women
  • Residents of long-stay care homes
  • Carers
  • People with close contact with immunocompromised patients
  • People aged 65 and over including those who will become 65 by 31/03/2021
  • Care / social employees of registered nursing/care homes / hospice (voluntary managed)

 4. Updated criteria for NHS flu jab 2020/2021

The Department of Health and Social Care (DHSC) announced that this year a broader group of patients will be offered free NHS flu jab. The updated criteria for this year will include the following patients/group of people (DHSC, 2020):

  • People who live in the same household as those who are on the NHS Shielded patient list, for example, people with severe respiratory conditions such as severe asthma, severe chronic obstructive pulmonary disease (COPD) and as cystic fibrosis. 
  • Children of school Year 7 age in secondary schools (those aged 11 on 31 August 2020). Community pharmacists do not vaccinate this group. 
  • Social and health care workers employed through a Direct Payment or Personal Health Budgets, for example, personal assistants who deliver care to patients 
  • DHSC also plans to extend the flu vaccination programme in November and December to those who are 50-64 years of age (phased out extension) if vaccinations are in stock. I would not rely on this extension as demand for flu vaccinations is expected to be very high, with intermediate out of stock situations to be expected as with previous years

 5. ‘At risk’ patient groups eligible for free NHS flu jab

The following patient groups (age: six months to 65) are defined as ‘at risk’ and therefore are offered free NHS flu jab: 

  • Patients with long term respiratory conditions such as chronic obstructive pulmonary disease (COPD), bronchitis and asthma
  • Chronic kidney disease (stage three or four)
  • Chronic heart disease, for example, heart failure
  • Liver disease
  • Patients with neurological disease, for example, Alzheimer’s disease, Parkinson’s disease
  • Patients with a learning disability 
  • Diabetic patients
  • Patients with splenic dysfunction or asplenia
  • Patients with compromised (a weakened) immune system due to drug treatment (cancer treatment for example) or due to disease, for example, AIDS (acquired immune deficiency syndrome) / HIV
  • Patients who are obese, with a BMI of 40 and over 
  • Pregnant women 
  • People who live with patients who are on NHS Shielded patient list for example with a patient with a weakened immune system
  • Patients who live in residential homes (long-stay)
  • People who receive carer’s allowance or people who are a carer of an older or disabled person
  • Social and health care staff who are an employee of care/nursing home and involved in the care of vulnerable patients
  • Employees of health and care staff in voluntary hospice and engaged in the care of vulnerable patients
  • Social and health care workers employed through a Direct Payment or Personal Health Budgets, for example, personal assistants who deliver care to patients

 6. What flu jabs will be offered in flu season 2020/2021

The following flu vaccinations will be offered in flu season 2020/2021 (DHSC, 2020):

  • QIVc: Injectable inactivated quadrivalent vaccine cultured on mammalian cellsQIVe: Injectable quadrivalent inactivated vaccine cultured on egg
  • aTIV: Adjuvanted trivalent inactivated influenza vaccine / Fluad 
  • QIVc: Quadrivalent influenza mammalian cell culture vaccine (QIVc)
Age groupPreferred flu jabAlternative option
At-risk adults (aged 18-64) or pregnantQIVc*QIVe
Patients 65 and overaTIV**QIVc***

*QIVc: This vaccine is preferable in individuals (age 18-64 and pregnant) due to clinical and cost-effectiveness (NHS England, 2019).

**aTIV vaccination is preferred in patients 65 and over as it is considered to be more effective in this group of patients as non-adjuvanted trivalent and egg-based quadrivalent influenza vaccines (QIVe)

***QIVc can only be offered to patients 65 and over when aTIV vaccine is not available. 

7. How much will flu jab cost? (private service)

As with previous years, a large proportion of patients will be offered free NHS flu jab. Patients who do not qualify for one (patient who are not ‘at risk’ or adults 18-64 and not pregnant) have the option of getting a flu jab privately. The prices for private flu jabs 2020/2021 service are as follows: 

Pharmacy chainFlu season 2020/2021Flu season 2019/2020
Tesco Pharmacy£9£9
Boots Pharmacy£13.99£12.99
Asda Pharmacy£8£7
Lloyds Pharmacy£12.99£11.50
Well Pharmacy£12.50£10
Superdrug Pharmacy£12.99£9.99

8. What is the cheapest flu jab in 2020?

Historically Asda Pharmacy offered the cheapest flu jab out of all UK pharmacies. It looks like this year will be the same, with the current price for private flu jab service standing at £8. Tesco Pharmacy is not far off with private flu jab service set at £9.

The cheapest flu jab in the UK

9. What is the COVID impact on the delivery of flu vaccination service?

Several measures are already in place to ensure safe and COID-proof delivery of flu vaccination service. Patients and pharmacist who deliver this service will be expected to wear personal protective equipment such as face masks. Additionally, many recommendations are considered, some of which will be implemented by community pharmacies this year, for example: 

  • Flu vaccinations delivered by appointment to minimise waiting times and to ensure social distancing is in place 
  • Providing advanced advice/information (expectations) to patients about their flu jab appointment 
  • Optional home visits to those on the Shielded Patient List 
  • Extended infection control procedures

10. Where to book flu jab online?

This year patients are more likely to see the delivery of flu jab service ‘by appointment’ (to minimise waiting times and maintain social distancing), for example, Tesco Pharmacy will be introducing an online booking system this year.

The same booking system is usually used for booking free NHS flu jab and a private flu jab. Flu jabs can be book/pre-booked on the individual pharmacy websites:

Tesco Pharmacy online flu jab booking website

  • Customers will be able to book Tesco flu jab online at: https://tesco-pharmacy.qudini.com or https://www.tesco.com/pharmacy only from 01/09/2020
  • Patients will be able to book an appointment 3 weeks in advance. Customers who are planning to book an appointment on 01/09/2020 will be able to book flu jab 3 weeks in advance on 21/09/2020 earliest.
  • Tesco flu jab service will commence on 21/09/2020
  • All patients including walk-in patients will be required to book an appointment via the website. Tesco pharmacy staff may be able to book on patients behalf e.g. for walk-in patients or patients who try to book an appointment over the phone).
  • Service provided by most Tesco Pharmacies
  • Most Tesco Pharmacies are open 7 days a week with extended opening hours

Boots Pharmacy online flu jab booking website

  •  Winter Flu Jab Service
  • service provided by most Boots pharmacies in the UK
  • flexible booking: choose time and place (the closest pharmacy)
  • private flu vaccination service for patients aged 16 and over (vaccination by injection)
  • private flu vaccination service for children aged 12 to 15 is available in selected stores only

Lloyds Pharmacy Flu Vaccination service

  • Winter Flu Jab Service open for pre-booking
  • service offered to patients 18 years and over
  • flu jab service to commence on 14th of September

Well Pharmacy Flu Jab booking website

  • Well Pharmacy Flu Jab booking online
  • the online booking system allows booking flu jab service only in some pharmacies, however, the system is being rolled out
  • service to start on 1st of October

Superdrug Pharmacy Flu Jab service

  • Superdrug offers walk-in vaccination service or
  • patients can book a flu jab service by calling 03333 111 007

11. Is flu jab out of stock?

At this point, no information is available on flu jab stock availability. This post will be updated throughout flu season 2020/2021. As with previous years, it is expected that flu vaccinations will be intermediately out of stock; however, one cannot predict how COVID is going to affect the demand for this service. 

12. Flu vaccine 2020/2021 strains

WHO recommendations for the composition of flu vaccine in flu season 2020/2021 are as follows (WHO, 2020):

Quadrivalent vaccines (QIV) recommendations

Egg-based Vaccines

  • an A/Guangdong-Maonan/SWL1536/2019 (H1N1)pdm09-like virus;
  • an A/Hong Kong/2671/2019 (H3N2)-like virus;
  • a B/Washington/02/2019 (B/Victoria lineage)-like virus; and
  • a B/Phuket/3073/2013 (B/Yamagata lineage)-like virus.

Cell- or recombinant-based Vaccines

  • an A/Hawaii/70/2019 (H1N1)pdm09-like virus;
  • an A/Hong Kong/45/2019 (H3N2)-like virus;
  • a B/Washington/02/2019 (B/Victoria lineage)-like virus; and
  • a B/Phuket/3073/2013 (B/Yamagata lineage)-like virus.

Trivalent influenza vaccines recommendations

Egg-based Vaccines

  • an A/Guangdong-Maonan/SWL1536/2019 (H1N1)pdm09-like virus;
  • an A/Hong Kong/2671/2019 (H3N2)-like virus; and
  • a B/Washington/02/2019 (B/Victoria lineage)-like virus.

Cell- or recombinant-based Vaccines

  • an A/Hawaii/70/2019 (H1N1)pdm09-like virus;
  • an A/Hong Kong/45/2019 (H3N2)-like virus; and
  • a B/Washington/02/2019 (B/Victoria lineage)-like virus.

Flu season 2020/2021: FAQ

What months is flu season 2020?

Officially, flu season 2020 starts at the beginning of September on 01/09/2020 and runs until 31/03/2021, however, flu jab stock availability normally affects the start of the vaccination programme.

When did flu season end 2020?

Flu season 2019/2020 ended on 31/03/2020.

References:

DHSC (2020). The national flu immunisation programme 2020 to 2021- update. Available at: https://www.england.nhs.uk/wp-content/uploads/2020/05/national-flu-immunisation-programme-2020-2021.pdf Accessed on 07/08/2020

NHS England (2019). Update on vaccines for 2019/20 seasonal flu vaccination programme. Available at: https://www.england.nhs.uk/wp-content/uploads/2019/01/vaccines-for-19-20-seasonal-flu-vaccination-programme.pdf Accessed on 13/06/2019

WHO (2020). Recommended composition of influenza virus vaccines for use in the 2020 – 2021 northern hemisphere influenza season. Available at: https://www.who.int/influenza/vaccines/virus/recommendations/2020-21_north/en/ Accessed on 08/08/2020

I am a community pharmacist working in UK. I blog about drugs, health and pharmacy.

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