This section covers those eligible for NHS flu vaccination in 2025, information on vaccinating patients on anticoagulants and contradications for the flu vaccination.

Eligible Patients 2025/2026

Eligible from 1st September 2025

• Pregnant women
• All children aged 2 or 3 years on 31st August 2025
• School age children (Reception to Year 11)
• All children aged 6 monhts to under 18 years in clinical risk groups

Eligible from October 2025 (Exact date to be confirmed by the NHS)

• Adults aged 65 years and over
• Adults aged 18 to under 65 in clinical risk grousp (as defined by the Green Book, chapter 19)
• Residents of long-stay residential care homes
• Carers in receipt of carer's allowance or those who are the main carer of an elderly or disabled person
• Close contacts of immunocompromised individuals
• Frontline social care workers without employer-led occupational health schemes including: 
  
  • Staff in residential care or nursing homes
  • Staff working for registered domiciliary care providers
  • Volunteers in managed hospice services
  • Personal Assistants funded therough Direct Payments or Personal Health Budgets
• Healthcare Workers:
  • All frontline healthcare workers (clinical and non-clinical) who have patient contact
  • Vaccination should be employer-provided as part of infection prevention
  • Employers are responsible for offering, encouraging, and monitoring uptake
• Additional Notes:
  • Social care workers directly working with clinically vulnerable individuals should be vaccinated by their employer
  • In cases where staff don't have acces to occupational health schemes, they may access the vaccine free through the NHS

Vaccinating Patients on Anticoagulants

According to The Green Book, there is no strong evidence that subcutaneous (SC) administration is safer than the intramuscular (IM) route for individuals on anticoagulants. In fact, SC administration may lead to increased local reactions.

Where a vaccine is licensed for both routes, SC administration is acceptable. However, if the vaccine is only licensed for IM use, it should not be given subcutaneously.

Clinical Guidance:

• Individuals on stable anticoagulation therapy (e.g. warfarin, with up-to-date INR testing and INR within range) can safely receive IM vaccination. When in doubt, contact the responsible clinician.
• Those with bleeding disorders may also receive IM vaccines, if deemed safe by a clinician familiar with their condition.
• If the individual receives bleeding risk reduction treatment (e.g. for haemophilia), vaccination should be timed soon after treatment.

Administration tip: Use a fine needle (23 or 25 gauge) and apply form pressure (without rubbing) to the injection site for at least 2 minutes post injection.

Contraindications

There are very few individuals for whom the inactivated flu vaccine is contraindicated. If there is any uncertainly, advice should be sought from an appropriate specialist, such as a physician or a consultant in health protection.

Vaccines should not be given to individuals who have had:

• A confirmed anaphylactic reaction to a previous dose of the vaccine.
• A confirmed anaphylactic reaction to any component of the vaccine.

For individuals with egg allergy:

• Egg free or low-ovalbumin content vaccines are available
• Flucelvax® is an egg-free vaccine
• The JCVI advises that most children with egg allergy can safely receive Fluenz (LAIV).

Fluenz must not be given to children with a history of severe anaphylaxis requiring intensive care.

Temporary Contraindications to Live Vacccines

Live vaccins may be temporarily contraindicated in individuals who are:

• Pregnant
• Immunosuppressed, due to treatment or underlying condition (e.g. chemotherapy, high-dose systemic steroids, HIV)
• Children and adolescents on salicylate therapy