Which patients in my practice are eligible for seasonal influenza vaccination, and how should I prioritise clinical risk groups this winter?

For England for the coming 2026/27 winter season:

Who is eligible

Your practice should offer seasonal influenza vaccine to:

• All children aged 2 or 3 years on 31 August 2026
• Primary school and secondary school-aged children (Reception to Year 11; with SEN-school nuances)
• Pregnant women from 1 September
• All children aged 6 months to <18 years in a clinical risk group
• Adults aged 18 years to <65 years in a clinical risk group from 1 October
• Everyone aged 65 years and over
• Residents in long-stay residential care homes / other long-stay care facilities
• Carers (carer’s allowance or the main carer of an older/disabled person)
• Close contacts of immunocompromised people
• Frontline health and social care workers (occupational offer, not usually through GP call/recall)
• People experiencing homelessness [1][2]

Clinical risk groups to prioritise

The Green Book says the list is not exhaustive and you should use clinical judgement; the main risk groups are:

• Chronic respiratory disease — especially COPD, bronchiectasis, cystic fibrosis, interstitial lung disease; asthma requiring repeated/continuous steroids or with prior hospital admission
• Chronic heart disease / vascular disease
• Chronic kidney disease (stage 3–5, kidney failure, nephrotic syndrome, transplant)
• Chronic liver disease
• Chronic neurological disease where respiratory function may be compromised, and other significant neurological disability
• Diabetes and adrenal insufficiency
• Immunosuppression due to disease or treatment
• Asplenia / splenic dysfunction
• Morbid obesity (BMI ≥40 kg/m²) [2]

Practical prioritisation this winter

There is no formal hierarchy within the clinical risk groups, but if you need to prioritise because of capacity/supply, I’d do it like this:

1. Pregnant women and children as soon as vaccine is available (September)
2. Care home residents / housebound frail patients
3. Severely immunosuppressed patients, transplant recipients, haematological malignancy, high-dose systemic steroids
4. Significant chronic cardio-respiratory / renal / liver / neurological disease
5. Other risk groups: diabetes, asplenia, BMI ≥40, carers, close contacts of immunocompromised patients, homelessness [1][2]

Operationally

• Invite from September for pregnant women and the children’s programme.
• Start adult call/recall from 1 October.
• Aim to complete most adult vaccination by end November.
• Use every clinical contact to identify eligible patients. [1][3]