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Welsh Health Circular

Issue date: 11 December 2023                  

Status: Action

Category: Public health

Title: Influenza (flu) vaccination programme deployment ‘mop up’ 2023 to 2024

Date of expiry / review: not applicable

For action by:

Chief Executives, Health Boards/Trusts

Immunisation Leads, Health Boards/Trusts

Immunisation Coordinators, Health Boards

Flu Leads, Trusts

Medical Directors, Health Boards/Trusts

Directors of Primary Care, Health Boards/Trusts

Nurse Executive Directors, Health Boards/Trusts

Executive Directors Therapies and Health Science

Chief Pharmacists, Health Boards/Trusts

Directors of Public Health, Health Boards/Trusts

Executive Director of Public Health, Public Health Wales

Head Vaccine Preventable Disease Programme, Public Health Wales

Director of Planning, Vaccination Programme Wales, NHS Wales Executive

General Practitioner Council, Wales

General Practitioners

Vaccination Programme Wales, NHS Wales Executive

Community Pharmacy Wales

Community Pharmacists(List those who should take action)

Sender: Chief Medical Officer for Wales 

HSSG Welsh Government Contact(s): Health Protection Services, Department for Public Health, Welsh Government, Cathays Park, Cardiff, CF10 3NQ


Dear Colleagues,

Influenza (flu) vaccination remains one of the most effective public health interventions to protect people against infection and reduce pressure on health and social care services over the busy winter period.

I am therefore concerned that vaccine uptake in the current programme is below the Welsh Government target of 75% across all eligible adult groups. Unless we take steps to address this, there is the potential for this to have significant consequences for the health of people at higher risk from COVID-19 and flu and for our health and social care services later in what we’re all expecting to be a challenging winter. It is imperative that we take action.

Consequently, as I did last year, I am asking health boards to support Primary Care services with targeted flu ‘mop up’ work from January 2024. This action aims to maximise uptake in all adult groups, particularly those in a clinical risk group. I hope that additional health board support alongside ongoing planned GP and Community Pharmacy flu vaccination, will help boost uptake whilst relieving pressure on Primary Care services during this challenging period.

I would like health boards, working in collaboration with GMS and Community Pharmacy Primary Care teams, to draw up plans on how the flu vaccination ‘mop-up’ exercise will operate, alongside the delivery of COVID-19 vaccination, which is already moving to a walk-in model. These plans, once finalised, should be shared with Vaccination Programme Wales. Health boards will also need to communicate a clear message to their local populations as to how, when and where individuals are able to access flu, alongside COVID-19 vaccination in their area. PHW are finalising national marketing materials to support local communications and engagement plans.

In particular, I would like health boards to engage directly with the 25% of GP practices which currently have the lowest flu vaccine uptake in their areas, to support them in every way possible to offer vaccination to their eligible patient cohorts.


As no additional supply of adult flu vaccine has been procured by Welsh Government this year, health boards should make the necessary arrangements to utilise surplus stock held in Primary Care (GMS and Community pharmacy) and in their own organization, to support this mop-up exercise. Supply for the children’s flu vaccination programme (LAIV) should be ordered in the normal way via Immform.

Vaccination data flow between health boards and GPs

As was the case last year, I am aware the timely write-back of vaccinations recorded in the Welsh Immunisation System (WIS) to GP systems will not be possible for this mop-up exercise. Instead, a weekly summary of administered vaccinations will be provided by health boards to the registered GPs of vaccinated individuals, which I recognise will require administrative work within practices. That work is, of course, very similar to that already required when recording flu vaccinations given in Community Pharmacy. There will, however, be a clinical record of the vaccination having been administered in WIS & CYPRIS. Health boards and General Practice are asked to work in partnership to manage this additional administration, which for individual practices is not expected to be significant.

The following systems would be used by health board teams for recording the vaccination in the first instance:

  • anyone aged 16 and over – on WIS
  • anyone aged 4 to 15 – on CYPRIS
  • anyone aged 2 and 3 – on CYPRIS

Due to multiple data systems in use to record influenza vaccinations, every effort should be made to check an individual’s previous vaccination history prior to vaccine administration, to reduce the risk of an individual being double vaccinated.

May I thank you again for your continued support in delivering the Winter Respiratory Vaccination Programme, which continues to help protect our citizens from potentially serious vaccine preventable diseases.

Yours sincerely,

Dr Frank Atherton
Chief Medical Officer / Medical Director NHS Wales