Eligible groups in the 2025 to 2026 flu immunisation programme
Further detail on the groups to receive a flu vaccine, with a focus on the children's programme as well as health and social care workers.
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The following provides an updated summary of the groups eligible for flu vaccination in 2025 to 2026.
Children
- Children aged two and three years on 31 August 2025, that is date of birth on or after 1 September 2021 and on or before 31 August 2023; vaccination will generally be offered through GP practice; children of this age must be individually invited by their GP practice.
- All children in primary school reception class and school years 1 to 6 (inclusive).
- All children and young people in secondary school years 7 to 11 (inclusive); for practical reasons, all children attending school in the eligible school years should be offered vaccination irrespective of their actual date of birth.
- Children and young people in the school age ranges above who are educated otherwise than at school should be offered vaccination through their GP practice unless the local health board has made alternative arrangements for them.
- Children between 6 months and two years of age should be offered vaccination in line with the clinical risk eligibility guidance outlined below, and if eligible require a proactive call and recall system.
People aged six months to 64 years in clinical risk groups
- People aged six months to 64 years in clinical risk groups including:
- chronic respiratory disease such as asthma requiring regular inhaled steroids, or chronic obstructive pulmonary disease (COPD)
- chronic heart disease
- chronic kidney disease at stage 3, 4 or 5
- chronic liver disease
- chronic neurological disease such as Parkinson’s disease, motor neurone disease
- learning disability
- severe mental illness
- diabetes
- epilepsy
- immunosuppression due to disease such as HIV/AIDS or treatment such as cancer treatment (and household contacts of at risk individuals)
- asplenia or dysfunction of the spleen
- morbidly obese (class III obesity); this is defined as those with a Body Mass Index (BMI) of 40 or above, aged 16 or over
Household contacts
- Household contacts of immunocompromised individuals, specifically individuals who expect to share living accommodation on most days over the winter and, therefore, for whom continuing close contact is unavoidable.
People aged 65 years and over
- All those reaching the age of 65 by 31 March 2026 (that is born before 1 April 1961).
Pregnant women
- All pregnant women at any stage of pregnancy (first, second or third trimesters) are eligible for the flu vaccine; health boards should ensure through midwifery services and engagement with primary care providers that pregnant women are made aware of their eligibility and encouraged to take up the offer; every effort should be made to make the flu vaccine as easily accessible as possible; vaccination should be recorded in WIS (Welsh Immunisation System), the appropriate local clinical system and should also be recorded within the handheld maternity record.
People living in care homes or other long-stay care facilities
- Vaccination is recommended for people living in care homes or other long stay care facilities where rapid spread is likely to follow introduction of infection and cause high morbidity and mortality:
- this includes adult residential care homes, nursing care homes and children’s hospices
- this does not include young offender institutions, university halls of residence or boarding schools (except those in eligible school years, or eligible due to another factor)
- opportunities for co-administration with the COVID-19 vaccine should be explored where individuals are eligible for both the COVID-19 and flu vaccines
Individuals experiencing homelessness
- Included are those sleeping rough, people in emergency accommodation and people recently homeless in supported accommodation.
Prisoners
- All adults resident in Welsh prisons.
Carers
- Those who are the unpaid carer, including young carers, of a person whose health or welfare may be at risk if the carer falls ill, including those who receive a carer’s allowance. The carer need not reside with, or be related to, the person being cared for.
Third sector carers
- Individuals who work on a voluntary basis (are not paid for their time and effort) providing care on a frequent basis to one or more elderly, disabled or otherwise vulnerable person whose welfare would be at risk if the individual became ill; these individuals should be identified by a letter from their organisation, confirming their name and role in the organisation.
Members of voluntary organisations providing planned emergency first aid
Individuals who work on a voluntary basis (are not paid for their time and effort) in organisations which provide planned emergency first aid at organised public events.
These individuals should be identified by a letter from their organisation, confirming their name, and role in the organisation.
This category does not include individuals who are qualified to provide first aid in other circumstances.
Community first responders
Active members of a Welsh Ambulance Service Trust (WAST) community first responder scheme providing first aid directly to the public.
These individuals should be identified by a letter from their organisation, confirming their name, and role in the organisation.
Healthcare workers (see 'children, and health and social care workers' for more details)
- Healthcare workers (including students, trainees and volunteers) who are in direct contact with patients/clients are eligible to receive a flu vaccine; this should normally be via their employer and actively encouraged and provided or facilitated as part of their occupational health care.
Social care staff (see 'children, and health and social care workers' for more details)
- Individuals (including students, trainees and volunteers) employed in adult residential care homes, nursing care homes and children’s hospices, or providing domiciliary care, who are in regular direct contact with residents/service users, are eligible to receive a flu vaccine; this may be via the community pharmacy flu vaccination service or through an alternative model if agreed locally; uptake of flu vaccination should be actively encouraged and supported/facilitated by their employer.
- Social care staff, apart from those referred to above, should be encouraged, supported and offered/facilitated vaccination by their employer.
Locum GPs
- Locum GPs may be vaccinated at the practice where they are registered as a patient.
Poultry workers
- In relation to premises at which avian influenza is suspected or confirmed, persons resident in Wales aged 16 years or over responsible for:
- catching or culling birds
- cleaning enclosed areas
- collecting carcasses
- Persons resident in Wales aged 16 years and over employed at or regularly visiting registered poultry [footnote 1] units where 50 or more birds are kept, who have direct exposure to faeces/litter through:
- routinely accessing enclosed poultry rearing or egg production areas
- collecting and removing poultry manure or litter from within enclosed poultry rearing or egg production areas or undertaking the final clean down of poultry sheds following their depopulation
- the initial sorting of poultry eggs, if the sorting area is an integral part of the production unit
- catching or culling poultry within enclosed poultry rearing or egg production areas
- Persons resident in Wales aged 16 years or over employed in poultry processing [footnote 2] units that:
- catch and handle live birds
- kill and eviscerate birds
- cleanse and disinfect areas and equipment contaminated by poultry faeces
Vaccinations for poultry workers will only be delivered in community pharmacies. Poultry workers who meet the eligibility criteria should present to their nearest community pharmacy with a confirmation letter they can obtain from their employer.
Others
- The list above is not exhaustive, and practitioners should apply clinical judgement to consider on a case-by-case basis the risk of flu exacerbating any underlying disease that a patient may have, as well as the risk of serious illness from flu itself; flu vaccine should be offered in such cases even if the individual is not in one of the groups specified above.
- Individuals recommended to receive flu vaccine who are long-term hospital in-patients during the flu season should be vaccinated in hospital; health boards and trusts are expected to make suitable arrangements to identify and vaccinate these individuals.
- Clinicians are encouraged to consider the needs of individuals waiting for a transplant; the current recommendations for flu vaccine cover a wide range of chronic diseases and therefore most transplant-list patients are likely to be in a recognised clinical risk group and eligible for immunisation; practitioners should apply clinical judgement to take into account the risk of flu exacerbating any underlying condition a patient may have.
Children, and health and social care workers
Children’s programme
Improving vaccine uptake in children is important for individual protection, and because of the indirect protection this offers to the rest of the population. Children are ‘super spreaders’ of flu and the nasal spray vaccine in this age group has been highly effective. Increasing uptake in eligible children would have a significant impact on reducing transmission of flu across all groups in the community. Ensuring children receive a flu vaccine may also reduce the risk of secondary infection in the event of an outbreak of another winter infection.
Following a downward trend, flu uptake in pre-school children, increased slightly in 2024 to 2025. However, the uptake for this cohort continues to lag behind the uptake seen in school aged children. When the vaccine becomes available, two and three-year-olds (age on 31 August 2025) should be actively called and offered vaccination as soon as possible, to help protect them and to reduce flu transmission in the community to other vulnerable groups.
Evidence shows that services taking the vaccine as close as possible to the eligible cohort is an effective way of maximising uptake and minimising inequity. In some areas of Wales, local agreements are in place to take the vaccine to children aged three years, such as to nursery settings, via the school nursing and health visiting service. These methods have proved effective in securing uptake and is one of the best practice delivery models that should be explored by health boards.
The school programme covers all children from reception class to year 11. All children attending school in the eligible school years should be offered flu vaccination irrespective of their actual date of birth.
An inactivated vaccine may be offered to children whose parents/guardians refuse the LAIV (Live Attenuated Influenza Vaccine) vaccine due to the porcine gelatine content or are otherwise contraindicated for LAIV. Health boards should ensure that a suitable gelatine free pathway is in place to offer equitable access to inactivated vaccine where appropriate and this is communicated to all providers and parents; this could include vaccination in schools.
At-risk children who are eligible for flu vaccination via the school-based programme because of their age will be offered immunisation at school. However, these children are also eligible to receive vaccination in GP practices if the school session is late in the season, parents prefer it, or they miss the session at school.
Health boards should ensure that a suitable pathway is in place for children who do not attend a school setting. This pathway should be communicated to all providers
and parents. This could be done by a domiciliary visit, a direction to the GP or by other appropriate means.
Health and social care workers
It is important that all health and social care workers (including students) with direct patient/client contact have timely flu vaccination to protect themselves and to reduce the risks of transmission of flu viruses to their patients/clients. High rates of staff vaccination help to protect the individual member of staff and, the people in their care and help maintain the workforce and services during the winter. It is vital that flu vaccination is accessible for staff, so that it is as easy as possible for them to get vaccinated during or around their shifts. It is also essential that organisations, and managers within organisations, actively promote and encourage take up of flu vaccination. Every effort should be made to ensure there is a significant improvement in flu vaccine uptake amongst health and social care workers this winter.
It is crucial that the NHS workforce, in particular, recognises the importance of vaccination, and its role in both encouraging and role-modelling take up amongst the wider eligible population. As described in the national immunisation framework, awareness raising training on vaccination is key to this.
As in previous years, flu immunisation should be offered by NHS organisations to all employees involved in direct patient care. An active vaccination offer should be made to 100% of eligible staff.
Independent primary care providers, including GP practices, dental practices, optometry practices and community pharmacies are included in the NHS seasonal influenza vaccination programme. Staff who are involved in supporting the delivery of the NHS services in a patient facing role may be vaccinated at the GP practice where they are registered as a patient. The inclusion of primary care providers is intended to complement, not replace, any established occupational health schemes that employers have in place to offer influenza vaccination to their workforce.
Staff with regular client contact working in adult residential care homes, nursing care homes and children’s hospices and staff providing domiciliary care, will continue to be eligible for free flu vaccination through the seasonal flu vaccination service offered by community pharmacies under the Primary Care (Contracted Services): Immunisation Directions 2025. In relation to those staff:
- care home managers should be encouraged and supported to promote flu vaccine uptake amongst their staff
- community pharmacies that supply medicines to care homes may wish to make arrangements with those homes to offer flu vaccination to staff on the premises; alternatively, staff may be directed to visit any pharmacy providing the PCCS:I (Primary Care Contracted Services: Immunisations) adult influenza programme
In some areas, there may be no local community pharmacy offering the adult flu vaccination service where a more flexible approach and mixed delivery model is more appropriate. In these circumstances, or where there may be other barriers to uptake, health boards should agree an alternative method of delivery and ensure awareness locally. This includes sharing the information proactively with managers to ensure their staff know where to access their vaccines. Health boards are expected to take account of shift patterns and other barriers to vaccination which exist for these workers when developing delivery plans.
Employers providing health and social care in other settings remain responsible for encouraging and facilitating/offering flu vaccination to employees with regular client contact.
Footnotes
[1] Poultry means all birds that are reared or kept in captivity to produce meat or eggs for consumption, the production of other commercial products, for restocking supplies of game or for the purposes of any breeding programme for the production of these categories of birds.
[2] Poultry processing means the business of raising, slaughtering, cleaning, packing, packaging, and related activities associated with producing poultry, including activities conducted by poultry processors at integrated feed mills, hatcheries, and processing plant facilities and the management of those activities.