The national COVID-19 vaccination programme autumn 2025 (WHC/2025/022)

Issue date:

26 June 2025.

Status:

Compliance / action.

Category:

Public health.

Title:

The national COVID-19 vaccination programme autumn 2025.

Date of expiry / review:

Non-applicable.

Required by:

Non-applicable.

Action by:

• Chief executives, health boards / trusts.
• Immunisation leads, health boards / trusts.
• Immunisation coordinators, health boards.
• Vaccination operational leads, health boards / trusts.
• Medical directors, health boards / trusts.
• Directors of primary care, health boards / trusts.
• Nurse executive directors, health boards / trusts.
• Directors of therapies and health sciences, health boards / trusts.
• Chief pharmacists, health boards / trusts.
• Directors of public health, health boards / trusts.
• Directors of maternity services, health boards.
• Directors of workforce and organisational development, health boards / trusts.
• Executive Director of Public Health, Public Health Wales.
• Nurse Director, Public Health Wales.
• Head of Vaccine Preventable Disease Programme, Public Health Wales.
• Director of Vaccine Delivery, Vaccination Programme Wales.
• General practitioners.
• Community pharmacists.
• Digital Health and Care Wales.

For information to:

• Welsh NHS Partnership Forum.
• General Practitioner Council, Wales.
• Royal College of GPs.
• Royal College of Nursing.
• Royal College of Midwives.
• Royal College of Paediatrics and Child Health.
• British Dental Association.
• Royal Pharmaceutical Society.
• Community Pharmacy Wales.
• Care Inspectorate Wales.
• Chief Executive, Welsh Local Government Association for onward issue to:
  • directors of social services, local authorities.
  • directors of public protection, local authorities.
  • directors of education, local authorities.
  • Social Care Wales.
  • Health Education and Improvement Wales.

Sender:

Dr Keith Reid, Deputy Chief Medical Officer (Public Health).

Welsh Government contacts:

Vaccination Division,
Welsh Government,
Cathays Park,
Cardiff.
CF10 3NQ.
Email: wg.vaccinationsprogrammeteam@gov.wales

Enclosures:

None.

Dear colleagues

This Welsh health circular is being published to provide detailed guidance for the COVID-19 vaccination programme for the coming autumn 2025 (national COVID-19 vaccination programme autumn 2025).

There are important changes from the way that the programme operated in autumn 2024.

1. The flu and COVID-19 vaccination programmes will no longer be treated as a single winter respiratory vaccination programme. Although opportunities for co-administration of these vaccines should continue to be maximised, they will be run as two programmes. Details of the autumn 2025 flu vaccination programme are included in WHC/2025/020.
2. In line with the advice of the Joint Committee on Vaccination and Immunisation, eligibility for the national COVID-19 vaccination programme autumn 2025 will be narrower than in previous autumn and winter campaigns, focussing only on those most vulnerable to the disease. Eligibility will now replicate the cohorts previously eligible under the 2025 spring vaccination programme (that is only those aged 75 years and older, those who are immunosuppressed and those who reside in care homes for older adults).

The detailed guidance on the COVID-19 vaccination programme is as follows:

Programme start and end dates

The programme will commence on 1 October 2025 and conclude on 31 January 2026.

Health boards should actively issue first appointment invitations to all eligible people to receive a vaccination as early as possible in the programme but by no later than 31 December. ‘Mop up’ activity, including recall and follow-up opportunities where the first offer of vaccination is not taken up, can start as early as required to meet local needs but should aim to conclude as early as possible in 2026.

Programme ambitions: maximising uptake and ensuring equity

The Welsh Government uptake target across all eligible groups remains at 75%. We expect local systems to develop robust delivery plans and monitor progress closely to achieve high levels of coverage as early as possible in the programme. We also expect early remedial action to be taken where trajectories are not being achieved. Planning by health boards should be focussed on achieving high levels of coverage by mid-December.

Uptake rates for all cohorts have fallen on average during recent campaigns. This is especially stark in the immunosuppressed group where uptake was under 24% at the close of last winter’s campaign. This trend must be reversed if we are to achieve the key clinical impacts and optimise protection during winter months. Our expectations are that all cohorts should be on a trajectory towards achieving 75% uptake by the end of the autumn 2025 campaign and that all health boards undertake any actions required to improve uptake rates.

Furthermore, coverage has been noticeably lower among those residing in the most deprived areas compared to those living in the least deprived. In autumn and winter 2024 to 2025, the overall gap in uptake was 24% between the most deprived (33.6%) and least deprived (57.6%). Health boards must act to significantly reduce the current equity gaps.

Our aim is to ensure that every eligible person in Wales can access a COVID-19 vaccination as easily as possible so we can drive improvement in vaccine uptake, safeguard the health of our population, and help prevent serious illness. For older people, the expectation is that health boards provide clear information on the vaccine and ensure local arrangements are in place with a time and venue to receive vaccination. Taking up a vaccination should be as accessible as possible, and health boards should be ambitious in undertaking activity that minimises patient burden (including travel burden) as much as possible.

In areas where vaccine uptake trajectories are below expectations, health boards will be expected to commence intervention activities immediately, alongside continued primary care contractor activity.

Vaccine ordering and supply

For the autumn 2025 COVID-19 programme, the following COVID-19 vaccines are available and advised (please refer to the COVID-19 chapter of the Green Book on gov.uk for more details).

For all individuals aged 18 years and over:

• Pfizer-BioNTech mRNA (Comirnaty) vaccine. Dose: 30 micrograms

For young people aged 12 to 17 years:

• Pfizer-BioNTech mRNA (Comirnaty). Dose: 30 micrograms

For children aged 5 to 11 years:

• Pfizer-BioNTech mRNA (Comirnaty). Dose: 10 micrograms

For children aged 6 months to 4 years:

• Pfizer-BioNTech mRNA (Comirnaty). Dose: 3 micrograms

Eligible cohorts for autumn 2025

The eligible cohorts for autumn 2025 are:

• adults aged 75 years and over on 31 January 2026
• residents in a care home for older adults
• individuals aged 6 months and over who are immunosuppressed (as defined in tables 3 or 4 in the COVID-19 chapter of the Green Book on gov.uk)

The vaccine should usually be offered no earlier than around 6 months after the last vaccine dose. Some operational flexibility around the timing of vaccination is considered appropriate but there should be a minimum interval of 3 months between doses. More information on operational flexibility will be provided in the COVID-19 chapter of the green book.

Service specifications and expectations

The Primary Care (Contracted Services: Immunisation) Directions 2021 set out the legal requirements on health boards for the autumn 2025 COVID-19 programme and set out a template specification to be used with primary care providers (currently General Medical Services (GMS) and community pharmacy) when engaging those providers to provide COVID-19 vaccination services.

Welsh Government expects that all those who are eligible will be invited to be vaccinated. Health boards and those they commission should use a proactive approach, adopting robust, verifiable call and reminder systems aimed at maximising uptake. Where the COVID-19 and the flu vaccines are being delivered by the same provider they can be co-administered to patients who are eligible for both.

To support a robust offer, improve uptake and align with other appointment mechanisms such as those in the outpatient guidance, three appointment offers should be made to an individual; an initial offer and then two more offers if an initial appointment is not taken up. Where the initial appointment offer is actively declined there is no requirement to issue two follow-up appointment offers.

Patient group directions

Patient Group Directions (PGD) links and supporting content will be available prior to the commencement of the season, and should be reviewed, ratified, and authorised locally by the health board/trust for local use. It is currently intended for national protocols to be available before the start of the season to support mixed workforce and flexible delivery models. Please see the relevant pages of the Welsh Medicines Advice Service website for more information.

Communications

Public Health Wales will lead a national immunisation communications and marketing campaign for winter viruses. This campaign will focus on flu vaccination but will include COVID-19 vaccination where applicable. Vaccination information will be available at:

Immunisation and Vaccines – Public Health Wales

Imiwneiddio a Brechlynnau - Iechyd Cyhoeddus Cymru

Surveillance and reporting

Surveillance of vaccination programmes is carried out by the Public Health Wales Vaccine Preventable Disease Programme (VPDP). Surveillance of the COVID-19 programme in those eligible due to age and clinical risk will be carried out using data from the Welsh Immunisation System (WIS).

Uptake will be reported on a weekly basis throughout the programme, with surveillance reports at national level, health board level, local authority level, primary care cluster level and GP level published on the VPDP Sharepoint site (access restricted to NHS).

Summary information at national level and health board level will be published through the Public Health Wales COVID-19 vaccination interactive report (publicly available on Tableau Public).

A mid-programme and end-programme analysis of equality of uptake in COVID-19 vaccination will be carried out by VPDP working with Swansea University SAIL (Secure Anonymised Information Linkage) team, to estimate uptake levels by sex, ethnic group, quintile of deprivation and rural or urban classification.

Public Health Wales VPDP surveillance team will continue to work with other UK nations to carry out surveillance of COVID-19 vaccine effectiveness.

The Green Book

The COVID-19 Chapter of the Green Book on gov.uk contains detailed clinical guidance on COVID-19 and COVID-19 vaccination.

COVID-19 vaccination remains an important public health intervention, and I wish to thank you for your continuing support in delivering this programme.

Yours sincerely,

Dr Keith Reid.
Deputy Chief Medical Officer (Public Health).