The national COVID-19 vaccination programme autumn 2026 (WHC/2026/009)

Issue date: 

1 July 2026

Status: 

Compliance / Action

Category: 

Public Health

Title: 

The National COVID-19 Vaccination Programme Autumn 2026

Date of Expiry / Review: 

N/A

Action by:                      

• Chief Executives, Health Boards and Trusts
• Immunisation Leads, Health Boards and Trusts 
• Immunisation Coordinators, Health Boards
• Vaccination Operational Leads, Health Boards and Trusts
• Medical Directors, Health Boards and Trusts
• Directors of Primary Care, Health Boards and Trusts
• Nurse Executive Directors, Health Boards and Trusts
• Directors of Therapies and Health Sciences, Health Boards and Trusts
• Chief Pharmacists, Health Boards and Trusts
• Directors of Public Health, Health Boards and 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

This Welsh Health Circular is published to provide detailed guidance for the COVID-19 vaccination programme in autumn 2026 (the National COVID-19 Vaccination Programme Autumn 2026).

The detailed guidance on the COVID-19 vaccination programme follows.

The programme will commence as soon as vaccines and the relevant legal authority (Vaccine Group Direction and Patient Group Direction) are available in October 2026 and concludes on 31 January 2027.

The expectation is that all eligible people should receive a vaccination appointment and these appointments should be scheduled to take place by 31 December 2026. This should be closely monitored by Health Boards from the start of the programme. Where necessary Health Boards must intervene early to ensure the 31 December 2026 expectation is met. ‘Mop up’ activity, including recall and follow-up opportunities, can start as early as required to meet local needs where the first offer of vaccination is not taken up. 

The overall Welsh Government uptake target across all eligible groups remains 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. Where existing uptake is below 75% Health Boards are expected to demonstrate improved delivery and a meaningful and significant increase in vaccination uptake compared to last year across all eligible cohorts. Targets for improved uptake should be justified in Health Board plans. The planning of the campaign in each Health Board area should involve coordination between all providers to achieve high levels of coverage by 31 December 2026. This is crucial to realise the key clinical impacts amongst the target population and optimise protection during winter months. 

Inequities in vaccine uptake persist and 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 2025 to 2026, the overall gap in uptake was 19.6% between the most deprived (51.4%) and least deprived (71.1%) communities. Similar patterns were observed within specific cohorts last autumn/winter: uptake in people aged 6 months and over who are immunosuppressed was 36.7% in the most deprived areas compared to 59.0% in the least deprived areas; in adults aged 75 years and over uptake was 57.0% in the most deprived areas compared with 74.5% in the least deprived areas. These findings underline the need for continued and targeted action by Health Boards to reduce disparities and improve access for people living in more deprived communities. Health Boards are expected to evidence interventions adopted to achieve this and to decrease the gap in vaccine uptake between the most and least deprived communities during autumn and winter 2026 to 2027.   

Our continued aim is to ensure that every eligible person in Wales can access a COVID-19 vaccination as easily as possible.  This is crucial if we are to drive improvement in vaccine uptake, safeguard the health of our population, and help prevent serious illness. Every effort should be made to ensure taking up a vaccination offer is as accessible as possible. Health Boards must plan and deliver or commission the campaign in a way that minimises patient burden (including travel burden). Those living in our most underserved communities, older people, people from ethnic minority backgrounds, those living with disabilities and people who are experiencing homelessness, must be given fair and equitable opportunity to benefit from COVID-19 vaccination.  Health Boards must provide clear information on the vaccine and ensure local arrangements are in place with a time and venue to receive vaccination.  

We expect early remedial action to be taken where improvements are not being achieved and where vaccine uptake trajectories are below expectations. As soon as variance from planned trajectory has been identified, Health Boards should immediately commence intervention activities aimed at recovering uptake trajectories, in parallel with primary care contractor activity. Health Boards should routinely signpost the vaccination offer and ensure that opportunities to administer vaccinations alongside other patient activity, including out-patient clinics, are explored and used wherever possible. 

The vaccine products to be used in the autumn 2026 programme will be set out in COVID-19: the green book chapter alongside clinical advice on their use. 

The eligible cohorts for autumn 2026 are:

• adults aged 75 years and over on 31 January 2027
• 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 COVID-19: the green book chapter)

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: Green Book chapter.

The Primary Care (Contracted Services: Immunisations) (COVID-19) (Wales) Directions 2026 set out a template specification to be used with primary care providers (currently GMS and community pharmacy) when engaging those providers to provide COVID-19 vaccination services.

All those who are eligible must be invited to be vaccinated as a condition of delivery under the relevant directions. Health Boards and those they commission should use a proactive approach, adopting robust, verifiable call and reminder systems aimed at maximising uptake. 

Every opportunity for co-administration of COVID-19 and influenza vaccines should be maximised by Health Boards and primary care providers.  Where the COVID-19 and the influenza vaccines are being delivered by the same provider they can be co-administered to patients who are eligible for both. 

Vaccinators should also consider opportunities to review the vaccination record of eligible individuals presenting for COVID-19 vaccination and identify any additional opportunities to deliver outstanding vaccinations (including, for instance, respiratory syncytial virus (RSV), shingles or pneumococcal) or to signpost to a relevant provider for vaccination.  Providers should note for reference that, in line with advice in the Green Book, RSV and influenza vaccines should not routinely be co-administered to eligible older adults.

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 further offers if an initial appointment is not taken up. Offering follow-up appointments via direct telephone contact with patients is especially encouraged.  Where the initial appointment offer is actively declined there is no requirement to issue two follow-up appointment offers. 

All COVID-19 vaccines administered to eligible people during the autumn 2026 programme must be digitally recorded in the Welsh Immunisation System (WIS).  This should be while, or as soon as possible after, the vaccination is given and, at the latest, by the end of the working day on the day that the vaccine is administered.

A template Patient Group Direction (PGD), for use with eligible children aged under 5 (for example, those aged 6 months to 4 years) will be available before the start of the programme.  The PGD should be reviewed, ratified and authorised locally by the Health Board/trust for local use. 

A ratified Vaccine Group Direction (VGD), for use with eligible children and adults aged 5 years and older, will also be available prior to the programme starting. This must be authorised by the Health Board or trust for local use. 

Please see the relevant pages of the Welsh Medicines Advice Service website for more information on PGDs and VGDs.

Public Health Wales will lead a national immunisation communications and marketing campaign in the autumn.  This campaign will focus on influenza and will include relevant information on COVID-19 vaccination where applicable. Vaccination information will be available at:

• Immunisation and Vaccines – Public Health Wales
• Imiwneiddio a Brechlynnau - Iechyd Cyhoeddus Cymru

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 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).

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 Secure Anonymised Information Linkage (SAIL) 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.

Updated campaign materials and training resources for healthcare professionals, to support the delivery of the autumn 2026 COVID-19 programme, will be available on VPDP’s webpage:

• Resources for health and social care professionals - Public Health Wales
• Adnoddau i weithwyr proffesiynol iechyd a gofal cymdeithasol - Iechyd Cyhoeddus Cymru

Public resources for the programme, including bilingual posters and patient information leaflets and accessible COVID-19 specific resources, will be available to order from Public Health Wales:

• Health Information Resources – Public Health Wales
• Adnoddau gwybodaeth iechyd - Iechyd Cyhoeddus Cymru

Detailed clinical guidance on  COVID-19 vaccination is contained in COVID-19: the green book chapter.

Vaccination against COVID-19 remains an important public health intervention and I thank you for your continuing support in delivering this programme.

Yours sincerely,

Dr Keith Reid

Deputy Chief Medical Officer (Public Health)