Winter respiratory vaccination strategy update: 21 March 2023

Our winter respiratory vaccination strategy sets out our plans for an integrated vaccination programme. It details how we will offer both the flu and COVID-19 booster vaccines to eligible individuals this year.

Our 3 main priorities for our winter respiratory vaccination programme are:

• protecting those at greatest risk
• protecting children and young people
• ensuring that nobody is left behind by continuing to offer the initial course of the COVID-19 vaccine

The winter respiratory vaccination programme (WRVP) commenced on 1 September 2022. It brings together the COVID-19 and flu vaccination programmes. This winter’s programme is now in its final phase as we move towards spring. An announcement has been made on the ending of the original, universal offer of a primary course and booster to everyone aged over 5. More information and further details are available in the ministerial statement. The minister has announced there will be a COVID-19 vaccination spring booster programme. Those eligible will receive an offer of a vaccination appointment from 1 April 2023.

Protecting those at greatest risk

Vaccination for the COVID eligible groups started on 1 September. The programme began vaccinating:

• residents and staff working in care homes for older adults
• individuals who are housebound
• frontline health and social care workers 

All individuals eligible for a COVID-19 booster vaccination should now have received their vaccination offer. If you are eligible but have not received your invite, please contact your local health board as soon as you can. All health boards are now operating walk-in clinics. You can find out more information on your health board’s website.

The Joint Committee on Vaccination and Immunisation (JCVI) has identified these groups as eligible for a booster:

• all adults aged 50 years and over
• persons aged 5 to 49 years in a clinical risk group, as set out in the Green Book (gov.uk)
• persons aged 5 to 49 years who are household contacts of people with immunosuppression, as defined in the Green Book (gov.uk)
• persons aged 16-49 who are carers

All individuals eligible for flu vaccination, which includes everyone over 50, should now have had an opportunity to receive their vaccination. If you are eligible but have not yet had your vaccine, please find out more about how you can access vaccination in your area of Wales. All health boards are now operating flexible options, with ‘walk-in’ arrangements in some places across Wales, including for children to receive their flu nasal spray.

Protecting children and young people

The following are eligible for the flu vaccination this year:

• children aged 2 and 3 years
• children in primary school from reception class to Year 6 
• children and young people in secondary school Year 7 to Year 11
• people aged 6 months to 49 years in a clinical risk group as set out in the Welsh Health Circular on flu

Parents or guardians will be asked to give consent. We encourage parents, guardians, children and young people to discuss together whether or not to have the vaccination. Factual information is available on the Public Health Wales website to help make this decision.

Most children and young people will get their COVID-19 vaccine at a vaccination centre. Some areas will also be offering the vaccine through special schools. Vaccine roll-out will be informed by local knowledge and may change depending on circumstances.

Health boards will mainly use school nursing services to deliver the children’s nasal flu spray vaccine. Follow up sessions and the use of GPs will also be part of the vaccination deployment model. To ensure vaccine uptake is maximised this year, particularly in the context of the recent high levels of respiratory illnesses circulating in the community and other viruses, such as scarlet fever and streptococcus A (strep A), ‘walk in’ options are now available to provide greater flexibility for families and ensure levels of protection are maximised.

Nobody left behind

Vaccine equity remains a key principle of Wales’ vaccination programme. The ‘nobody left behind’ principle, embedded into our vaccination strategy, is built on the premise that everyone should have fair access and fair opportunity to take up the offer of a vaccination.

Following advice from the JCVI, we have announced the offer of the universal booster (third) dose, offered from autumn 2021 to all the population aged over 5, will cease on 31 March 2023. The offer of the initial two dose universal primary course of vaccine, that was offered from December 2020 to all the population aged over 5, will cease on 30 June 2023.

This does not signal a closure of the COVID-19 vaccination programme; we expect COVID-19 vaccination to continue to be a feature of our vaccination programme in Wales. People who develop a new health condition that places them in a clinical risk group, who haven’t yet had their primary course and/or booster dose, will still be able to be vaccinated during the next campaign window or sooner on the advice of a clinician.  

Additionally, as previously announced, people at higher risk (as determined by the JCVI) will be offered an additional booster in autumn 2023 and planning is also currently underway for a possible spring 2023 booster programme, subject to advice shortly on this from the JCVI.

The vaccine continues to be the best way to prevent serious illness and the spread of COVID-19 and everyone eligible who has not yet had their primary course or their original 2021 booster dose is urged to come forward before these universal offers end.

Health Boards are continuing to work in partnership with wider stakeholder groups and key partners with a view to maximising uptake of these universal offers and going forward during future campaigns.

The National Immunisation Framework describes vaccination equity as being at the core of service design and delivery. The Framework outlines key actions to make this a reality for all vaccination programmes.

In line with our strategy, all eligible individuals were issued with an invitation to receive a COVID-19 vaccine by 30 November and an opportunity to receive their flu vaccine by 31 December. We are now in the ‘nobody left behind’ phase of the programme with health boards seeking to maximise uptake through a continuing offer, via walk-in clinics.  

Since commencement of the winter respiratory vaccination programme on 1 September:

• 1,152,736 COVID-19 boosters have been given (as at 20 March 2023)
• 15,696 COVID-19 boosters have been given to staff working in care homes (as at 20 March 2023)
• 11,498 COVID-19 boosters have been given to care home residents (as at 20 March 2023)
• 38,329 COVID-19 boosters have been given to people who are severely immunosuppressed (as at 20 March 2023)

The summary of flu uptake published by Public Health Wales on 16 March 2023 notes the following uptake levels, which are broadly in line with previous years at this point in the campaign:

• 76.2% of 65 years and older
• 44.1% of those at risk aged 6 months to 64 years
• 44.1% of children aged 2 and 3 years
• 45.2% of NHS staff

Community pharmacies are offering flu vaccinations to care home staff across North Wales

Care home staff are a priority group eligible for flu vaccination. Betsi Cadwaladr University Health Board held almost 120 flu vaccination sessions in care homes this year. This increased the opportunities for care home staff to secure flu vaccination. A community pharmacist also answered any staff questions or concerns about their vaccination.  

The approach pairs a community pharmacist with care homes in their area. The pharmacist vaccinates staff at a shift change or other mutually convenient time. Pharmacists have often returned to care home venues many times. This maximises uptake of flu vaccination amongst this key group.

This flu season is the third year that this model has been in operation. There was a very successful campaign last year and a pilot scheme in 2020 to 2021. 

The staff vaccinated gave very positive feedback on the value of the flu vaccine.  They reported how easy and convenient it is to secure their vaccination as part of this approach. 

The health board continues to work with care home operators and managers to promote vaccination for their staff, which helps protect individuals and the vulnerable people they care for.

Public Health Wales has FAQs about the vaccines and safety. They also publish regular surveillance data releases.

Read a range of information on our vaccination programme, including how to get your vaccination.