Grwpiau cymwys yn rhaglen imiwneiddio rhag y ffliw 2026 i 2027

The following provides an updated summary of the groups eligible for flu vaccination in 2026 to 2027. 

1. Children aged two and three years on 31 August 2026 (for example, date of birth on or after 1 September 2022 and on or before 31 August 2024). Vaccination will generally be offered through GP practice. Children of this age must be individually invited by their GP practice.
2. All children in primary school reception class and school years 1 to 6 (inclusive). 
3. 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.
4. 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. 
5. Children between 6 months and 2 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.

6. 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 and vascular 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 and adrenal insufficiency
   • 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

For full details of the clinical risk categories please refer to table 19.4 in chapter 19 of the Green Book, Influenza Chapter. 

7. Household contacts of immunocompromised individuals (defined as immunosuppressed in table 19.4 in chapter 19 of the Green Book, Influenza Chapter).  Specifically individuals who expect to share living accommodation on most days over the winter and, therefore, for whom continuing close contact is unavoidable.

8. All those reaching the age of 65 by 31 March 2027 (for example, born before 1 April 1962)

9. 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 easily accessible. Vaccination should be recorded in the Welsh Immunisation System, the appropriate local clinical system and should also be recorded within the handheld maternity record.

10. 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. 
    1. This includes adult residential care homes, nursing care homes and children’s hospices.
    2. 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). 
    3. Opportunities for co-administration with the COVID-19 vaccine should be explored where individuals are eligible for both the COVID-19 and flu vaccines. 

11. Included are those sleeping rough, people in emergency accommodation and people recently homeless in supported accommodation. 

12. All adults resident in Welsh prisons.

13. 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.

15. 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. 

16. 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.

(see 'children, and health and social care workers' for more details)

17. Health Board and NHS Trust staff are eligible to receive a flu vaccine. This should normally be via their employer, actively encouraged and provided or facilitated as part of their occupational health care. 

(see 'children, and health and social care workers' for more details)

18. Individuals (including students, trainees and volunteers) aged 16 and over employed in adult residential care homes, nursing care homes and children’s hospices, or providing domiciliary care, who are in 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 or facilitated by their employer. 
19. Social care staff, apart from those referred to above, should be encouraged, supported and offered/facilitated vaccination by their employer.

20. Locum GPs may be vaccinated at the practice where they are registered as a patient.

21. In relation to premises at which zoonotic influenza is suspected or confirmed, persons resident in Wales aged 16 years or over responsible for: 

• culling or handling live unwell animals
• cleaning enclosed areas
• collecting carcasses

22. Person’s resident in Wales aged 16 years and over employed at or regularly visiting statutorily registered poultry (where 50 or more birds are kept), cattle or swine units^[footnote-1]who have direct exposure to faeces or litter through:

    a) routinely accessing enclosed animal rearing or production areas

    b) collecting and removing manure or litter from within enclosed sheds and buildings or performing final clean down of enclosed sheds and buildings

    c) the initial sorting of poultry eggs, if the sorting area is an integral part of the production unit

    d) catching or culling poultry within enclosed poultry rearing or egg production areas

23. Person’s resident in Wales aged 16 years or over employed in poultry, cattle or swine processing units^[footnote-2] that:

    a) catch and handle live birds

    b) kill and eviscerate animals

    c) cleanse and disinfect areas and equipment contaminated by animal faeces

Vaccinations for eligible workers aged 18 years and older will only be delivered in community pharmacies. Eligible poultry workers and livestock workers aged 16 and 17 years should approach their GP for vaccination. Poultry workers and livestock workers who meet the eligibility criteria should present to their nearest community pharmacy, or GP in the case of workers aged 16 and 17 years, with a letter they can obtain from their employer confirming eligibility. 

24. 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.                                                                                                            
25. 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.
26. 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 consider the risk of flu exacerbating any underlying condition a patient may have.

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 is effective in reducing the spread of flu. 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. 

As soon as the vaccine becomes available in September, two- and three-year-olds (age on 31 August 2026) should be actively called and offered vaccination as soon as possible.  This will help protect them and reduce flu transmission in the community to other vulnerable groups. 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. 

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 vaccine due to the porcine gelatine content or if their children are otherwise contraindicated for LAIV. 

LAIV remains the recommended vaccine for children, however, Health Boards are expected to ensure an equitable offer and suitable alternative to LAIV is available. This must be clearly communicated in consent information.  The aim should be to offer vaccination concurrently with other children. The TIVc should be available in any school setting where LAIV has been declined in favour of a gelatine-free alternative as recorded in consent forms. 

A suitable adult, responsible for any child in primary school who has declined LAIV in favour of a gelatine-free alternative, should be supported to attend vaccination with the child so that they can receive TIVc.

If the above arrangements are unsuccessful a timely alternative appointment for vaccination with their GP or Local Health Board vaccination facility must be offered. This must be communicated to all providers and parents.

At-risk children who are eligible for flu vaccination via the school-based programme because of their age will be offered immunisation at school. 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 to identify and offer vaccination to 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 and NHS Trust staff

It is important that all health and social care workers and NHS Trust staff have timely flu vaccination. This includes students, bank or temporary staff, staff with direct patient or client contact and staff in roles within those settings whose absence due to flu infection would directly disrupt services that provide care to patients or clients (including business critical functions across a range of services in those settings that includes support services). Vaccinating will protect staff and 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, 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 maximise flu vaccine uptake amongst health and social care workers and NHS Trust staff this winter.  It is crucial that the NHS workforce 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.

Uptake of vaccination is a professional standard for all medical staff and all dental professionals.  It is implicitly included in the professional code for nursing staff and similarly implicitly included in the requirements of Allied Health Professionals registered with the HealthCare Professions Council under a generic requirement to “Establish and maintain a safe practice environment”.  Profession leaders have a role in promoting vaccination as a matter of maintaining these professional standards. 

As in previous years NHS organisations should offer flu immunisation to all eligible employees. 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, whether in a patient-facing role or roles that are directly involved in supporting services that provide care to patients, 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 in direct patient contact in adult residential care homes, nursing care homes and children’s hospices, and staff providing domiciliary care are eligible for free flu vaccination. For these staff the seasonal flu vaccination service is offered by community pharmacies (if aged 18 years or older) and GP surgeries (if aged 16 to 17 years old ) under the PCCS:I. 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 arrange with those homes to offer flu vaccination to staff on the premises. Alternatively, staff may be directed to visit any pharmacy (for staff aged 18 years and older) or their registered GP (for staff aged 16 and 17 years) providing the adult influenza programme under the PCCS:I.

In some areas there may be no local community pharmacy offering the adult flu vaccination service, so 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 local awareness. 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 and employees directly involved in roles in those settings that support services that provide care to those clients.

[1] Poultry, cattle and swine mean all birds, cattle and pigs 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.

[2] Poultry, cattle and swine processing means the business of raising, slaughtering, cleaning, packing, packaging, and related activities associated with producing poultry, cattle and pigs including activities conducted by poultry, cattle and pig processors at integrated feed mills, hatcheries, processing plant facilities and the management of those activities.