Guide to winter vaccinations for flu and COVID-19

With winter on its way, health officials fear a ‘twindemic’, which may see both flu and COVID-19 spread across the country at the same time, posing a serious risk to public health.

It’s important to do everything you can to keep yourself and your family safe this year, and so tens of millions of people in the UK are being urged to have their vaccines to protect against flu and COVID-19 as soon as possible.

Vaccines are the most effective protection against infectious illnesses, including flu and COVID-19. Over many decades, vaccinations have helped the UK eradicate debilitating diseases such as smallpox, while minimising the effects of others like measles.

We all know how easily germs can be spread, particularly through winter, especially when you throw in factors like children in nurseries and schools, packed public transport, and of course, the odd Christmas party or two. Increasing protection from illness is vital for everyone as it minimises the risk of severe illness or hospitalisation and also helps protect the NHS during one of its busiest times of the year.

So which vaccines do you need this year? And can you get the flu vaccine and COVID-19 booster at the same time? We answer your questions about these vaccines, including questions about children, and whether you should get vaccinated during pregnancy.

A complete guide to the flu vaccine

Should I get a flu vaccine this year?

Boosting your immunity with recommended vaccinations is even more critical this year as predictions suggest we may see a significant rise in people catching both flu and COVID-19. If you are eligible, we would strongly encourage you to get your vaccines when you’re invited.

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Virus transmission usually accelerates at this time of year as we socialise indoors more. While COVID-19 restrictions kept flu rates low over the last two years, returning to pre-pandemic levels of socialising means both viruses are ripe to spread this season, when immunity in the population is low. And don’t forget, the flu virus changes every year so the vaccine for it changes, which is why you should get this every year if you can.

Who is eligible for a free NHS flu vaccine?

A flu vaccine is the most effective defence against what can be a debilitating winter virus. Those at greatest risk of getting serious complications from flu are invited to receive an NHS flu vaccination at no cost to them. Many young children are also eligible for the flu vaccine to protect them and prevent it spreading to people that may be at risk of getting seriously ill from flu.

If you fall into one of the following categories, you are eligible for a free NHS flu vaccine:

• Aged two and three years on 31 August 2022

• School aged children (all primary school aged children (reception year to year 6) and eligible secondary school aged children)

• Those aged six months to under 50 years in clinical risk groups

• Pregnant women

• All those aged 50 years and over

• Those in long-stay residential care homes

• Carers / in receipt of carer’s allowance / or main carer of an older or disabled person

• Close contacts of immunocompromised individuals

• Frontline social care workers without access to occupational health schemes (frontline health and social care staff should get the flu jab through their employer)

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If you’re unsure whether you’re eligible for a free NHS flu vaccine, you can find out more on the NHS website at www.nhs.uk/wintervaccinations.

Free NHS flu vaccinations are available via your GP practice, a participating community pharmacy and if you are pregnant, you can ask your maternity service.

The flu vaccine takes around 10 days to work and should help protect you during this year’s flu season. Side effects from the vaccine are generally mild, cold-like symptoms. Remember that you may still get flu, there tend to be a few strains of the virus floating around each winter, but crucially if you do, it will be a much milder case than if you weren’t vaccinated.

Can my child get a flu vaccine and what type of flu vaccine will my child be given?

Children aged two and to three years old will be invited to receive their flu vaccine at their GP.

Primary school children in Reception to Year Six will receive their flu vaccine from the local NHS School Aged Immunisation Service. This will either be in school or at a community clinic.

All children in a clinical risk group can get their flu vaccine at their local GP surgery.

If your child is in a clinical risk group, you do not need to wait for an invite from the NHS School Aged Immunisation Service. Please contact your GP surgery if you would like your child to receive the vaccine earlier in the season.

Most children aged two or above are offered a nasal spray vaccine. A small number cannot have it due to pre-existing medical conditions or treatments and are offered protection through an injected vaccine instead. The nasal spray contains small traces of porcine gelatine. For those who may not accept the use of porcine gelatine in medicines, an injectable vaccine is available, which you may discuss with a health professional.

If your child is aged between six months and two years old and is in a clinical risk group for flu, they will be offered an injected flu vaccine as the nasal spray is not recommended for children under the age of two.

Some secondary school aged children will be offered a flu vaccine by the local NHS School Aged Immunisation Service, most likely later in the season. Parents should wait to be invited and complete the necessary consent documentation provided by the school age immunisation service accordingly.

Pregnancy and vaccinations

Am I at risk from flu if I am pregnant?

There is good evidence that pregnant women have a higher chance of developing complications if they get flu, particularly in the later stages of pregnancy.

One of the most common complications of flu is bronchitis, a chest infection that can become serious and develop into pneumonia. If you have flu while you're pregnant, it could cause your baby to be born prematurely or have a low birthweight, it increases the need for admission to intensive care for mum and baby and may even lead to stillbirth or death. If you get flu and COVID-19 at the same time, the symptoms are likely to be more serious.

Can I get the flu vaccine if I’m pregnant?

If you are pregnant, the NHS urges you to have the flu vaccine, whatever stage of pregnancy you’re at. It helps protect both you and your baby. It’s safe to have the flu vaccine at any stage of pregnancy, from the first few weeks up to your expected due date.

Women who have had the flu vaccine while pregnant also pass some protection on to their babies, which lasts for the first few months of their lives. It's also safe for women who are breastfeeding to have the vaccine.

Contact your midwife or GP surgery to find out where you can get the flu vaccine. It's a good idea to get vaccinated as soon as possible after the vaccine becomes available in September. In some areas, midwives can give the flu vaccine at the antenatal clinic. In others, you will need to arrange an appointment at your GP surgery. Many community pharmacies now offer the NHS flu vaccine to those eligible.

What is whooping cough?

Whooping cough (also known as pertussis) causes long bursts of coughing and choking, making it hard to breathe. The ‘whoop’ noise is caused by gasping for breath after each burst of coughing.

Young babies don’t always do this which can make it difficult to recognise the disease. Whooping cough commonly lasts for two to three months. Babies under one year of age are most at risk from whooping cough. For these babies, the disease is very serious and can lead to pneumonia and permanent brain damage. In the worst cases, it can cause death. .

Expectant mothers can protect their babies against this serious and potentially fatal disease from birth, by having the whooping cough vaccination whilst pregnant. It is also recommended that those who are pregnant receive the vaccine in every pregnancy as your immunity reduces over time.

When should I get myself and my baby vaccinated against whooping cough?

The best time to get vaccinated to protect your baby is from week 16 up to 32 weeks of pregnancy. You can have the vaccine anytime from 16 weeks but if you have it after 38 weeks it may be less effective.

The immunity you acquire from the vaccine will be passed to your baby through the placenta. This will help protect your baby in the first few vulnerable weeks of their life until they are old enough to have the vaccine at eight weeks of age. Babies are offered whooping cough vaccination at 8, 12 and 16 weeks of age as part of their routine immunisations.

The whooping cough vaccine is not a live vaccine so it can’t cause whooping cough in you or your baby. It’s safer for you to have the vaccine than to risk your newborn baby catching whooping cough.

Uptake of the vaccine amongst pregnant women has been very encouraging and the vaccination programme has been very effective in protecting young babies against whooping cough.

Can I get the flu and whooping cough vaccines at the same time?

If you are pregnant during the flu season, then you should have the flu vaccine as early as possible in your pregnancy. If you are 16 weeks and over, then you can have both the flu and whooping cough vaccines at the same time.

The whooping cough vaccine can be given at the same time as the flu vaccine but do not wait until the winter season to have them together. Your baby will get the best protection if you have the vaccine from week 16 of your pregnancy.

I’m pregnant, am I at risk of COVID-19?

When you become pregnant it gets harder to fight off infections. This means you are at greater risk from becoming seriously ill with COVID-19, especially in the third trimester, which could cause complications for both you and your baby.

Studies of those who are pregnant admitted to hospital with COVID-19 show there is higher risk of admission to intensive care, high blood pressure due to pre-eclampsia and premature or stillbirth.

Vaccination remains the best way to protect you and your baby from the virus, and is recommended by the Royal College of Obstetricians and Gynaecologists and the Royal College of Midwives.

Can I get the COVID-19 vaccination while pregnant?

You can be vaccinated at any time during pregnancy. Your immunity reduces over time, so even if you have already had this vaccine, for extra protection you can now get a further dose ahead of winter as soon as it has been three months since your last one.

Research shows being vaccinated in pregnancy can also protect your baby from COVID-19 for six months after they are born, reducing the risk of them needing hospital treatment for severe COVID-19 related illness.

You can book an appointment online, call 119 or speak to your GP surgery, midwife or pharmacist about other ways to get your vaccine.

Guide to the COVID-19 vaccine this winter

This autumn and winter, everyone aged 50 years and older, care home residents, those aged five years and over and at greater risk from the virus, and frontline health and social care workers can get the COVID-19 vaccine.

It must be at least three months since your last dose of vaccine. If you have recently had COVID-19 you will need to wait 4 weeks before getting vaccinated.

If you are eligible for a flu vaccine, you may be able to have them at the same time – if not please go ahead anyway, you can catch up with the other vaccine later.

The COVID-19 vaccine will help your body to maintain protection against the virus throughout the critical winter months when viruses spread most and cause greatest harm.

The COVID-19 vaccine has worked wonders, helping to keep tens of thousands of people out of hospital. However, immunity starts to decrease over time, so another dose provides a ‘top-up’ for those who most need extra protection.

The NHS is contacting eligible people to remind them they can book an appointment. If you believe you are eligible and it has been three months since your last dose, visit the National Booking Service or call 119 for free to arrange an appointment.

Can I have the flu vaccine and COVID-19 booster at the same time?

Many people feel nervous about getting a vaccine, and finding the time can be tricky when you’re busy. Some people may be offered the flu vaccine and COVID-19 booster at the same time and choose to have them both together. Many people will be offered or choose to get them separately though. The important thing is to get them as soon as you can.

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There’s no need to worry about safety after getting both a flu and COVID-19 vaccine at the same time. The UK’s medicines regulator, the MHRA, and the Deputy Chief Medical Officer for England have confirmed that it is safe.

Immunisations and children: current guidance

Children are offered a range of vaccinations before they start school to protect them from common but preventable infectious diseases. Childhood vaccinations are the safest and most effective way to protect your child from serious childhood diseases, such as mumps, measles, rubella and polio.

Vaccines are safe, quick, and free as part of the NHS routine immunisation schedule.

You can check if your child is up to date by looking at their Personal Child Health Record (Red Book) and if they have missed a vaccination, you can contact their GP surgery to book an appointment.

Can getting measles, mumps and rubella be serious?

Measles, mumps and rubella (MMR) are highly infectious and can easily spread between unvaccinated people. These diseases can lead to serious problems such as meningitis and hearing loss. Most people are vaccinated against measles, mumps and rubella. Since the vaccine was introduced in 1988, these conditions have become rare in the UK as the vaccine provides good protection.

How can my child get the MMR vaccine?

The Measles, Mumps and Rubella vaccine (MMR) protects against these three potentially serious illnesses. With rates of measles cases increasing globally, vaccination is more important than ever. Two MMR doses are needed to give effective protection and will be offered through your child’s GP surgery. The first dose is given after your child’s first birthday and the second dose is given at three years four months old or soon after to protect them before they start school. The vaccine is given by injection into the leg or upper arm.

The MMR vaccine has been safely protecting children for many years in many countries worldwide. In the UK, millions of doses have been given since it was introduced in 1988. Before vaccines can be used, they have to be thoroughly tested for safety. Many studies have taken place to look at the safety and effectiveness of MMR vaccine. The evidence is clear that there is no link between MMR vaccine and autism.

What is polio and when should my child be vaccinated?

Polio is an infection caused by a virus that attacks the nervous system – it can cause permanent paralysis of muscles. The polio vaccine is free and given as part of combined jabs to babies, toddlers and teenagers. Children need all five doses of the vaccine to be fully protected against polio.

The polio vaccine is given when a child is:

• 8, 12 and 16 weeks old as part of the 6-in-1 vaccine (DTaP/IPV/Hib/HepB)

• Three years and four months old as part of the 4-in-1 (DTaP/IPV) pre-school booster

• 14 years old as part of the 3-in-1 (Td/IPV) teenage booster

What do I do if myself or my child have not been vaccinated against polio?

It is never too late to catch up for free on the NHS at any time. People should also get vaccinated even if they’ve had polio before as the vaccine also protects against other serious diseases. Recently Polio has been detected in the sewage in parts of London.  Whilst there have been no confirmed cases in London, the NHS are encouraging all children ages one to nine years old to come forward for a polio booster vaccination to stop the spread of the vaccine-derived polio in the community. This can be booked through their GP surgery or at a walk-in vaccination centre in London. This can be found at www.nhs.uk/polio-sites.

Vaccines: your questions answered by a GP

We teamed up with the Department of Health and Social Care to hold an expert Q&A on winter vaccines last year. Dr Farzana Hussain is an NHS GP with over 20 years’ experience and mum of two teenagers. She is Clinical Director of a Primary Care Network and won GP of the year in 2019.

Here are her answers to your questions on the flu and COVID-19 vaccines.

“I read about a study that said it’s safe to do both jabs at the same time, but it didn’t mention if the study included immunocompromised people or pregnant women, is it safe for them also?” MonetManet

Dr Farzana says: “Immunocompromised people and pregnant women can have flu and COVID-19 vaccinations around the same time. A pregnant woman can have her whooping cough vaccine at the same time too. But you don’t need to try and coordinate to have the vaccines at the same time – it is best to organise an appointment for the earliest slot you are offered.”

“My GP surgery wants to do both at the same time because I have it at home so it makes it easier/quicker for them. I really don't think it's wise because my immune system is pretty much non-existent due to medical reasons and medication. I reacted really badly to the first COVID-19 vaccine, but it wasn't too bad with the second. Can and should I push the issue and get them done separately?” TellMeItsNotTrue

Dr Farzana says: “It's always YOUR choice of when you want your jabs but if you have a weak immune system it's even more important that you get protected from COVID-19 and flu. Having two separate visits will delay you being protected from one of the viruses, but if you are offered an appointment for either jab you should take it up without delay and get both jabs as soon as you can.”

“Why has immunity reduced if so many groups are encouraged to take up the flu vaccine? What has caused the lowering of immunity?” Asuwere

Dr Farzana says: “As we were in lockdown last winter, we were less exposed to viruses and and the level of flu infections went down. This year we are expecting more flu as we are mixing again so it's important to get protected with the flu vaccine especially if you are at higher risk of getting complications with flu, such as if you are pregnant.”

“Will my flu jab protect my breastfed baby too?” namenomnombre

Dr Farzana says: “Women who have had the flu vaccine while pregnant pass some protection on to their babies, which lasts for the first few months of their lives. It’s safe for women who are breastfeeding to have the vaccine but there is no way that the flu vaccine will pass through breast milk to your baby. Although only women who are pregnant or have an underlying health condition are eligible for the free flu vaccine. For more information see the NHS website here.”

“I had my flu vaccine and was offered the COVID-19 booster straight after which I accepted. Was the flu vaccine I had, the same thing as my children have up their nose? Why do children get it nasally and adults by needle?” CinemaPantomime

Dr Farzana says: “The nasal spray vaccine has been found to be most effective in children and is currently only licensed for children aged two to 17 years old. Unlike the adult injectable vaccine, the flu nasal spray is a live but weakened vaccine, which mimics natural infection, whereas the traditional vaccine is inactivated (or a ‘killed’ vaccine). There are some children for whom the nasal spray is not suitable for medical reasons. They are offered an injectable flu vaccine instead.”

“I've only had a flu vaccine in pregnancy. Never had flu and in mid-forties. I'm a key worker and had children at school throughout lockdowns. I don't feel any more at risk than in the past. I'm double vaccinated against COVID. I live a healthy lifestyle and just don't feel like I need a flu jab. What would you say to me to encourage me to have a flu vaccine?” DatingDisastrously

Dr Farzana says: “If you are under 50 and have no health conditions and are not health and care staff, then you are not recommended for a free NHS flu or autumn COVID-19 booster vaccine.

Obviously, flu and COVID-19 have not gone away, which is why it’s important those who are at most risk from these viruses top up their protection to date. We can all continue to do our bit too, by practising simple measures this winter to stop us catching or spreading viruses - including washing hands frequently and using then binning a tissue if we sneeze.”