For most people, the flu - albeit an unpleasant illness - is not serious. However, certain people are more likely to develop serious complications of flu, such as bronchitis and pneumonia. Influenza immunisation has been recommended in the UK since the late 1960s, with the aim of protecting clinically at-risk groups who are at a higher risk of influenza-associated morbidity and mortality. In 2000, the policy was extended to include all people aged 65 years and over, and in 2010 pregnancy was added as a clinical risk category. In 2013-14, the childhood programme was first implemented to target children from the age of two to nine years old. This was extended in 2018-19 to all those aged 10 years old. In the winter of 2020-21, during the coronavirus (Covid-19) pandemic, the flu vaccination programme was expanded to include adults aged 50–64 and household members of shielded patients. This came alongside research suggesting an increased risk of severe illness and death from co-infection with flu and Covid-19.
The seasonal influenza immunisation programme in England aims to protect those who are most at risk of serious illness or death following influenza infection. Here we look at England’s flu vaccine uptake for people aged 65 years and over, as well as how the UK compares internationally.
Flu vaccine coverage for older adults
The ambition for flu vaccine coverage is to reach or exceed 75% uptake for people aged 65 years and over, as recommended by the World Health Organization (WHO). In England, between 2004-05 and 2019-20, flu vaccine uptake fluctuated between 71% and 75%. In 2020-21, uptake in people aged 65 years and over reached 81%; this was the first time the WHO target had been met since the winter of 2005-06. In 2021-22, flu vaccine coverage for people aged 65 years and over increased to 82%, the second year in a row that the target had been met. In 2022-23, although coverage fell to 76%, it remained higher than the target, resulting in three consecutive years of flu vaccine coverage at a standard espoused by the WHO. Since data for 2022-23 is only available up until November 2022, it’s possible that it underestimates the actual level of coverage.
Flu vaccination coverage by country
Between 2007 and 2021, England had some of the highest levels of flu vaccination coverage among those aged 65 and over compared to other OECD countries. In 2021, 82% of registered patients aged 65 and over were immunised. The United States and England have the highest levels of flu vaccine coverage, while Austria, Japan and Germany have the lowest levels of coverage.
Since 2018, there has been an increase in flu vaccination coverage among those aged 65 and over in all countries for which data has been reported above, the largest increase for which was observed in Denmark (45% in 2020 to 78% in 2021) and Greece (51% in 2018 to 65% in 2021).
About this data
England time series: It is important to note that influenza vaccine uptake data is only a snapshot of the GP registered patients vaccinated at the time of data extraction. Data captured at the time of data extraction will exclude, for example, updates to patient records on vaccination status, newly registered patients or changes in clinical risk status. For example, patients who are vaccinated, but have not had their electronic patient record updated by the time of data extraction, will be included within the denominator, but will not be included in the count of the number vaccinated. For more information, please see the UK Health Security Agency’s Seasonal flu vaccine uptake in GP patients: monthly data, 2021 to 2022 report.
OECD data: Influenza vaccination rates refer to the number of people aged 65 and over who have received an annual influenza vaccination, divided by the total number of people over 65 years of age. In some countries, the data includes people over 60 years of age. The main limitation in terms of data comparability arises from the use of different data sources, whether survey or programme, which are susceptible to different types of errors and biases. For example, data from population surveys may reflect some variation due to recall errors and irregularity of administration. The definition and comparability information are taken directly from the OECD report Health at a Glance. Detailed information about the definitions, source and methods for each country can be downloaded here.