The below detail is from The National flu immunisation programme 2025 to 2026 letter which was released 19 Februaru 2025. It states:
Recommended adult influenza vaccines that will be reimbursed
Vaccines that are currently listed here as quadrivalent (Q) formulations are likely to be supplied as trivalent (T) ones (and therefore both formulations are listed in the tables).
| Aged 18 to 64 years in clinical risk group (including pregnant women) | Aged 65 years and over |
| First line (listed alphabetically) adjuvanted (aTIV) (in those from 50 years of age) or cell-culture (TIVc) or high dose (TIV-HD/QIV-HD) (in those from 60 years of age) or recombinant (TIVr/QIVr) Second line egg-culture (TIVe/QIVe) only reimbursed as set out in the section on ordering below | First line (listed alphabetically) adjuvanted (aTIV) or high dose (TIV-HD/QIV-HD) or recombinant (TIVr/QIVr) Second line cell-culture (TIVc) only reimbursed as set out in the section on ordering below |
| aTIV: adjuvanted trivalent influenza vaccine TIVc: cell-culture trivalent influenza vaccine TIVe: egg-culture trivalent influenza vaccine QIVe: egg-culture quadrivalent influenza vaccine TIV-HD: high-dose trivalent influenza vaccine QIV-HD: high-dose quadrivalent influenza vaccine TIVr: recombinant trivalent influenza vaccine QIVr: recombinant quadrivalent influenza vaccine |
Reimbursement
Contractual requirements for all commissioned NHS flu vaccination providers state that to receive payment for flu vaccination and reimbursement of flu vaccine they will need to use the specific flu vaccines outlined for the appropriate cohort and administer vaccines in line with the announced and authorised cohorts. Please note that commissioners will actively recover any payments made for the incorrect vaccine administered.
Ahead of the flu season first line vaccines should always be ordered for a given cohort. Once the vaccination campaign has started, if providers need additional stock, second line vaccines should only be ordered if first line options are not available to order. Clinics should be planned using the recommended first line vaccine. Where a provider does not have a first line vaccine in stock, patients should be directed to an alternative provider who has stock of a first line vaccine or told to rebook when the new stock is available. Vaccination with a second line vaccine should only be considered on an exceptional basis where there is a valid reason why the patient may not return for a further appointment. Practices and community pharmacy should aim to minimise the need for this by procuring adequate stock before the campaign starts.
With the exception of frontline workers in certain social care settings (see cohort eligibility above), the vaccination of all other frontline health care staff (for example, those working in NHS Trusts, Primary Care organisations, and private sector health care organisations) will not qualify for payment or reimbursement.
Due to manufacturing processes and commissioning arrangements, some vaccines may only be available in limited quantities, or batches of vaccine may be subject to delay. Therefore, it is recommended that orders are placed with more than one manufacturer to ensure providers receive sufficient stock. A list of all influenza vaccines marketed in the UK is available on GOV.UK. Providers should remain flexible when scheduling vaccination sessions and be prepared to reschedule if necessary.
Children’s vaccines
No changes were recommended by JCVI for children’s flu vaccines for 2025 to 2026.
For those in clinical risk groups aged 6 months to less than 2 years
The first line vaccine is the cell-culture influenza vaccine (TIVc). Where this is not available, egg-culture influenza vaccine (TIVe/QIVe) can be offered as a second line choice.
For those aged 2 years and above in eligible and clinical risk groups
The first line choice is the live attenuated influenza vaccine (LAIV). TIVc is recommended where LAIV is contraindicated or otherwise unsuitable (for example, parents object to LAIV on the grounds of its porcine gelatine content). Where TIVc is not available, TIVe/QIVe can be offered but this is the least preferred option.
Recommended flu vaccines for children
| Children aged 6 months to less than 2 years in clinical risk groups | Children aged 2 to less than 18 years in eligible groups (including clinical risk groups) |
| Offer in the following order of preference: First line • TIVc Second line • TIVe/QIVe | Offer in the following order of preference: First line • LAIV Second line • TIVc is recommended where LAIV is contraindicated or otherwise unsuitable (for example, parents object to LAIV on the grounds of its porcine gelatine content) Third line • TIVe/QIVe |
The UK Health Security Agency (UKHSA) supplies all flu vaccines for the children’s programme and these will be available to order through ImmForm and are not reimbursable.
As in previous seasons, ordering controls will be in place in 2025 to 2026 to enable UKHSA to balance vaccine availability and demand appropriately across the programme. The latest information on ordering controls and other ordering advice for UKHSA supplied flu vaccines will be featured on the ImmForm news page, both prior to and during the flu vaccination period. Information will also be featured in Vaccine Update and disseminated via the National Immunisation Network as appropriate. It is strongly advised that all parties involved in the provision of flu vaccines to children ensure they remain up to date with this information at all times.