We are writing to all practices to highlight a developing issue in terms of flu vaccine supplies for the imminent flu 2026/27 season which, for certain patient categories, begins on 01 September.
Practices who have placed an order with Sanofi for the Trivalent Influenza Vaccine IIVr (recombinant) should have received an email advising this 2026/27 order has been cancelled, that is, no delivery will occur. Colleagues should note this is a nationwide issue and the LMC is awaiting an update from NHS England, although this is not yet available.
The LMC fully understands this may create significant uncertainty, disruption and frustration. These changes create significant challenges for practices and for those responsible for organising flu vaccination delivery. The LMC and LPC (Local Pharmaceutical Committee) have already written to Surrey and Sussex ICB (and separately contacted Southwest London ICB) warning that a supply shortfall and any delay in alternative stock supply will cause significant challenges.
If your practice has ordered IIV-HD (high dose), this is unaffected and Sanofi’s email advises that this will be delivered as scheduled.
Sanofi advise they will have additional supplies of IIV-HD but only by November and cannot confirm the delivery week. Practices can put themselves on a waiting list for November delivery on a first-come, first-served basis, but should check Sanofi’s conditions of Sale or Return (SoR) relating to flu vaccines.
Separately, Community Pharmacies were informed in July that Viatris would not supply any flu vaccines for the 2026/27 flu season, thus creating a supply shortfall across the sector and a demand from alternative suppliers.
Based on information from practices, if a practice approaches an alternative supplier, they need to assure themselves of:
- The cost of the vaccine in any order and whether any additional order(s) incur a higher price.
- Sale or Return (SoR) arrangements.
- Payment arrangements and timescales (noting potential cash flow implications depending on payments to the practice via the ES and PPA).
- Estimated or assured delivery weeks.
Colleagues are also advised to only order vaccines that are included within NHS England’s confirmed NHS reimbursement arrangements, as there is no indication that these will be varied in the light of this supply disruption and the LMC cannot advise practices to assume this will occur.
As a reminder, the current NHS reimbursement vaccination arrangements are:
Table 1. Preferred adult influenza vaccines that will be reimbursed
| Aged 18 to 49 years in clinical risk group (including pregnant women) | Aged 50 to 64 years (in a clinical risk group) | Aged 65 years and over |
| All vaccines are listed alphabetically. Order any of these vaccines: • cell-cultured (IIVc) • or recombinant (IIVr) | All vaccines are listed alphabetically. Order any of these vaccines: • adjuvanted (aIIV) • or cell-cultured (IIVc) • or high dose (IIV-HD) (licensed from 60 years of age but can be given off label to those aged 50 to 59 years) • or recombinant (IIVr) | All vaccines are listed alphabetically. Order any of these vaccines: • adjuvanted (aIIV) • or cell-cultured (IIVc) • or high dose (IIV-HD) • or recombinant (IIVr) |
Further details are available in the “flu letters”, signposting is available on the SSLMCs website, and the national flu immunisation programme 2026/27 (last updated on 9th June 2026, so before potential shortages were known).
Colleagues will note that in both the 50-64 age range, (where clinically indicated), and the 65 years and older eligible groups, IIV-HD (high dose) is a substitute for IIVr (recombinant), although this is not the case for patients aged 18-49 at clinical risk.
Practices should carefully consider the financial viability of the seasonal flu programme if costs, or likely uptake (which may be affected by delivery schedules) will be affected. The LMC (and GPC England) longstanding position is that the current Item of Service (IoS) fee of £10.06 is economically unrealistic in terms of delivering the programme, given the costs involved. However, as was clear from responses to the SSLMC July Flu Survey, many practices choose to continue to deliver the programme, primarily to ensure patients can access immunisation services.
The National Booking Service is now open, allowing patients to book appointments to receive flu (and, if eligible, Covid) vaccinations. If, as a result of vaccine supply issues, your practice needs to adjust its planned clinics, it should do so promptly.
As I noted, this is a national issue and because practices have differing vaccine supply arrangements, it is likely to have a variable effect on practices. As further information is available, the LMCs website will be updated and any information to patients should make it clear these problems with vaccine supply are outside practices’ control. Although discussions have occurred in terms of moving to a central supply arrangement across England for adult seasonal flu vaccines, no firm commitments have been made.
We hope this update is helpful. Practices with further queries can check the LMC website or use our Contact Us form.
What if we want to withdraw from the Enhanced Service?
Practices do have the option of withdrawing from the Enhanced Service under 3.6.3 of the ES specification; practices are required to give at least 28 days written notice to the commissioner, unless the latter agrees a different timescale. If practices are considering this option they should contact the ICB and it is also very helpful if the LMC can be advised.