| 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
The national flu immunisation programme letter for 2025/26 states:
Contractual requirements for all commissioned NHS flu vaccination providers will 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.