All those eligible for the flu vaccine have been urged to come forward as cases rise to levels not seen since before the pandemic.

So far this year, flu vaccine uptake in eligible groups is similar to the last couple of years, although there is a particular need for pre-schoolers, pregnant women and those in the health and social care workforces to take up the offer.

Latest UKHSA data shows there have been jumps in emergency department flu attendances and hospital admissions in the last week. The intensive care admission rate is now higher for flu than for Covid.

In the week 14 to 20 November 2022:

The hospital admission rate for flu increased to 24 per million population, up from 15 per million the previous week. The highest rates were in the under 5s followed by the 75 years plus group. The Covid rate was 44 per million population.

The intensive care and high dependency care for influenza increased to 21 per 10 million population compared to 13 per 10 million population in the previous week. The highest rates were in the under 5s followed by the 65 years plus group. The Covid rate was 17 per 10 million population.

Those aged 2 and 3 years old are eligible for nasal spray flu vaccines, with parents and guardians also urged to book appointments to ensure the younger age group is protected.

With both flu and Covid cases both circulating this winter, it is also vital all those eligible get both vaccines as soon as possible.

Due to the increase in levels of flu circulating in the community, the UK Health Security Agency (UKHSA) has recommended that it is now appropriate for antiviral medicines to be prescribed in primary care settings.

Those eligible for antivirals if they have flu include patients in clinical at-risk groups as well as any who are at risk of severe illness and complications from flu if not treated. This includes people in those groups who present with symptoms of flu and those who have been exposed to flu-like illnesses from someone they live with, including residents of care homes.

As has happened in flu seasons before the pandemic, following an UKHSA recommendation, the Chief Medical Officer together with the Chief Pharmaceutical Officer have issued an alert to the NHS notifying the healthcare system that antiviral medicines can now be prescribed and supplied for cases of community acquired influenza.

Chief Medical Officer, Professor Chris Whitty, said:

Flu and Covid are both circulating. We are currently seeing higher rates of flu at this time of year than usual.

It is important those eligible have their flu jab as soon as they can. Vaccines are the best defence against these viruses. The most effective approach is to get vaccinated before it is circulating at very high rates.

As flu cases have risen and in order to protect the most vulnerable – in line with pre-COVID flu seasons antiviral medicines can now be prescribed in primary care settings such as GPs and pharmacies to those eligible who are most at risk to the complications of flu.”

Health and Social Care Secretary Steve Barclay said:

Flu is a serious virus and, while we haven’t seen the number of cases we’re used to over the last couple of years, it is starting to circulate at high levels this season.

Thankfully we have the tools to protect those most at risk to flu. Thanks to our fantastic vaccination campaign, more than 17 million flu jabs have been given in England this season already.

For all those eligible who have not yet come forward for their free winter vaccines for flu and Covid, please do not delay in coming forward for your jab. It could not be easier.”

In England, the first weekly winter update shows there were an average of 344 patients a day with flu in hospital last week, more than ten times the number seen at the beginning of December last year.

In October, a new country-wide marketing campaign urging millions of eligible people to get their flu and Covid booster vaccines to top up their immunity was launched.

Building on the success of the 2021/22 Covid vaccination campaign, the campaign stressed that the protection provided by vaccines wanes over time, so everyone eligible should boost their immunity by getting both vaccines ahead of a difficult winter.

Dr Mary Ramsay, Director for Immunisation & Programmes at UKHSA:

Our surveillance shows recent increases in laboratory and clinical influenza indicators across England, particularly NHS emergency department attendances, hospitalisations and intensive care. Alongside older adults, flu rates are rapidly rising in younger children. Vaccination remains critical and I urge everyone eligible to take up the offer.

Flu antivirals are effective in helping to keep people out of hospital and preventing the virus spreading to other more vulnerable household and family members. Now that we are seeing flu increasing it’s important that GPs consider the possibility of flu in respiratory patients and the use of antivirals in line with national guidance, particularly if they have ruled out COVID-19.”

Professor Sir Stephen Powis, NHS national medical director, said:

The first weekly data this year shows that flu is already with us as we enter what could be the most challenging winter in NHS history, with hundreds of beds a day already occupied with patients with flu.

Flu can be extremely serious for lots of people, so pharmacies and GPs will now be able to prescribe antivirals to those most at risk of its complications to help people avoid the need for hospital care.

But the best way people who are eligible can protect themselves is by getting vaccinated without delay – there are thousands of sites across the country offering flu and covid jabs so please book in today if you haven’t already.”

The alert concerning flu antiviral medicine has been issued to primary care settings including GPs and community pharmacies in England.

The Department of Health and Social Care continues to work closely with the manufacturers of antiviral medicines, used in the treatment of flu, to monitor stocks and ensure that there are adequate supplies of these medicines available to meet UK demand.

The prescription and supply of antivirals in primary care settings is in line with NICE guidance.

Background

Antiviral medicines do not work like a vaccine which helps to stop you from getting the flu, but they can reduce the severity of the disease if you are treated early.

Antiviral medicines may be prescribed at any time in the secondary care setting for patients with suspected seasonal influenza infection. In primary care, once it has been confirmed that flu is circulating in the community, antiviral medicines may be prescribed for patients in “clinical at-risk groups” as well as any who are at risk of severe illness and/or complications from flu if not treated.

This alert is issued based on advice from UKHSA, which monitors the level of flu circulating in the community based on a range of different indicators. This includes the number of positive tests for flu, the number of acute respiratory outbreaks reported, hospital admissions, and the number of GP consultations for flu like illness.

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The alert can be found here: https://www.cas.mhra.gov.uk/ViewandAcknowledgment/ViewAlert.aspx?AlertID=103217

Link to latest weekly UKHSA national flu and Covid surveillance report can be found here: https://www.gov.uk/government/news/national-flu-and-covid-19-surveillance-reports-published