Flu vaccine

Flu is serious. With coronavirus (COVID-19) around it's more important than ever to get the flu vaccine this autumn to protect yourself, others and the NHS.

Who will be offered the flu vaccine

Vaccination for different groups will begin as soon as the necessary supply of vaccine becomes available. The people most at risk will be prioritised.

If you receive a letter inviting you to get the flu vaccine, please follow the instructions.

Learn about when vaccination begins for different groups

If you're 16 years old or over and not eligible for the free vaccination you can get the vaccine in many community pharmacies for a fee.

Changes to the flu vaccination this year

This year you may notice you're invited to a new location to receive your flu vaccine or the health professional giving your immunisation has changed. Depending on where you live, you may be able to get your vaccine at:

• healthcare settings such as GP practices, hospitals or community pharmacies
• community venues such as town halls, village halls, sports halls and secondary schools
• drive-through or walk-through clinics

What happens if there's a shortage of flu vaccines?

We have enough flu vaccine doses for everyone who's eligible - around 2.4 million people.

Scotland has a good track record of delivering the flu vaccine. During the 2019/20 flu season, 74% of people over 65 were given the vaccine - a higher number than the rest of the UK, and any other EU country. This year, we've planned for 90% of people over 65 to be vaccinated.

However, if demand exceeds what we've planned for, the priority will be to protect the people most vulnerable to flu, based on the best clinical advice.

How will I know about getting my flu vaccination?

Most people entitled to a free flu vaccination will get a letter from their local health board. It'll give you an appointment time and tell you where to go.

For more information visit NHS inform or call 0800 22 44 88.

The flu vaccine is the safest and most effective way to help protect against flu.

The Scottish Government is encouraging everyone who is eligible to get vaccinated.

Why can't I get the flu vaccine from my GP practice?

This year, delivering the flu vaccine is the responsibility of NHS health boards and Health and Social Care Partnerships.

The challenge is to deliver the best local vaccination programme we can while still taking precautions against coronavirus infection for staff and patients.

The need to maintain good infection prevention and control measures and proper physical distancing will make it hard for GP practices to deliver the flu vaccine to the levels of previous years.

During the coronavirus pandemic, it's important we make sure as many people as possible who are at risk of either flu or coronavirus are vaccinated against flu. 

Why haven't I been able to book an appointment by phone?

Some local health boards have received a huge volume of calls. Please try to call again at another time. You can also use the ‘How to get the flu vaccine in my area’ guide above to find out how to arrange your vaccination.

Please be assured the Scottish Government are working with NHS health boards to ensure all those eligible for the flu vaccine will receive an appointment.

It is important that everyone who is eligible for a free flu vaccine takes up this opportunity.

Why is a phased approach necessary?

Using a phased approach lets local health boards begin vaccinating vulnerable groups earlier, instead of waiting until the last delivery date.

Will free eligibility be extended to any more groups this flu season?

Coronavirus has affected every part of public health, including world-wide vaccine supply.

This has forced the Scottish Government to make hard decisions about expanding eligibility.

The coronavirus pandemic means the current situation can change at very short notice. This approach allows NHS Scotland and the Scottish Government to adapt to change through the flu season, while always prioritising those most at risk and protecting the NHS as much as possible.

Once it's known how many people are vaccinated among groups at the greatest clinical risk, it'll be possible to look at expanding eligibility to other groups, including people aged 50-54. This will always depend on vaccine supply.

Will the start of the flu vaccination programme be affected by the coronavirus pandemic?

The flu programme is more important than ever this year, to help protect the most vulnerable and, at the same time, support the NHS.

Vaccination of eligible people, as well as social care workers delivering direct personal care and household members of those shielding, began on 1 October - the usual start date for the flu vaccination programme.

Those with existing eligibility for the flu vaccine are:

• those aged 65 and over
• those who have an eligible health condition
• pregnant women
• health care workers
• young and unpaid carers
• children aged 2-5 (and not yet at school)
• primary school children

Flu symptoms

Flu symptoms come on very quickly and can include symptoms such as:

• fever (temperature above 37.8°C)
• aches
• dry, chesty cough
• tiredness or exhaustion
• headache

More about the symptoms of flu or visit our the Self-help guide about Flu-like illness.

The vaccine takes around 10 days to work and should help protect you from flu for around a year. You have to get immunised every year because flu viruses change constantly and your immunity reduces over time.

The flu vaccine can’t give you flu, but it can stop you catching it.

Which vaccines are used?

The following vaccines are routinely used in Scotland:

• cell based Quadrivalent Inactivated Vaccine (QIVc) Flucelvax Tetra (Seqirus)
• egg based Quadrivalent Inactivated Vaccine (QIVe) Sanofi Pasteur)
• Adjuvanted Trivalent Inactivated Vaccine (aTIV) (Seqirus)
  

The adjuvanted Trivalent Inactivated Vaccine (aTIV) contains a substance, known as an adjuvant, to help to stimulate the immune system and create a better response.

This vaccine's been widely used in many other countries and has been shown to offer better and longer lasting protection in older people than flu vaccines without an adjuvant

It's being offered this year to people aged 65 or over.

If you have an egg allergy

Some of the vaccines for this year are prepared in hens’ eggs.

However one ‘egg-free’ brand which can be used in people from 9 years old is available.

Arrangements are also in place for younger children with an egg allergy to receive the flu vaccine.

If you're affected, please speak to your health professional for advice.

Vaccination is the best protection against flu

Over the last 10 years, the flu vaccine's generally been a good match for the circulating strains of flu.

You can be confident getting vaccinated is the best way to help protect yourself against flu.

Even when it's not as well matched, if you catch flu and you've had the vaccine, symptoms may be less severe, and you may be less likely to develop complications.

Vaccination for different groups

The Scottish Government has expanded eligibility for the free flu vaccine to social care workers who provide direct personal care, household members of those shielding, and people aged 55-64.

The flu vaccination programme officially began on 1 October. A phased approach is being taken this year, which means different groups will be vaccinated at different times.

Vaccine supply

We have enough vaccine to meet our aim of vaccinating 2.4 million people in Scotland during the flu season.

If demand for the vaccine is a lot higher than we predicted, then we'll prioritise those at the greatest clinical risk. This means people in the Phase 1 groups, who have been eligible for vaccination since 1 October. This group includes people aged 65 and over, those with an eligible health condition, pregnant women, young and unpaid carers, and health and social care workers, as well as eligible children.

People in the Phase 1 groups will remain eligible for vaccination throughout the flu season.

It is really important that everyone who is eligible for the vaccine gets it, and everyone who is eligible will be able to get the vaccine now or later in the year.

Flu season in the UK usually begins in December and reaches its peak in January and February. So anyone who gets the flu vaccine will be protected before we expect flu cases to be at their highest.

Scotland has a good track record delivering the flu vaccine. During the 2019/20 flu season, 74% of people over 65 were given the vaccine - more than in the rest of the UK and any other EU country. This year, we've planned for 90% of people over 65 to receive the vaccine.

Why are healthcare workers being prioritised for the flu vaccine?

It's important health and social care staff take every measure possible to protect themselves and their wellbeing.

Health and social care staff also have a duty to ensure everyone in their care is safe and protected.

All health and social care staff are encouraged to get vaccinated, especially those working with people who are at high risk from flu.

Should parents prioritise getting the flu vaccine for their children?

Flu can be serious and can result in even healthy children being hospitalised. The vaccine remains the best and safest way to protect your child against flu and its complications.

It also helps protect those around them who may be more vulnerable to flu if your child has received the flu vaccine.

Primary school children can only get their flu vaccination at school if a consent form is signed and returned to their school. Parents and carers should look out for the form and ensure their child is registered for this year’s vaccination programme as soon as possible.

Across Scotland, flu vaccination consent forms started arriving home from school in August for primary school-aged children. If you haven't returned the completed form you could be putting your child at risk.

If your child is 2-5 years old and not yet in school, look out for your child's appointment letter and leaflet in the post. You can also use the How to get the flu vaccine in your area self-help guide for more information about how to get your child's flu vaccine.

What about people who might not want to go into a healthcare setting for vaccination this year, or who feel anxious about it?

Flu vaccination is critical this winter. It's important to encourage people who are newly eligible to get their flu vaccine, and to reassure people feeling more anxious or nervous about getting vaccinated.

Vaccination will be safe, with strict infection prevention and control measures in place, including PPE and physical distancing.

Vaccine safety

All medicines (including vaccines) are tested for safety and effectiveness before they're allowed to be used.

Once they're in use, the safety of vaccines continues to be monitored by the Medicines and Healthcare Products Regulatory Agency (MHRA).

Scotland’s Chief Medical Officer recommends you have the free flu vaccine this year if you:

• are aged 65 or over (by 31 March 2021)
• have an eligible health condition
• live in the same home as people previously shielding from coronavirus
• are an unpaid or young carer

With coronavirus around it's more important than ever to get the flu vaccine.

Getting the vaccine is the safest and most effective way to help protect yourself against flu and it's also one of the most important reasons for leaving your home.

If you are aged 65 or over, or have an eligible health condition, the risk of getting seriously ill with the flu virus is greater than the risk of going to get your vaccine.

During vaccination, strict infection prevention and control measures will be in place.

Why get the vaccine

Every year in Scotland, around two-thirds of people who get severe flu and need intensive care treatment have a health condition such as diabetes, chronic lung or heart disease.

Adults with a health condition are more at risk of flu-related complications and need extra protection. Even if you feel healthy or that your health condition is mild or well-managed.

Who's eligible for the flu vaccine

People with certain health conditions are at greater risk from flu. Conditions and diseases which can make flu more dangerous include:

Anyone undergoing chemotherapy treatment or on medication that reduces their immunity is at higher risk and should get immunised.

If you’re under 18 years and have a health condition (or care for someone who does) you should also get the vaccine. You may be eligible to have the vaccine as a nasal (nose) spray. For more information visit the child flu page.

Carers

Unpaid carers and young carers are also eligible for the free flu vaccine.

Unpaid carers provide help and support to a partner, child, relative, friend or neighbour, who couldn’t manage without their help.

This could be due to age, physical or mental illness, addiction or disability.

A young carer is an under-18 providing support which would normally be undertaken by an adult.

Find out how to get the flu vaccine in your health board area

People aged 55 to 64 will not be vaccinated until December, and no appointments will be offered for this age group until then.

This is to ensure that those who are most at risk are vaccinated first.

If you are 55 to 64 and you are in one of the other groups which is eligible for the flu vaccine, for example you have a health condition which puts you at risk from the flu, you will be invited earlier.

If you're living with someone previously shielding

If you live in the same home as someone who was previously advised to shield to protect them from coronavirus (COVID-19), you can now get the free flu vaccine.

This aims to provide additional indirect protection to individuals who were shielding.

Why not vaccinate everyone aged 50 and over?

People aged 50-54 will be vaccinated based on vaccine supply. Clinical advice is that prioritising the vulnerable groups is the best way to manage the risks of flu.

Evidence suggests the people who are already eligible to get the flu vaccine are the people most at risk.

Vaccinating social care workers, and household members of those who are shielding, can also help protect the most vulnerable people.

The next group at high risk of flu, especially during the coronavirus pandemic, are people aged 55-64.

Is Scotland using the same vaccination approach as the UK Government?

NHS Scotland's priority is to vaccinate high-risk groups.

We're confident we'll have enough vaccine to meet demand for existing groups and expand the flu vaccine to other groups later in the season.

Learn about vaccination for different groups

Why are those aged 55-64 in the second phase?

The clinical advice is to vaccinate the people who are most at risk from flu earlier.

People aged 55 to 64, who don't have an underlying health condition, are at less clinical risk than those in more vulnerable groups.

The Royal College of Midwives along with Scotland’s Chief Medical and Chief Nursing Officers recommend that all pregnant women should have the free flu vaccine every time you are pregnant as the flu viruses circulating change each year.

Why get the vaccine

Pregnant women are at a greater risk of serious flu-related complications such as early labour, low birth weight and stillbirth so need extra protection.

Every year in Scotland, a number of pregnant women will get influenza (flu virus), some will require hospital treatment or be admitted to intensive care.

Reducing your flu risk

Pregnant women with a health condition such as diabetes or asthma are particularly vulnerable.

The flu vaccine:

• can help protect you and your developing baby against this year’s flu virus and for at least three months after birth
• contains no live viruses, so it can't give you flu
• is safe for your baby and for you at any stage of your pregnancy

Stay protected

Even if you’ve had a flu vaccine in the past, you need to get protected again this year because the virus changes constantly and your immunity reduces over time.

It only takes a few minutes to get immunised. The flu vaccine takes around 10 days to work, so the sooner you get it the better.

You can get the flu vaccine at any stage of pregnancy and at the same time as the whooping cough vaccine.

Keep healthy and flu free

If you’ve been pregnant before, remember that a healthy flu-free pregnancy last time is no guarantee you won’t catch flu this time. To make sure you get the maximum protection, you must get the vaccine again.

During vaccination, strict infection prevention and control measures will be in place.

Scotland’s Chief Medical and Chief Nursing Officers agree – healthcare workers should have the flu vaccine. If you don't get the vaccine you are putting yourself and people you care for at risk.

Healthcare workers should get the vaccine

Healthcare workers, directly delivering care, are more likely to be exposed to the flu virus.

Every year in Scotland, a number of healthcare workers get flu, particularly where there are flu outbreaks in care homes and hospitals.

Having the vaccine is the best way to help protect yourself against flu this year.

It reduces the risk of spreading flu to your family, patients and colleagues who could be at risk of catching the virus.

Healthcare workers who have flu can spread flu to their patients and family even if they've very mild symptoms or have no symptoms at all.

Patients with health conditions are 18 times more likely to die from flu than people without health conditions. In fact, people with a compromised immune system are over 50 times more likely than a healthy person to die of flu. And people with liver problems are 80 times more likely to die.

Even for healthy people, flu can be serious, making them feel extremely unwell and unable to carry on with everyday activities.

Who should have the flu vaccine

It’s recommended that anyone who works in healthcare, and is directly involved in patient care, should have the flu vaccine. This includes, but isn't limited to:

• anyone who works in a GP practice, pharmacy, dental surgery or hospital
• workers in paediatric wards, cancer centres and intensive care
• those working in the community, visiting patients at home

More information for healthcare workers

Visit the NHS Education for Scotland website to find out why getting immunised against flu's important.

This year, the Scottish Government is offering the free flu vaccine to social care workers of all ages employed by local authorities, private providers and third sector organisations who deliver direct personal care in the following settings:

• care and secure care for children
• care for persons at home (including housing support and care at home services)
• homes for adults

Protecting those most at risk

The aim is to protect those most at risk from concurrent infection of COVID-19 and flu.

If social care staff catch flu, they can spread it to people receiving care and their colleagues, even if they have very mild symptoms or no symptoms at all.

Social care workers often come into contact with those most vulnerable to the seasonal flu.

Vaccinating them will:

• help to protect social care workers from flu
• indirectly protect the people they care for.

Avoiding the spread of flu

A high rate of social care worker vaccinations will help protect individual staff members and reduce the risks of passing on flu infections to the most vulnerable in social care premises.

In addition, it will help to maintain the workforce and minimise disruption to services providing patient or client care by reducing staff sickness absence.

The flu vaccine provides the best protection available against the virus.

The vaccine:

• is given in the autumn ideally before flu starts circulating.
• does not contains live viruses, so can’t give you flu.
• has to be given every year because the virus changes constantly and your immunity reduces over time.

Remember, the flu virus is different from coronavirus (COVID-19).

The best way for social care staff to avoid flu is to get a flu vaccine as soon as possible.

Each NHS Board will work with social care organisations providing direct hands-on care to arrange flu vaccination for social care staff.

As with all medicines, side effects of the flu vaccine are possible, but usually mild and may include:

• injection site tenderness, swelling and/or redness
• headache
• muscle ache
• fever (temperature above 37.8°C)

If you are concerned about your child or anyone else in your household who is unwell following a vaccination, call NHS24 on 111.

Flu vaccination, fever and coronavirus

It is quite common for children and adults to develop a fever after a vaccination. This would normally happen within 48 hours of the vaccination and usually goes away within 48 hours.

You don't need to self-isolate or book a coronavirus test unless you or your child have other coronavirus symptoms (a new continuous cough or a loss of, or change in, sense of smell or taste) or:

• you have been told by NHS Test and Protect that you or your child are a close contact of someone who has tested positive for coronavirus
• you live with someone who has recently tested positive for coronavirus
• you live with someone who has symptoms of coronavirus

If the fever started 48 hours after the vaccination or continues beyond 48 hours from the time of the vaccination, you should self-isolate and book a test for you or your child. Your household should follow the guidance for households with possible coronavirus infection.

Further information about vaccine side effects

More information on the possible side effects of the flu vaccine is available in the Patient Information Leaflets (PILs):

• Quadrivalent Inactivated Vaccine (Sanofi Pasteur)
• Quadrivalent Inactivated Vaccine (Mylan)
• Quadrivalent Inactivated Vaccine (Flucelvax Tetra)
• Adjuvanted Trivalent Inactivated Vaccine - aTIV (Fluad®)

Where can I report suspected side effects?

You can report suspected side effects of vaccines and medicines through the Yellow Card Scheme.

This can be done by:

• visiting the Yellow Card Scheme website
• phoning the free Yellow Card hotline on 0808 100 3352 (available Monday to Friday, 10.00am to 2.00pm)

If you’re unsure about anything, or have any questions about the flu vaccine, speak to a health professional, such as your immunisation or practice nurse or GP.

Immunisation leaflets

Public Health Scotland have produced leaflets explaining the flu vaccination in Scotland, why it's offered and when it's given.

The leaflets are produced in Easy Read English and other languages – including Polish, Mandarin (Simplified Chinese) and Arabic.

65 years or over flu leaflet

Living with a health condition flu leaflet

Pregnant? flu leaflet

Work in health care? flu leaflet

Work in social care? flu leaflet

Flu vaccine leaflet (BSL)

Flu vaccine leaflet (Audio)

How does giving the free flu vaccine to more people manage the risk of a second wave of coronavirus?

With two potentially serious and life threatening viruses in circulation, it's vital to protect people at higher risk and help reduce the pressure on the NHS this winter.

It'll also help protect the people who are most vulnerable from being infected by flu and coronavirus at the same time.

Flu and coronavirus are different, but they have similar symptoms. If a patient has had the flu vaccine, it should reduce the chance they're suffering from flu. This means that if high-risk patients have had the flu vaccine, it's possible to diagnose coronavirus faster.

Why are social care workers, those living with people shielding, and 55-64 year olds getting the free flu vaccine?

Social care workers often come into contact with those most vulnerable to flu. Vaccinating them will help protect them from catching the flu and passing it on to the people they care for.

People previously asked to shield have already been identified as being at a high risk from coronavirus, and they could could catch the flu at the same time.

Vaccinating households that contain someone in the coronavirus shielding group will provide extra protection by vaccinating the people they're most likely to come into contact with.

Vaccinating 55-64 year olds will help to protect an age group vulnerable to both coronavirus and flu. It'll lower the risk of people in that group getting both viruses at the same time, although they're at a lower clinical risk from the flu than other eligible groups.

Why are those shielding not automatically eligible for the free flu vaccine?

Since most people shielding are either over 55 or have an underlying health condition, it's likely many are already eligible for the flu vaccine.

However, some people shielding have an underlying condition which may cause a poorer response to the flu vaccine.

The best protection we can offer people who are shielding is indirect protection through vaccinating those closest to them.

The current guidelines will be continually assessed in line with coronavirus shielding policy changes. If progress continues to be made on coronavirus, it's likely that the shielding policy and advice will change.​

Why isn't the Flu Programme expanding to cover first year pupils in secondary schools, like in England?

It's because of the different education systems. In Scotland, all pupils are eligible for the flu vaccination during their seven years of primary school.

England have six years of primary school and are expanding to their year 7’s, the first year of secondary school.

There's a large overlap between our primary 7’s, who are already eligible, and English year 7’s, who will be newly eligible this year.

Those of secondary school age who are considered at risk due to existing health conditions will remain eligible for the flu vaccine.

How will people find out about the Flu Programme, particularly if they're newly eligible?

The Scottish Government has launched a national campaign for the flu season. This will run on TV, radio, digital and print advertising.

A number of partners are also helping to share vaccination information with those most vulnerable to flu.

NHS inform is the best source of public information about the Flu Programme. Keep checking our flu vaccination page, or phone 0800 22 44 88.