What are the current recommendations for seasonal influenza vaccination in high-risk groups?

Current recommendations for seasonal influenza vaccination in high-risk groups include:

• Offer free flu vaccination to people in clinical risk groups, which include those with chronic respiratory diseases (such as asthma requiring steroids or previous hospital admissions, COPD, bronchiectasis), chronic heart, kidney (stage 3 or above), liver, neurological diseases (e.g., Parkinson's, motor neurone disease, learning disabilities), diabetes, immunosuppression (due to disease or treatment), asplenia or splenic dysfunction (including sickle cell disease and coeliac disease), and morbid obesity (BMI ≥40) ¹,³.
• Vaccinate pregnant women and carers (both those receiving carer's allowance and informal main carers) as they are also eligible groups ¹.
• Use age- and risk-appropriate vaccines: for adults aged 65 and over, adjuvanted quadrivalent influenza vaccine (aQIV) or high-dose quadrivalent influenza vaccine (QIV-HD) are preferred; for eligible adults 60-64 years, QIVc or QIV-HD; for adults 18-59 years in risk groups, QIVc; for children 6 months to under 2 years in risk groups, QIVc; and for children 2 to under 18 years, live attenuated influenza vaccine (LAIV) is preferred unless contraindicated ²,³.
• Do not vaccinate individuals with a confirmed anaphylactic reaction to a previous dose or any vaccine component (except ovalbumin in most cases), and postpone vaccination in those acutely unwell with febrile illness until recovery ²,³.
• Fluenz nasal spray (LAIV) is contraindicated in severely immunocompromised children or young people, those with severe egg allergy requiring intensive care, and those on systemic salicylate therapy ²,³.
• Vaccination should also be offered to household contacts of immunocompromised individuals to reduce transmission risk ³.

Additional recommendations to increase uptake include: using every opportunity in primary and secondary care to identify and offer vaccination to eligible individuals, providing multiple convenient vaccination routes (GP, pharmacies, clinics), and targeted communication and education for both patients and healthcare staff ¹.