Autumn/Winter (AW) 2023-24 Flu and COVID-19 Seasonal Campaign

Classification: Official
Publication reference: PRN00695


  • Integrated care board (ICB) chief executives
  • Trust chief executives
  • GP practices
  • Community pharmacies
  • Primary care networks
  • Local government chief executives
  • Health and Justice healthcare providers
  • School aged immunisation service providers
  • Directors of public health


  • Regional directors
  • Regional directors of commissioning

Dear colleagues,

Autumn/Winter (AW) 2023-24 Flu and COVID-19 Seasonal Campaign

Thank you for your continued commitment to all routine and seasonal vaccination programmes and for the planning you have undertaken to date in readiness to deliver the forthcoming Autumn Winter Flu and COVID-19 campaign.

Following JCVI advice earlier this week, we are now in a position to set out next steps for Flu and COVID-19 delivery for Autumn Winter 2023/24 to maximise protection and uptake for all of those eligible.

We ask that both flu and COVID-19 vaccinations for adults commence in October and are preparing to offer the most up-to-date COVID-19 vaccine as the predominant vaccine in Autumn. Flu vaccines for children should start from September.

Vaccination is an essential part of protecting the public and staff over the colder months. The approach being taken to timing and coadministration maximises clinical protection, and therefore the resilience of health and care services, over the later winter months when flu and COVID-19 are most likely to be prevalent.

By supporting greater levels of co-administration of vaccines we also collectively have an opportunity to achieve greater efficiency in delivery for providers at what we know is already a busy time of year.

Cohort eligibility

The Government has this week accepted final Joint Committee for Vaccination and Immunisation (JCVI) advice for a COVID-19 Autumn 2023 seasonal campaign. The groups to be offered a COVID-19 booster vaccine are:

  • Residents in a care home for older adults
  • All adults aged 65 years and over
  • Persons aged 6 months to 64 years in a clinical risk group, as laid out in the Immunisation Green Book, COVID-19 Chapter (Green Book)
  • Frontline health and social care workers
  • Persons aged 12 to 64 years who are household contacts (as defined in the Green Book) of people with immunosuppression
  • Persons aged 16 to 64 years who are carers (as defined in the Green Book) and staff working in care homes for older adults.

The JCVI also advises primary course vaccination for individuals in the above cohorts who have not had any previous doses should be offered. They should receive a single dose of COVID-19 vaccine during the campaign period.

Eligible cohorts for the flu programme remain unchanged from those set out in the National flu immunisation programme 2023 to 2024 letter. The age cohorts for flu and COVID-19 vaccinations have been aligned and will allow for co-administration.

All those who turn 65 years by 31 March 2024 are eligible for both vaccinations.

Campaign timing


To maximise and extend protection during the winter and through the period of greatest risk in December 2023 and early January 2024, systems must commence vaccination for care home residents and care home staff from 2 October 2023, and other eligible flu and COVID cohorts from the 7 October. 

Flu and COVID-19 vaccination for all cohorts should be completed by 15 December 2023, with all systems identifying opportunities to maximise the offer of co-administration of flu and COVID-19, to improve convenience and uptake for communities.  We will set out some narrow clinical exceptions in the coming days.

Payment for vaccinations will ordinarily only be made following the service commencement date. However, we understand that some firm commitments and appointments have already been made, so where this is the case and the patient wishes to receive flu vaccination in September, NHS England will permit payment claims to be submitted.

To give maximum protection to frontline health social care workers and to protect patients and residents, all systems are asked to ensure convenient flu and COVID-19 vaccination opportunities are available from 7 October 2023. All frontline eligible staff will continue to be able to self-declare on NBS and we expect all systems to have communication plans in place to maximise uptake for this group.

Systems are asked to maintain their focus on health inequalities and should continue to deliver engagement, outreach and pop-up clinics to support vaccination of underserved communities up to 31 January 2024. 


Flu vaccinations for 2-3-year-olds, school-age children (reception to year 11) and children in clinical risk groups must start from 1 September 2023 or as early as possible after the vaccine becomes available.  This group must be prioritised early in the season to reduce transmission and ensure minimal impact on routine immunisations in the new year. The school-age programme should be completed no later than 15 December 2023.

GPs and SAIS providers should also take the opportunity to check children’s MMR status and offer vaccination if not up to date, as well as signpost to COVID-19 vaccination services for those who are eligible. This is particularly important in areas with low uptake and for those who are immunocompromised.

Next steps

  • Care homes and housebound: Working with their PCN Groupings and providers, regions should prioritise vaccination of residents and staff in older adult care homes and arrange vaccination for eligible individuals who are housebound or resident in non-older adult care homes.
  • The National Booking Service (NBS) will be opened for participating sites to post appointments from the 25 September 2023. NBS will be open for the public to book appointments, whether via, the NHS App or telephone, from 2 October 2023 in readiness for 7 October start. In support of co-administration people will be able to book a joint flu and COVID-19 appointment which improves the experience for citizens and offers efficiency for providers.
  • The COVID-19 vaccine for Autumn Winter 2023/24 will be confirmed shortly and we can confirm there are no supply constraints.  As with previous campaigns, supply will be made available at least 1 week before the commencement of the campaign to enable sites to open calendars for bookings. Site designation will need to be confirmed before supply can be delivered. Following your feedback, changes to supply arrangements will increase flexibility and responsiveness, such as sharing visibility of flu delivery dates with all sites.  Where sites have issues with larger supply volumes, central storage solutions will be made available via your regional team.
  • COVID-19 vaccination site readiness and stand up: working with their Integrated Care Boards (ICBs), regional teams should identify the sites which will deliver COVID-19 vaccinations in this campaign. New vaccination sites (including those which have delivered in previous campaigns but subsequently closed) will need to be designated via the established process. Regional teams will need to confirm which sites currently delivering in the programme (in an active or paused state) will be commissioned for the next campaign. The Community Pharmacy Expression of Interest was published on 4 August 2023 [CP EOI process]. Site Designation Guidance will follow shortly.
  • Training materials and contracts: National Protocols (NP), Patient Group Directions (PGD) and updated training materials will be published for the COVID-19 campaign. Updated flu and COVID-19 contracts can be found in Appendix 1.
  • Systems should make tackling health inequalities and areas/groups of low uptake a priority for all their work on flu and COVID-19 vaccination. The local approach in each system should be detailed in specific engagement and outreach plans and funded by system access and inequality allocations.  This funding for continued engagement and outreach resource is supported through a reduced item of service payment and is made available to all systems to improve uptake and promote health equity.  Plans to support community engagement, outreach and targeted delivery (through pop-ups and mobile clinics for example) must be informed by the needs of local communities and co-developed with local partners, especially local authorities, primary care and voluntary, faith and community sector partners.  Plans aligned to population health analysis should build on existing evidence and evaluation, and systems are required to monitor the impact of funded activity through the monthly national data return, including utilising the available digital tracking solution for published communications.

We are grateful for your ongoing leadership of a world-leading vaccination programme, which helps keep people well and protect those most at risk from the effects of these vaccine preventable diseases, and we look forward to working with you to deliver a successful campaign in AW23/24. 

Yours sincerely,

Steve Russell, National Director for Vaccinations and Screening, NHS England

Documents for GPs

Documents for CPs