|All people aged 65 years or over
||Including those becoming age 65 years by 31 March 2017.
|People aged from 18 years to less than 65 years of age with one or more serious medical condition(s) outlined below:
|Chronic (long term) respiratory disease, such as severe asthma, chronic obstructive pulmonary disease (COPD) or bronchitis
||Asthma that requires continuous or repeated use of inhaled or systemic steroids or with previous exacerbations requiring hospital admission.
Chronic obstructive pulmonary disease (COPD) including chronic bronchitis and emphysema; bronchiectasis, cystic fibrosis, interstitial lung fibrosis, pneumoconiosis and bronchopulmonary dysplasia (BPD).
|Chronic heart disease, such as heart failure
||Congenital heart disease, hypertension with cardiac complications, chronic heart failure, individuals requiring regular medication and/or follow-up for ischaemic heart disease.
|Chronic kidney disease at stage three, four or five
||Chronic kidney disease at stage three, four or five, chronic kidney failure, nephrotic syndrome, kidney transplantation.
|Chronic liver disease
||Cirrhosis, biliary atresia, chronic hepatitis.
|Chronic neurological disease, such as Parkinson’s disease or motor neurone disease, or learning disability
||Stroke, transient ischaemic attack (TIA). Conditions in which respiratory function may be compromised due to neurological disease (e.g. polio syndrome sufferers).
Clinicians should offer immunisation, based on individual assessment, to clinically vulnerable individuals including those with cerebral palsy, learning disability, multiple sclerosis and related or similar conditions; or hereditary and degenerative disease of the nervous system or muscles; or severe neurological disability.
||Type 1 diabetes, type 2 diabetes requiring insulin or oral hypoglycaemic drugs, diet controlled diabetes.
|A weakened immune system due to disease (such as HIV/AIDS) or treatment (such as cancer treatment)
||Immunosuppression due to disease or treatment, including patients undergoing chemotherapy leading to immunosuppression, bone marrow transplant, HIV infection at all stages, multiple myeloma or genetic disorders affecting the immune system (e.g. IRAK-4, NEMO, complement deficiency).
Individuals treated with or likely to be treated with systemic steroids for more than a month at a dose equivalent to prednisolone at 20mg or more per day (any age), or for children under 20kg, a dose of 1mg or more per kg per day.
It is difficult to define at what level of immunosuppression a patient could be considered to be at a greater risk of the serious consequences of influenza and should be offered seasonal influenza vaccination. This decision is best made on an individual basis and left to the patient’s clinician.
Some immune-compromised patients may have a suboptimal immunological response to the vaccine.
||This also includes conditions such as homozygous sickle cell disease and coeliac syndrome that may lead to splenic dysfunction.
|All pregnant women (including those women who become pregnant during the flu season)
|Pregnant women aged 18 or over at any stage of pregnancy (first, second or third trimesters).
|People living in long-stay residential care homes or other long-stay care facilities
||Vaccination is recommended for people living in long-stay residential care homes or other long-stay care facilities where rapid spread is likely to follow introduction of infection and cause high morbidity and mortality. This does not include, for instance, prisons, young offender institutions, or university halls of residence. For the pharmacy service, this only applies to those aged 18 or over.
||People who are in receipt of a carer’s allowance, or those who are the main carer of an older or disabled person whose welfare may be at risk if the carer falls ill.
|Household contacts of immunocompromised individuals
||People who are household contacts, aged 18 and over, of immunocompromised individuals, specifically individuals who expect to share living accommodation on most days over the winter and, therefore, for whom continuing close contact is unavoidable.