General practitioner GP practices England Wales

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Vaccinations and immunisations guidance

The national arrangements for providing vaccines and immunisations are set out in the additional services section of the Statement of Financial Entitlements (SFE).

Those vaccines and immunisations that are provided as enhanced services will have their arrangements outlined in service specifications.

Influenza immunisations for 2018/19

Following advice by NHS England, Public Health England and the JCVI about the adult flu programme on quadrivalent vaccine for at risk groups and adjuvanted trivalent vaccine for over 65s, NHS England published guidance to practices on vaccine ordering for 2018-19 influenza season, which recommends the use of the adjuvanted trivalent vaccine (aTIV) for over 65s, and the quadrivalent vaccine (QIV) for 18 - under 65s at risk. There will be a phased approach (across September, October and November) for delivery of aTIV.

Further advice and FAQs are available on the NHS England website.

The Public Health Medicine Committee has also written to NHS England expressing concerns about the efficacy of the flu vaccine for 2018/19. Read NHS England’s response.


GP contract-related changes to vaccinations and immunisation programmes

From 1 April 2018, there were changes to some vaccination and immunisation programmes as outlined in the 2018/19 GP contract agreement for England. The item of service (IoS) fee for a number of vaccinations was increased from £9.80 to £10.06 per dose, as shown in the section below.

The following documents from NHS Employers contain more detailed guidance on a majority of the programmes listed below:

  • Vaccination and immunisation programmes 2018-2019 guidance and audit requirements
  • Technical requirements for 2018-2019 GMS Contract changes

More information about all the changes are available on the NHS Employers website


Changes to existing vaccination programmes

Hepatitis B at-risk (new born babies)

SFE (IoS £10.06 per dose)

New born babies whose mother has Hepatitis B are at increased risk of contracting the disease. The number of recommended doses has been reduced to three, removing the third dose at 2 months. This was an in-year change effective from 30 October 2017.


Meningococcal ACWY (MenACWY)

The MenACWY 18-25 year programme was removed on 1 April 2018.


Meningococcal ACWY (MenACWY) completing dose

SFE (IoS £10.06 per dose)

The cohort has been extended to include eligible school leavers previously covered by the 18 years programme. The eligibility is now 1 April 2012.


Meningococcal B (Men B) infants

SFE (IoS £10.06 per dose)

The programme is for three doses of vaccine at 2, 4 and 12 months (in line with the childhood immunisation programme), with a catch-up element in place for children up to 2 years who can be vaccinated on an opportunistic basis. The programme has now been moved in to the SFE, but is not included in the targeted programme.

NHS Employers' vaccs and imms FAQs explain the eligible age cohort and what practices can do if parents approach them about having children outside the cohort vaccinated privately.


Pneumococcal PCV

SFE (IoS £15.02 per dose)

There is a consultation underway relating to the removal of one dose of pneumococcal PCV from the childhood programme. In the event this change is agreed, the funding for the remaining dose will remain at £15.02.



Continuing vaccination programmes

The following vaccination programmes are continuing unchanged.


Childhood immunisations (targeted programme)


The arrangements for the Childhood vaccines and immunisations targeted programme are set out in Chapter 11 of the Statement of Financial Entitlements.


Childhood seasonal influenza

Enhanced service (IoS £9.80 per dose)

1 dose of nasal spray recommended for 2-3 year-olds, with alternative inactivated vaccine only available for children defined as at-risk in the specification and green book.

Service specification for childhood seasonal influenza vaccination 2018/19 (NHS England, PDF)


HPV completing dose

SFE (IoS £10.06 per dose)

Practices to administer HPV booster vaccinations opportunistically or following patient request when child unable to access or missed school programme provision. The patient cohort for this programme is girls aged 14-18 years.


Meningococcal ACWY (MenACWY) vaccination for university freshers

Enhanced service (IoS £10.06 per dose)

Service specification for MenC vaccination for freshers 2018/19 (NHS England, PDF)



SFE (IoS £10.06 per dose)

In  2013-14, there was a MMR catch-up campaign in England in response to local measles outbreaks. From 1 April 2015, patients over 16 who have no record of vaccination and who self-present to the practice requesting vaccination, are to be continued to be vaccinated.


Pertussis (whooping cough) for pregnant women

Enhanced service (IoS £9.80 per dose)

Pertussis (whooping cough) vaccination programme for pregnant women 2018/19 service specification (NHS England, PDF)



SFE (IoS £10.06 per dose)

The rotavirus vaccine is part of the childhood immunisation schedule and should be provided at 6 weeks and 6 months.

Read Public Health England guidance on the rotavirus vaccination


Seasonal flu and pneumococcal vaccination programme

(IoS £9.80 per dose)

The enhanced service specifications for 2018/19 has been published on the NHS England website, as well as the Annual national flu immunisation letter for 2018/19.

As of November 2017, are workers can also access the flu vaccine via their community pharmacy, further information is available on the NHS England website.

Further guidance from Public Health England on the Annual flu programme


Shingles Routine vaccination

SFE (IoS £10.06 per dose)

Patients are eligible when they turn 70, rather than their age on a specific date. Practices can now offer the shingles vaccine opportunistically to patients throughout the year as they become of eligible age.


Shingles Catch up programme

Enhanced service (IoS £10.06 per dose)

Patients are eligible when they turn 78 or 79 at the time of the vaccination. Patients previously eligible remain eligible until their 80th birthday.

Service specification for shingles (catch-up) vaccination programme 18/19 (NHS England, PDF)

Further information about both the routine and catch up programmes are available from the NHS Employers website.


Further guidance

Focus on travel immunisation
Our summary guidance explains which travel immunisations are available on the NHS and which can be charged for privately.

Focus on hepatitis B immunisations
Our summary guidance on hepatitis B immunisations aims to clarify the circumstances where charges can be made and where active attempts to encourage immunisation ought to be made.

Focus on vaccines and immunisations
Information for GPs about payment for vaccines and immunisations, including additional guidance specific to the devolved nations.

Patient Group and Patient Specific Directions
Our guidance explains when Patient Group and Patient Specific Directions should be used to prescribe and administer a Prescription Only Medicine (POM).

Public Health England immunisations PGD templates - Public Health England