Preparing for Winter 2020 - Why you should have the flu vaccination

By Sammer Tang, Public Health Registrar, Gloucestershire Hospital NHS Foundation Trust ; Public Health Lead, College of Paramedics, Kirsty Morgan, Assistant Director of IPC, NHS England and NHS Improvement - Midlands Region



Amid the COVID-19 pandemic, another flu season is upon on us. Every year, Influenza kills an average of 8,000 people every year in the UK. This is not your average common cold.
Influenza or 'flu' is a respiratory illness associated with infection by influenza virus. For most people, flu is just a nasty experience, but for some it can lead to more serious illnesses. The most common complications of influenza are bronchitis and secondary bacterial pneumonia. These illnesses may require treatment in hospital and can be life threatening, especially in the elderly, very young children, and people with underlying health conditions.

Why should I be vaccinated?

It’s impossible to predict the impact that flu and COVID-19 will have this winter. The common symptoms of COVID-19 are very similar to those of influenza, including: fever, cough, sore throat and fatigue, this could make differentiation between the two difficult. In addition, it is well known that frontline healthcare workers are more likely to be exposed to Influenza virus and it has been estimated that up to 1 in 4 healthcare workers will become infected with influenza during a mild influenza season, this is considerably higher than the 5.44 in 100 people in the general population1.

70.2% of frontline ambulance clinicians in the NHS Ambulance Trusts in England were vaccinated against seasonal flu compared to 75.4% of healthcare workers with direct patient contact in Acute Trusts in 2019-2020. Although this is an increase of 4.7% across NHS Ambulance Trusts since the previous year2, this is short of the ambition of the Secretary of State for Health’s ambition of 100% of healthcare workers being vaccinated, unless they have a “very good, essentially clinical reason” not to be vaccinated.

While the seasonal flu vaccine won't protect you against COVID-19, it will reduce your risk of influenza. By protecting ourselves with the flu vaccine, paramedics not only reduce the risk of spreading flu to patients and our own families, but reduce the risk of service disruption, which is particularly important throughout winter where increased pressure on services is common. There is no such thing as natural immunity against the flu virus and healthcare workers are encouraged to have their vaccine annually to ensure they are protected.

What to do next?

The year flu vaccine is a quadrivalent vaccination which contains four inactivated influenza viruses3,4. It is considered to be the best protection against an unpredictable influenza virus and has a good safety record, therefore we should all be vaccinated to protect ourselves, our patients and our families, unless there is a clinical reason not to be vaccinated. This year is particularly important for you to be vaccinated as early in the flu campaign as possible, this will reduce the burden of flu related admissions as well as ensuing that paramedics and all frontline ambulance staff are able to have the COVID-19 vaccination should it become available.

In addition to frontline healthcare workers, the flu vaccine is also offered to at risk groups, as part of making every contact count paramedics should be encouraging the uptake of vaccination in these patient groups5:

• All children aged two to year 7 at secondary school.
• Those in clinical risk groups and aged between six months and under 65 years
• Pregnant women
• Those aged 65 years and over
• Those in long-stay residential care homes
• Carers
• Those on the shielding list for COVID-19
• Close contacts of immunocompromised individuals and household contacts of those people on the shielding list for COVID-19


1. Kuster et. al. (2011) Incidence of Influenza in Healthy Adults and Healthcare Workers: A Systematic Review and Meta-Analysis

2. Public Health England (2020a) Seasonal influenza vaccine uptake in healthcare workers (HCWs) in England: winter season 2019 to 2020 [Online]

3. Tang S. & Morgan K. (2020). Seasonal flu, vaccinations and COVID-19, Journal of Paramedic Practice. 12(9): 346-348 [Online]

4. WHO (2020) Recommended composition of influenza virus vaccines for use in the 2020 - 2021 northern hemisphere influenza season [Online]

5. Public Health England (2020b). National flu immunisation programme plan