Pharmacies experiencing flu vaccine shortages should direct patients to another provider rather than use a vaccine that is not first-line, Community Pharmacy England (CPE) has said.
Patients should be offered a first-line vaccine wherever possible, CPE advised, as pharmacy owners report strong demand during the first weeks of the seasonal vaccination programme.
Some contractors are reporting particular pressure on supplies of IIVc (cell-cultured inactivated influenza vaccine), with some saying they have exhausted their stocks.
This comes as Superdrug has advised patients that its online system for flu vaccination appointments is closed to further bookings. A message on the company's booking system says: "Due to limited vaccine stock availability, we have now closed bookings for the current season."
CPE said pharmacy owners should first establish whether another local pharmacy or general practice has first-line vaccines available before considering an alternative.
Under the NHS England Seasonal Vaccination Services Specification, patients should be directed to another provider with recommended vaccine stock or asked to rebook when the pharmacy expects its own supplies to become available.
The guidance is set out in paragraph 6.13 of the specification, which states that where a pharmacy contractor does not have a recommended vaccine in stock, patients should be directed to an alternative provider or told to return when supplies are available.
CPE said local communication between pharmacies and general practices would be important in identifying where first-line vaccines remained available. Local Pharmaceutical Committees (LPCs) may be able to support this coordination.
When can pharmacies use second-line flu vaccines?
The service specification states that alternative vaccines should only be considered when the recommended vaccine is unavailable to order from any manufacturer or the pharmacy's regular wholesaler.
Their use may also be considered in exceptional circumstances where there is a valid reason why a patient may not be able to return for another appointment.
CPE said it had been informed that IIVc was no longer available to order from manufacturers or wholesalers.
Where no first-line vaccine is available locally, pharmacy owners can consider offering a second-line vaccine. For patients aged 18 to 49, this would be IIVe (egg-cultured inactivated influenza vaccine).
However, pharmacies considering this option should keep a record of the steps taken to establish whether first-line vaccines were available locally before offering a second-line alternative.
The recommended vaccines for the 2026-27 season are set out in the government's Annual Flu Letter and the UKHSA's flu vaccine guidance poster.
CPE reiterated that the aim was to ensure patients received a recommended first-line vaccine wherever possible, rather than routinely switching to an alternative because a pharmacy had exhausted its own supplies.
