Officials have confirmed that the scope of the campaign for the coming flu season could be expanded and that health fears sparked by the COVID-19 pandemic could push up demand.
A joint NHS England and DHSC letter to GPs on 14 May warned that delivering the flu vaccination programme in 2020/21 'is likely to be more challenging because of the impact of COVID-19 on our health and social care services'.
But despite the challenging environment, practices may need to deliver more vaccinations than in previous years to help ease pressure on the health services amid concerns that next winter could see flu and COVID-19 circulating in tandem.
The letter confirms that 'discussions to consider expansion of the flu programme for this autumn are underway', and that 'concerns about COVID-19 may increase demand for flu vaccination in all groups this year'.
For the time being, flu jabs under the national vaccination programme will cover children aged two to 10, those aged six months to under 65 years in clinical risk groups, pregnant women, people over 65, care home residents, carers, close contacts of immunocompromised individuals and health and social care staff.
However, details of the second phase of NHS England's response to the pandemic revealed that officials 'expect an expanded winter flu vaccination campaign' for 2020/21.
The most recent letter says if any changes are confirmed, GPs will be updated 'in due course'.
During a webinar on Thursday evening (14 May), NHS England director of primary care strategy Ed Waller said that he hoped practices would receive further information about whether the flu campaign would be expanded 'as quickly as possible'.
He added that NHS England also planned to share ideas and best practice about how practices could deliver flu vaccinations this autumn because 'if we're still in a world of social distancing and PPE, that will make it more complicated'.
The letter says: 'Flu vaccination is one of the most effective interventions we have to reduce pressure on the health and social care system this winter. We are currently seeing the impact of COVID-19 on the NHS and social care, and this coming winter we may be faced with co-circulation of COVID-19 and flu.
'We understand that planning this year is more challenging with the uncertainties of staff absences, and how long policies around social distancing and school closures will remain in place.
'However, it is more important than ever to make every effort to deliver flu vaccination. Those most at risk from flu are also most vulnerable to COVID-19. We must do all we can to help protect them this winter.'
The letter adds that GP practices should currently continue to plan for the flu programme 'as usual', with a view to completing vaccinations by the end of November.
It warns: 'This season it will be more important than ever to ensure that sufficient stocks of the recommended adult flu vaccines have been ordered for your eligible patients. In light of COVID-19, we ask primary care providers (GP practices and community pharmacies) to urgently review your vaccine orders now to make sure the number of vaccines ordered meet at least national ambitions and previous uptakes rates, whichever is highest.'
The letter adds that NHS officials 'expect universal vaccination of health and care workers' - and says further guidance will be issued on this in due course.