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Seasonal flu vaccination for care home residents

For prescribers and all staff responsible for administering vaccines in care homes.

You can download a full pdf version of this document by following the link on the right.


This information ensures that seasonal flu vaccinations for residents in a care home happen safely and in line with current best practice.


All residents living in long-stay residential care homes should be offered a seasonal flu vaccine.


When a clinician administers vaccines to a resident in a care home, they must have documented consent. It’s very important to make sure that residents who have capacitygive consent to vaccination, or to act in the best interests of those without capacity.

The consent needs to happen on a yearly basis. The Medical Defence Union has some useful guidance on consent and capacity in relation to administration of flu vaccine to care home residents. We strongly recommend that clinicians refer this before administering, or instructing others to administer vaccinations.

Find out more about consent to treatment and capacity and decision making and consent

Residents’ relatives, friends, or care home staff who don’t have the appropriate legal powers can’t sign vaccination consent forms.

Authorising administration

A GP or independent prescriber can administer a vaccine. They may also authorise others to administer them.

There are two ways of doing this.

Patient group direction (PGD)

A registered nurse or paramedics employed by the registered GP practice may administer vaccines to residents. They can use the NHS England PGD for the current year if they’re named and certified as competent to use it.

You can’t use an NHS PGD to authorise vaccine administration by non-NHS staff employed in care homes.

Patient specific direction(PSD)

A PSD authorises suitably trained and competent healthcare professionals to administer a vaccine to a group of residents.

The residents must be:

  • identified by name
  • date of birth
  • NHS number
  • individually assessed as suitable to have the vaccine.

The GP or IP responsible for the patient’s care must sign the PSD and specify:

  • the vaccine brand
  • route of administration
  • dose
  • frequency
  • start and finish dates

You must retain a copy of all signed PSDs in line with the NHS Records of Code Practice.

Any person administering a vaccine must:

  • have the necessary experience, skills and training
  • be competent to administer the vaccine
  • be able to identify adverse reactions.

Allergic reactions to the flu vaccine

There should be a protocol for managing anaphylaxis and the use of adrenaline (epinephrine) 1:1000 injection in the care home. The GP practice should supply vaccines along with the adrenaline with registered patients in the care home.

Serious allergic reactions (anaphylaxis) to flu vaccines are very rare. Healthcare staff giving vaccinations should be fully trained to recognise and deal with anaphylaxis reaction.

Vaccine records

You must keep your own records of vaccines administered at the care home, even when they’re administered by NHS staff.

You should record the:

  • vaccine name, product name, batch number and expiry date
  • site of the vaccine administration
  • date of vaccine administration
  • name of the nurse administering and their signature
  • PGD or PSD. If the vaccine was administered under PSD, you should also record the name of authorising.

You must also send full details to the GP practice for audit and recording purposes and to facilitate recall.

Vaccine storage

You must store seasonal flu vaccines in a specialist refrigerator (+2 to +8 degrees centigrade).

Do NOT store vaccines in a domestic refrigerator. Check fridge temperatures daily using a maximum/minimum thermometer and record those temperatures.

Care home staff should know what to do when storing vaccines in fridges.

You must make sure there’s adequate refrigerated storage in the care home if you plan to store stock. You must also maintain the cold chain during any transfer of the vaccine.

Additional information

National flu immunisation programme plan 2023 to 2024


Consent for immunisations

Supporting the delivery of immunisation education