By Lucy Ashton
The decision is revealed in a letter from Sir Gregor Smith, Scotland’s Chief Medical Officer, which also excludes other groups previously offered early access to the vaccine through NHS Scotland.
Those aged 65-74, pregnant women and others at ‘clinical risk’ from chronic respiratory, heart, kidney, liver and neurological conditions and diabetes are among Scots no longer set to automatically be eligible to receive the vaccine through their health board.
While health and care staff are not being offered the COVID vaccine, residents in older adult care homes will still be eligible.
Adults over 75 years old and the immunocompromised will also still be offered early access to the COVID vaccine through NHS Scotland.
The updated guidance comes after the UK-wide Joint Committee on Vaccination and Immunisation’s updated its advice on COVID vaccination programmes.
The Chief Medical Officer also writes that, with population immunity to COVID increasing due to a combination of acquired immunity after having COVID and vaccine-derived immunity, it is now a ‘relatively mild disease’ for most.
COVID and flu head in opposite directions
However, eligibility for both the adult and child flu vaccination programme in 2025-26 ‘remains identical’ to the winter 2024-25 vaccination programme.
It also follows rising rates of hospitalisations caused by the flu and the number of flu deaths in Scotland reaching a 45-year high this year, nearly double those seen in 2024.
By contrast, the harm caused by COVID has seen a relatively steady decline since it last peaked in July of 2024.
Despite a winter 2023-24 spike in hospitalisations from COVID almost exactly aligned with the flu spike, from December 2024 to January 2025, COVID hospitalisations remained low amid the huge spike in hospitalisations for the flu.
This also follows a decrease in both COVID-19 and flu vaccine uptake for all eligible groups for 2023-25 winter compared to winter 2022-23.
Health and social care workers and pregnant women were among the least likely to take up the offer of vaccination despite what Public Health Scotland’s Head of Vaccination and Immunisation Dr Sam Ghebrehewet said are the clear benefits:
“Vaccination remains the best protection against severe outcomes of both flu and COVID-19 and reduces the likelihood of severe illness, hospital admission, and in some cases death.
“Work is underway to understand the reasons behind the decrease in vaccine uptake. This is crucial to ensure that those most vulnerable are aware of their eligibility for vaccination.”
Now, while encouraging those groups to take up their flu vaccinations, Scotland’s CMO say a ‘more refined approach’ will be taken to the COVID vaccination programme.
In his letter co-signed by the Chief Pharmaceutical Officer and Acting Deputy Chief Nursing officer, CMO Sir Gregor Smith says focusing on providing vaccination to individuals at ‘high risk of hospitalisation and/or mortality,’ is the priority and aligns with the latest UK-wide advice.
The Royal College of Physicians of Edinburgh told healthandcare.scot that the factors which led to this decision will be monitored “very carefully” along with the levels of illness caused by COVID to assess the impact of the new winter vaccination programme.
RCPE President Professor Andrew Elder, pictured left, said: “We are aware that the JCVI has decided to decrease the number of cohorts of individuals who are eligible for a COVID vaccination for winter 25/26 and it has based this on a number of factors, including levels of immunity to COVID increasing due to greater naturally acquired immunity following recovery from infection.
“We understand this decision but know the JCVI, along with governments and public health agencies across the UK, will continue to monitor very carefully levels of illness caused by COVID and assess the impact of the new eligibility categories as winter progresses.”
Professor Elder said the College shares concerns about the reduction in winter uptake of the flu vaccination last year among health and social care workers, adding:
“We would urge everyone eligible for vaccinations to take these up as these remain the best possible protection against illness and, in extreme cases, death. We would urge NHS and social care employers to help ensure their staff can become vaccinated and have the flexibility necessary to attend vaccination appointments.”
Top of page picture: Sir Gregor Smith, Scotland’s Chief Medical Officer.