RSV, flu and winter vaccines: who should really get protected?

Creator: Longeva Wellness
Published: 2026-08-10T09:28:22-0400

August 10, 2026|Longeva Wellness

Every autumn the NHS opens its winter vaccination programme, and every autumn the same question comes up at the pharmacy counter: which of these jabs do I actually need? Flu, pneumococcal and RSV vaccines each protect against a different infection, and each has its own eligibility rules. The short answer: if you are 65 or over, pregnant, or living with a long-term health condition, you are likely eligible for one or more free on the NHS. If you fall outside those groups but still want protection, you can usually have them privately. Here is who should consider each one, who pays, and whether you can have more than one at the same time.

The flu vaccine: needed every year

Flu is the vaccine most adults will recognise. It is offered on the NHS every autumn or winter, and it has to be given annually for two reasons: protection fades over the months, and the strains in circulation change from one season to the next, so the vaccine is reformulated each year.

The free NHS flu vaccine is offered to adults aged 65 and over, people with certain long-term health conditions, pregnant women, care home residents, carers, people who live with someone who has a weakened immune system, and frontline health and social care workers.

Which long-term conditions count as at risk?

The list of qualifying conditions is broad. According to the NHS, it includes breathing conditions such as asthma needing a steroid inhaler or tablets, COPD or cystic fibrosis; heart conditions such as coronary heart disease or heart failure; chronic kidney disease; liver disease such as cirrhosis or hepatitis; some brain or nerve conditions; diabetes or Addison's disease; a weakened immune system from HIV, chemotherapy or steroid medicine; spleen problems; a learning disability; and a body mass index of 40 or above. If you live with any of these, you are in an at-risk group and the flu vaccine is free.

Timing matters too. For the 2025/26 programme, pregnant women and eligible children could start being vaccinated from 1 September 2025, with other adult flu cohorts starting from 1 October 2025 and the programme running to 31 March 2026. If you are not eligible on the NHS, you can book a private flu vaccination instead. You can see our current flu vaccination options in Manchester and check timing against your own circumstances.

The pneumococcal vaccine: usually one and done

Pneumococcal disease can cause pneumonia, blood poisoning and meningitis, and the vaccine that protects against it works differently from the annual flu jab. Most adults are offered a single dose of the pneumococcal vaccine when they turn 65, and that one dose gives long-term protection. There is no annual repeat for the general over-65 group.

Who under 65 should consider it

The pneumococcal vaccine is also offered to people under 65 at higher risk. The NHS lists those with spleen problems or who have had a splenectomy, sickle cell disease, coeliac disease, chronic respiratory conditions such as COPD or cystic fibrosis, heart disease, chronic kidney disease, liver conditions such as cirrhosis, diabetes, a weakened immune system, cerebrospinal fluid leaks and cochlear implants.

One-off dose or repeat every five years?

Whether you need a single dose or a repeat depends on your underlying condition. People at higher risk may be given a single one-off dose or one dose every five years; those whose spleen does not work properly, or who have chronic kidney disease, may need booster doses every five years. If you are unsure which applies to you, a pharmacist can check your history during a consultation.

The RSV vaccine: newer, and worth understanding

RSV (respiratory syncytial virus) is the most recent addition to the winter programme, and it is the one people understand least. RSV is a common cause of coughs and colds that usually gets better by itself, but in some people, especially babies and older adults, it can cause illnesses such as pneumonia and bronchiolitis and can become life-threatening. UKHSA estimates RSV causes 5,000 to 7,500 deaths in older adults in England and Wales every winter, with the vast majority in adults over 75.

Who is eligible for the RSV vaccine?

The NHS RSV vaccine is offered to people who are aged 75 or over, who live in a care home for older adults, or who are 28 weeks pregnant or more, with the vaccine recommended during every pregnancy. The programme is also widening: from 1 April 2026 the NHS RSV programme expanded to include all adults aged 80 and over and all residents of care homes for older adults, around 3 million additional people. To put the scale in context, RSV causes around 9,000 hospitalisations in those aged over 75 in the UK each year.

How often do you need it?

RSV is not an annual jab. Pregnant women receive one dose of the RSV vaccine per pregnancy, and older adults receive a single dose that should protect them for several years. You can read more on our RSV vaccination page.

NHS or private: who pays?

The pattern is consistent across all three vaccines. If you fall into an eligible NHS cohort, age 65 or over for flu and pneumococcal, age 75 or over or pregnant for RSV, or you have a qualifying long-term condition, the vaccine is free. If you fall outside those groups, for example you are under 65 and otherwise healthy but want flu protection, or you are between 65 and 74 and would prefer not to wait for the RSV programme to reach you, you can have these vaccines privately. We also offer the pneumococcal vaccination for those who want it outside the NHS schedule.

For completeness, COVID-19 sits alongside these in the winter programme. For the 2025/26 season the NHS COVID-19 vaccine is offered to people aged 75 and over and to people aged 6 months and over who are immunosuppressed as defined in the Green Book, with that programme running from 1 October 2025.

Can you have more than one at the same appointment?

This is the question we are asked most, and the answer is not a simple yes for every combination.

The pneumococcal and RSV vaccines can be given together. Abrysvo, the RSV vaccine, can be safely given with other inactivated vaccines routinely given to older people eligible for the RSV programme, such as the pneumococcal vaccine. Where more than one vaccine is given, they should be at a separate site, preferably a different limb, or at least 2.5cm apart if in the same limb.

Flu and RSV are the exception. UKHSA guidance recommends that the RSV and seasonal flu vaccines should not routinely be scheduled to be given at the same appointment or on the same day, because co-administration may reduce the immune response to the RSV vaccine and potentially the influenza A(H3N2) component. In practice that usually means spacing those two out across separate visits, which a pharmacist can plan with you.

Frequently asked questions

Can you have the flu and RSV vaccine together?

UKHSA advises that the RSV and seasonal flu vaccines should not routinely be scheduled for the same appointment or the same day, because giving them together may reduce the immune response to the RSV vaccine and potentially to the influenza A(H3N2) component. Your pharmacist can plan separate visits so both are covered.

Do you need the pneumococcal vaccine every year?

No. Most adults are offered a single dose of the pneumococcal vaccine when they turn 65, and that one dose provides long-term protection. Only people with certain conditions, such as a spleen that does not work properly or chronic kidney disease, may need booster doses every five years.

Who is eligible for the free NHS RSV vaccine?

The NHS RSV vaccine is offered to people aged 75 or over, those living in a care home for older adults, and women who are 28 weeks pregnant or more, with vaccination recommended in every pregnancy. From 1 April 2026 the programme widened to include all adults aged 80 and over and all older-adult care home residents.

Why does the flu vaccine have to be given every year?

The flu vaccine is given annually because protection reduces over time and the flu strains in circulation change each year, so the vaccine is updated for each season. It is offered on the NHS every autumn or winter.

I am not eligible on the NHS. Can I still get protected?

Yes. If you fall outside the NHS cohorts you can have flu, pneumococcal and RSV vaccines privately. A consultation lets a pharmacist confirm which vaccines are right for you and how to space them.

Book a winter vaccination consultation

If you are not sure which winter vaccines apply to you, or you want to arrange them privately, we can help. Book a consultation with our pharmacy team in Manchester and we will check your eligibility, confirm what you need, and plan the right timing for flu, pneumococcal and RSV.