Flu Vaccination Decline

If you have been contacted by the Practice or are eligible to receive a free flu vaccination for this year’s flu campaign (eligibility below) and wish to decline please complete the following information. If you change your mind during the flu campaign, you can still have the vaccine and can arrange this by contacting the Practice.

Flu Decline
Please use this date format: DD/MM/YYYY.
Any responses we send will go to this email address.

People who should have a flu vaccination

The injected flu vaccine is offered free of charge on the NHS to people who are at risk. This is to ensure they are protected against catching flu and developing serious complications.
You are eligible to receive a free flu jab if you:

• are 65 years of age or over (if you are currently 64 but will be 65 on March 31 2019, you do qualify)
• are pregnant
• are living in a long-stay residential care home or other long-stay care facility
• receive a carer's allowance, or you are the main carer for an elderly or disabled person whose welfare may be at risk if you fall ill

Have certain medical conditions:

• chronic (long-term) respiratory diseases, such as asthma (which requires an inhaled or tablet steroid treatment, or has led to hospital admission in the past), chronic obstructive pulmonary disease (COPD), emphysema or bronchitis (COPD)
• chronic heart disease, such asheart failure (COPD)
• chronic kidney disease
• chronic liver disease, such as hepatitis
• chronic neurological conditions, such as Parkinson's disease, motor neurone diseaseor multiple sclerosis (MS)
• diabetes
• problems with your spleen – for example, sickle cell disease or if you have had your spleen removed
• a weakened immune system as the result of conditions such as HIV and AIDS, or medication such as steroid tablets or chemotherapy
• being seriously overweight (BMI of 40 or above)

Front-line health and social care workers are also eligible to receive the flu vaccine. It is your employer's responsibility to arrange and pay for this vaccine.