From the start of October, people sleeping rough or staying in homeless hostels and night shelters in England can get a free flu vaccine for the first time. But will the jab reach those who need it?

The case for eligibility is not in doubt. The UK’s Joint Committee on Vaccination and Immunisation (JCVI) based its recommendation on evidence that homeless people face a similar risk of hospitalisation and death from flu as people aged 65 and over. Many also live in shared dormitories, day centres and crowded hostels, where respiratory viruses are likely to spread easily.

A record 4,793 people were counted sleeping rough in autumn 2025. The figure reflects a single night. The hostel and shelter population is likely to be far larger.

The problem is that eligibility may not be the main barrier. Many homeless adults were already eligible for a flu jab long before this change. Most were not getting one.

A London survey during the 2011-12 flu season found that 42% of homeless people were entitled to the vaccine because of their health, mostly because of lung disease, liver disease or problems with their immune system. Less than a quarter of those eligible (24%) had been vaccinated, compared with over half nationally (53%) for the same risk groups.

The obstacles are practical. For many people, the flu programme works through GP registration, an invitation sent to a home address and an appointment at a surgery. Someone sleeping rough may have none of those, so the offer never reaches them and, if it does, there is nowhere convenient to take it up.

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