England's Early Flu Rise in Autumn 2026, Explained
Flu arrived earlier than usual in England in autumn 2026, rising through August and September to levels above the same period in the previous four winters.
The UK Health Security Agency assessed flu in early October as at low levels but rising, based on test positivity and visits to family doctors for flu-like illness. September activity was higher than September in the past four winter seasons, the agency said. The Guardian
The Week 41 national surveillance report, published 8 October with data up to week 40 ending 4 October, recorded flu activity as increased and circulating at baseline levels. Positivity in hospitals, the share of flu tests that come back positive, reached 6.5% on the most recent Sunday, up from 5.0% the Sunday before. Positivity from GP swab tests rose to 10.0% in week 40 from 7.6% the week before. GP consultations for flu-like illness increased to 5.6 per 100,000 people from 4.0 per 100,000. UKHSA
Two influenza A subtypes were circulating, H1N1 and H3N2. UKHSA said the H1N1 component had drifted slightly from the strain used to make the 2026 vaccine, meaning it had picked up small genetic changes. The increase appeared to be driven by cases among young adults aged 18 to 24.
Severity measures moved up from a low base. The overall weekly hospital admission rate for flu was 1.97 per 100,000 in week 40. The overall weekly admission rate to intensive care and high-dependency units was 0.06 per 100,000. Emergency department visits for flu-like illness were above seasonally expected levels in early October. The number of flu-confirmed outbreaks of acute respiratory infection in the community was stable compared with the week before.
Other respiratory viruses took different paths. UKHSA reported COVID-19 activity increased and was circulating at low levels in week 40. COVID-19 PCR positivity in hospitals increased to 9.1% on the most recent Sunday from 7.9% the Sunday before. Emergency department visits for COVID-like illness increased and were above seasonally expected levels. The number of COVID-confirmed outbreaks in the community increased week on week. RSV activity remained low and was circulating at baseline levels.
The 2026 flu vaccination offer started 1 October, with eligible adults to be offered vaccine from early October, NHS England confirmed. Everyone aged 65 years and over is eligible for the autumn 2026 flu vaccine. All adults aged 18 to under 65 in clinical risk groups, people with health conditions that raise flu risk, are also eligible under guidance UKHSA published 27 August in "Your guide to who's eligible for the autumn 2026 flu vaccine".
Uptake reporting began in week 40. By the end of that week, 10.2% of people aged 75 and over had received an autumn 2026 dose since 1 October. Among people aged under 75 with a weakened immune system, coverage was 4.1%. Weekly uptake for 2026 to 2027 was lower than the equivalent week last season for ages 65 and over, for ages 6 months to under 65 in clinical risk groups, and for 2- and 3-year-olds. Uptake among pregnant women was comparable to last season.
UKHSA urged those eligible to get vaccinated amid possible signs of an early season. Prof Sir Andrew Pollard, director of the Oxford Vaccine Group, urged people at risk by age or underlying health conditions to get vaccinated as soon as possible before peak transmission. The agency pointed to last winter, when it estimated the programme in England prevented about 100,000 hospital admissions and 7,000 deaths. Its analysis found vaccinated children were around 65 to 70% less likely to attend or be admitted to hospital with flu.
The broader context here is timing colliding with coverage. An early rise led by younger adults does not in itself fix the peak or severity, but it shortens the window for vaccination before wider spread among older and immunosuppressed groups. Low early uptake relative to last season leaves that window underused. The metrics to watch are not case counts alone but whether hospital and ICU admissions follow the curve in positivity and GP consultations, alongside COVID-19 co-circulation. If admission rates follow positivity, pressure could arrive before campaigns reach steady pace. If they decouple, as in some prior seasons after uptake increased in children and older adults, the early signal will matter less than the next four to six weeks of vaccine delivery.
