Soaring demand has caused a major shortage of flu jab appointments across England, the Guardian can reveal,NHS leaders have issued urgent pleas to the public to get their flu jabs and help the health service cope with a crippling “flu-nami”, which last week led to hospitals in England treating record numbers of seriously ill patients with flu,But the biggest pharmacy chains have no bookable appointments available in many of their city centre branches amid dwindling stocks of the flu vaccine,The shortages were revealed as resident doctors in England began five days of strike action after rejecting the government’s latest offer to resolve the long-running dispute over pay and jobs,Older people; those with long-term health conditions; pregnant women; and children are eligible for the flu jab on the NHS.

But latest figures from UKHSA show markedly low vaccination rates in some at-risk groups, with only 35.6% of pregnant women and 37.4% of under-65s with one or more long-term health conditions vaccinated, compared with 71.7% of over-65s.On Wednesday, , the World Health Organization said that 27 out of 38 countries in its European region have high or very high levels of flu.

Dr Hans Henri Kluge, the WHO regional director for Europe, said a new strain of flu was driving infections and “now accounts for up to 90% of all confirmed influenza cases in the European region”.The UK flu season started four to five weeks earlier than usual and has been dominated by a strain of H3N2 that has acquired mutations since this year’s vaccine was produced.This prompted fears that the UK could be heading for a once-in-a-decade flu surge.However, the latest data suggests that this could simply be an early flu season – possibly due to waning immunity in the community to H3N2, which was last the dominant strain in 2021-22 – rather than an especially bad season.The vaccine is also providing relatively good protection, despite not being ideally matched.

Vaccination can reduce the risk of serious ill health from flu, but when the Guardian tried to book an appointment in London, Manchester and Birmingham for an over-65 patient, there were almost no bookable appointments at many branches of Boots, Superdrug, or Tesco in-store pharmacies.The only availability on the day of research in larger stores in these cities appeared to be for Boots Long Acre in London and Superdrug in Manchester Piccadilly.For pregnant women and patients under 65 with an underlying health condition, there are even fewer bookable appointments.Boots is no longer offering any online NHS under-65 flu jab appointments.Tesco’s website said its flu jab appointments “are now very limited.

Availability can vary by location and some pharmacies may have no slots.”At Superdrug, there are limited NHS and private appointments.A spokesperson said: “Given the increased demand across the UK this flu season, we have limited stock available across our pharmacies.”For private vaccinations, those who have a pre-paid flu voucher can book online at selected pharmacies where stock is available, and walk-in appointments “are available to patients without a voucher subject to availability”, the spokesperson added.A spokesperson at Boots said the lack of bookable appointments was to help stores manage capacity.

They said: “We have seen strong demand for flu jabs throughout the winter season.We continue to carry out pre-booked appointments and there are a small number of appointment bookings still available for both NHS and private patients in selected stores.Many of our stores across the UK are offering vaccinations on a walk-in basis.”Flu vaccinations are typically ordered from manufacturers by providers about a year in advance.Peak demand for jabs is usually in October and November, with fewer patients wanting to be inoculated in the run-up to Christmas.

But increased demand throughout December has depleted supplies more quickly.The situation is so acute in London that NHS England’s Covid-19 and influenza immunisation programme team has issued an alert to community pharmacies, urging them to reorder vaccines direct from the manufacturer.“Manufacturers have confirmed that flu vaccine stock is available.If a wholesaler is out of stock, [pharmacies] can and should order directly from the manufacturer … It is essential that all community pharmacies ensure they have sufficient stock to continue vaccinating eligible patients throughout winter,” the alert stated.Responding to the shortages, Dr Andrew Hill, an expert in drugs and the drugs industry who works at Liverpool University, said: “It is beyond belief that flu vaccines are unavailable while cases and hospitalisations are rising so quickly.

People who are vaccinated have a lower risk of hospitalisation.The government should be making sure there is widespread access to vaccines.This would help to lower hospitalisations at a time of intense pressure for the NHS.”While the problem is affecting the biggest pharmacy chains, smaller providers said they were not experiencing these issues to the same extent.Janet Morrison, the chief executive of Community Pharmacy England, said: “With a late surge in the number of people seeking flu jabs, people may need to wait a little longer than usual to secure an appointment.

While we have had some isolated reports of pharmacies struggling to obtain flu vaccination supplies, this seems to be very dependent on location.”Those that had low stock were working hard to source extra stock if needed, she added.Dr Leyla Hannbeck, the chief executive of the Independent Pharmacies Association, said that despite the “big surge” in demand for flu jabs causing vaccine stocks to deplete in some areas, “most pharmacies can obtain vaccines directly from the manufacturer”.Olivier Picard, the chair of the National Pharmacy Association, said: “Most independent pharmacies tell us they have good availability and are in a position to vaccinate patients promptly.”Tesco and the Department of Health and Social Care were approached for comment.

An NHS spokesperson said: “There is no national flu vaccine shortage.The free NHS programme has over 3 million vaccines in the system and more readily available to order should a site run out locally.“There are still hundreds of thousands of NHS flu vaccine appointments available through the national booking service in the run-up to Christmas, so we strongly encourage eligible people to come forward and get protected.”