The flu vaccine is intended for people with chronic heart or chest complaints, chronic kidney disease, diabetes, lowered immunity, or any other serious illness as well as the elderly living in residential homes. This year, 6 million doses will be available at a cost of pounds 30m.
But uptake by high-risk groups is estimated at no more than 50 per cent, although the vaccine is highly effective. A study in Leicester showed that up to 45 per cent of hospital admissions due to flu complications could be saved by targeting those most at risk.
Dr Jon Van-Tam, lecturer in public health medicine and epidemiology at University Hospital, Nottingham, who conducted the Leicester study, said: "Flu vaccination can reduce hospitalisation for pneumonia, influenza, bronchitis and emphysema by 60 per cent. This clearly shows the importance and efficacy of flu vaccines for those at higher risk."
In 1993, 13,000 deaths were associated with flu in the United Kingdom. The last big outbreak in 1989 led to around 27,000 deaths. Doctors believe 75 per cent of these deaths could be avoided by repeat vaccination.
Research in GP practices by Dr John Watkins, director of primary health care at Gwent Health Commission, found that in 25 per cent of cases the vaccine did not go to someone in a high-risk group.
This could mean that sometimes a doctor decides a patient is at risk despite falling outside one of the recognised brackets. But Dr Watkins added: "I think that probably a significant number of that group are healthy."
Dr Watkins said the misdirection of some of the vaccine was an inevitable consequence of raising public awareness. "The more you raise public awareness the more you attract people who are not necessarily in the high risk groups," he said. "You get this trade off."
Doctors advise that it is better for the young and healthy to suffer three or four days of flu than to have a jab, as a bout of the illness provides several years of good immunity against a particular strain.
"On balance we take the view that for young, fit people an attack of influenza is the preferred option to having a vaccine every year," said Dr Douglas Fleming, director of the Royal College of General Practitioners flu research unit in Birmingham.
Dr Fleming said the research unit would not use the word "epidemic" for a flu outbreak unless it became really serious. In previous years a figure of more than 150 GP visits per 100,000 population per month has been said to be an epidemic. He said it would be an "unusual" winter if visits went above 200 and above 400.
Such a level has not been seen since 1976 although the 1989 outbreak fell just below it. In 1969 there was a pandemic when the level shot above 1,000 GP visits.Reuse content