974 deaths, average age 47: rough sleepers are now on the NHS jab list
What happened
On 1 October 2026, people aged 16 and over who are experiencing homelessness became eligible for free NHS flu and pneumococcal vaccination for the first time. On 2 October, the NHS set out how it plans to actually reach them: pop-up clinics and mobile vans in rough-sleeping hotspots, alongside GP surgeries and community pharmacies. "Experiencing homelessness" has a narrow meaning here. It covers people sleeping rough, and people staying in hostels for the homeless or in night shelters. It does not cover every kind of homelessness, so someone sofa-surfing or in temporary council housing is not automatically included. Teams can use their judgement to vaccinate someone under 16 where that makes sense. The letter that set this up was published on 14 July 2026, signed by Caroline Temmink, Director of Vaccination at NHS England, and Dr Mary Ramsay CBE, Director of Public Health Programmes at the UK Health Security Agency. It tells vaccination providers they are "expected to deliver a 100% offer to the eligible groups". Note that this is two vaccines, not one. The first is the seasonal flu jab, the same one offered every autumn to people aged 65 and over, pregnant women and adults with certain long-term conditions. The second is a pneumococcal vaccine called PCV20, sold as Prevenar 20. Pneumococcal bacteria are a common cause of pneumonia, and can also cause meningitis and blood poisoning. Both jabs can be given in the same visit. The Prime Minister, Andy Burnham, said: "Nobody should have to sleep rough, but while people are on the streets, we have a duty to keep them safe." Some pop-up clinics are doing more than vaccinations. Reports of the launch describe TB screening, cancer checks and sexual health services offered at the same visit.
Why this matters
The day before this came in, on 1 October, the Office for National Statistics published its latest figures on deaths of people experiencing homelessness. They are worth sitting with. An estimated 974 such deaths were registered in England and Wales in 2025, in a range of 908 to 1,041, because these deaths have to be identified from records rather than simply counted. The mean age at death was 47.3 years for men and 43.2 years for women. For the general population aged 15 to 74, the same figures were 61.1 and 62.1 years. So people who die while homeless are dying roughly 15 to 19 years earlier than everyone else. That gap is the real reason this change exists. There is also a very ordinary, practical reason. Most of us get through flu with a few days in bed, a warm room, a kettle within reach and someone to check on us. A person sleeping rough has none of those things. The same illness, in a damp sleeping bag in October, is a different illness. And then there is the way the NHS normally invites people in. Vaccination assumes a letter arriving at an address, a GP you are registered with and an appointment you can keep. Many people in this group have none of that. That is why the vans matter as much as the policy. Changing who is eligible is the easy half. Reaching them is the hard half.
What the evidence actually says
This decision did not come out of nowhere, and it is not a gesture. The Joint Committee on Vaccination and Immunisation, the independent expert group that advises UK governments on vaccines, looked at this at its June 2024 meeting. It advised that people experiencing homelessness should be routinely offered both pneumococcal and seasonal flu vaccination. Its reasoning is the key sentence in the whole story. The committee pointed to "evidence of high comorbidity rates placing them at a similar level of risk of hospitalisation and death from these diseases as people aged 65 and over". In plainer words: so many people in this group are already living with other illnesses that, as a group, their risk from flu and pneumococcal disease looks like the risk of someone over 65. We already give the over-65s these jabs free, without debate. So the same logic applies. This is risk matching, not charity. It is also worth being straight about what these two vaccines will not do. Look again at the ONS causes of death for 2025. Accidents were the largest group, at an estimated 380 deaths, or 39%. Drug poisoning accounted for 304 deaths, or 31.2%. Intentional self-harm was 84 deaths, liver disease 67, and ischaemic heart disease 55. Flu and pneumonia are not at the top of that list, and nobody should expect two vaccines to move those numbers much. What vaccination is, honestly, is a small, cheap, deliverable thing that can be done this winter while the much harder problems of housing, addiction and mental health treatment go on. It reduces risk. It does not remove it. And it is not a substitute for a home.
Qurexa perspective
We will be upfront: Qurexa is not running these clinics and has no part in this programme. But the thinking behind it is familiar, because it is the thinking behind what we do. Our whole job is closing the gap between a medicine existing and a person actually having it in their hand. That gap is where a lot of treatment quietly fails. Working in healthcare logistics teaches you how much of the system is built around a stable address. Prescriptions, reminders, appointment letters, deliveries, ours included. It works well for most people, then stops working completely for the people who need it most. Sending a van to where someone already is, instead of asking them to come to a building at a fixed time with ID, is that same insight applied to vaccination. We think it is the right one. One genuinely useful thing, if you are reading this because of someone else: community pharmacies give flu vaccinations without an appointment. If you support someone in a hostel, or run a shelter, that is often the shortest route there is.
Practical advice
If you are sleeping rough, or staying in a hostel or night shelter: - You are now entitled to both the flu jab and the pneumococcal jab free on the NHS. You do not have to explain or justify it. - You can walk into a community pharmacy that offers flu vaccination and ask. You usually do not need an appointment. - Ask for both in one visit. They can be given at the same time, and a second trip is one more thing to remember. - Ask for the pneumococcal one by name if it is not offered, because the flu jab is the one people think of first. It is PCV20, or Prevenar 20. - You can register with a GP without a fixed address and without photo ID. A practice cannot refuse you just because you have no address. You can use the surgery's address or a day centre's. - Ask at day centres, hostels and outreach teams where the pop-up clinics and vans will be. If you work or volunteer with people who are homeless: - The instruction to providers is a 100% offer, so it is reasonable to ask your local vaccination service what they are doing to reach your residents or clients. - Ask whether a visiting clinic can bundle things together. One visit is worth far more than three invitations. - Offer to go with someone. For a lot of people the barrier is not the needle, it is the door. For everyone else: - If you are eligible for a flu jab yourself, autumn is the time to book it. Vaccination protects the person who has it, and slows flu down on its way to everyone else. - The NHS offer still covers people aged 65 and over, adults with certain long-term conditions, pregnant women, children, carers and health and care staff. If you are unsure whether that is you, ask your pharmacist.
What to know
From 1 October 2026, people aged 16 and over who are sleeping rough or staying in homeless hostels or night shelters can get both the seasonal flu vaccine and the PCV20 pneumococcal vaccine free on the NHS. It is the first time a national vaccination programme has specifically included this group. The two can be given together, at a GP surgery, at a community pharmacy without an appointment, or at pop-up clinics and mobile vans sent to rough-sleeping hotspots. The reason is risk, not sympathy. The JCVI found that high rates of other illness leave this group facing roughly the same risk of hospital admission and death from these infections as people over 65, who have been offered these vaccines for years. The scale of the problem is larger than two vaccines can solve. ONS figures published on 1 October 2026 estimate 974 deaths of people experiencing homelessness registered in England and Wales in 2025, at a mean age of 47.3 for men and 43.2 for women, against 61.1 and 62.1 in the general population aged 15 to 74. Accidents and drug poisoning, not infections, led the causes. If you can pass this on to one person who is eligible, that is probably more use than anything else here. Sources: NHS England and UK Health Security Agency, "People experiencing homelessness eligible for pneumococcal vaccination letter", 14 July 2026, https://www.gov.uk/government/publications/pneumococcal-vaccination-expansion-of-eligibility-to-people-experiencing-homelessness/people-experiencing-homelessness-eligible-for-pneumococcal-vaccination-letter. Office for National Statistics, "Deaths of people experiencing homelessness in England and Wales: 2013 to 2025 registrations", 1 October 2026, https://www.ons.gov.uk/peoplepopulationandcommunity/birthsdeathsandmarriages/deaths/bulletins/deathsofhomelesspeopleinenglandandwales/2013to2025registrations. The Pharmaceutical Journal, "Rough sleepers and people using homeless hostels to be added to flu vaccination programme", 9 June 2026, https://pharmaceutical-journal.com/article/news/rough-sleepers-and-people-using-homeless-hostels-to-be-added-to-flu-vaccination-programme. Pharmacy Business, "NHS to Provide Flu Vaccines for Rough Sleepers", 2 October 2026, https://www.pharmacy.biz/nhs-flu-vaccines-rough-sleepers/. This article is for general information and does not replace advice from a doctor, pharmacist or other qualified healthcare professional. If you are unsure which vaccines you are eligible for, ask your GP surgery or any community pharmacy.
Related articles
Six hours, not never: the ICU filter notice the MHRA issued today
The UK's medicines and devices regulator has issued a new safety notice to hospitals, and it is about timing. On 13 October 2026 the Medicines and Healthcare p…
Eight pages to a minister: what the data guardian says trust is worth
On 12 October 2026, the government published a letter about who should be trusted with NHS patient data. It was written by Dr Nicola Byrne, the National Data G…
Update: the tests came back, and it was not plague
This is a follow-up to a story we covered on 5 October, when nearly 200 people were being monitored after the death of a laboratory worker in Siberia. There has…