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Patients with respiratory disease such as COPD are not coming forward for flu jabs this winter, according to DoH figures, which also revealed low uptake in patients with chronic liver and renal disease.

The figures for the provisional national flu vaccination uptake to the end of December 2006 in England show that large numbers of patients within medical risk groups have not been vaccinated. But 72 per cent of patients aged 65 and over received the vaccination, passing the national target of 70 per cent set by the Joint Committee on Vaccination and Immunisation.

Experts said that there were a number of factors that could be affecting the uptake figures despite GP efforts.

Chairman of the General Practice Airways Group (GPIAG) and Somerset GP Dr Steve Holmes said that he encouraged immunisation for those with chronic respiratory disease. He thought the low figure for this group may be due to how the figures were compiled.

‘The uptake number may be low in the chronic respiratory group depending on how they counted the patients,' he said.

Many COPD patients may have been vaccinated and included in the figures for the over-65 group, he suggested. Other patients, such as those with chronic kidney disease, may also overlap with over-65s.

Berkshire GP and RCGP immunisation spokesman Dr George Kassianos said: ‘We can never be absolutely sure what the reasons may be for not achieving higher influenza vaccination uptake among these groups at risk.'

Dr Kassianos suggested that the late deliveries of flu vaccines and consequent delayed start of the vaccination period might have affected uptake. A mild winter, no reports of bird flu in birds and the lack of a media campaign for patients were also reasons for low uptake, he said.

North Somerset GP Dr Richard Lawson said that some patients may also avoid the flu jab because they feared side-effects, commonly symptoms of upper respiratory tract infections after the vaccine.

‘I always make sure I am vaccinated. Not all our staff share my enthusiasm,' he said.