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Doctors have expressed alarm at a seemingly sharp fall in the number of people having the seasonal flu jab.

Tens of thousands of high-risk people in England may be vulnerable to the virus after a 6% fall in immunisations at GP surgeries.

The perceived failures of last year's vaccine and warmer seasonal weather than usual may be contributing to the fall, the Royal College of GPs says.

However, some people may still be having the jab at their local pharmacy.

A new seasonal flu jab is needed annually to match the strains of flu that are circulating that year.

But now doctors are complaining of fridges full of unused vaccine.

Last winter's jab was at one point deemed "barely effective" after the flu virus mutated so the vaccine offered limited protection.

Figures eventually showed it worked in a third of cases and it is too soon to gauge the effectiveness of this winter's jab.

"It is possible that perceptions of lower vaccine effectiveness last year may have influenced people," said Prof Simon de Lusignan from the RCGP.

The organisation estimates that each of England's 8,000 practices has immunised 100 fewer patients than at this point last year.

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The greatest concern is for at-risk groups, which include the elderly, pregnant women and those with other medical conditions.

The chairwoman of the RCGP, Dr Maureen Baker, said: "These figures are extremely alarming.

"We are experiencing an incredibly mild November this year, but we don't need cold weather for a flu outbreak and influenza is a horrible illness that can also trigger a host of other health problems."

However, for the first time this winter people have been able to get their NHS flu jab at pharmacies.

The pharmacy should tell the GP surgery that the immunisation has taken place, but it is not clear if all vaccinations have been recorded and are up-to-date.

Dr Richard Pebody, from Public Health England, said: "NHS England has confirmed that 400,000 vaccinations have been given to adults in risk groups through pharmacies so far this flu season.

"It's likely that some of these vaccinations have yet to be entered on to patient records, which could partly be attributing to lower uptake figures in adults so far this season."

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