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Public confidence in the flu vaccine has declined after a series of high-profile gaffes, doctors warn.
A control blunder resulted in delays in the transmission of the vaccine to some general practitioners and pharmacies, resulting in the referral of patients.
Doctors say that many of those who were not able to get the shot in September and October did not bother to come back.
Others have lost self-confidence after failing to work in recent years because it contained the wrong strains of the virus.
Fewer people have been vaccinated this winter, leaving hundreds of thousands of vulnerable patients at risk.
Health officials are now desperately trying to stimulate absorption before temperatures drop and infections rise.
Each year, about 8,000 deaths are related to flu complications.
Dr. Peter Swinyard, from the Association of Family Physicians, said, "When you lose confidence in a vaccine, it is very difficult to recover.
"This year, the process of ordering vaccines and delivering to patients has caused a great deal of confusion.
"Some people who were refused early did not come back.
"Others said that they did not see the benefit of receiving the vaccine because they had caught the flu in previous years, even after having had it.
"Fortunately, the vaccine appears to be the strain that is in circulation this year and should therefore be more effective.
"Patients must receive the vaccine as soon as possible."
All retirees and those under age 65 with a serious long-term health problem may receive free shots.
Only 45.7% of working-age patients had this syndrome – down 3% from last year.
PAA participation is down 1% to 70.5%.
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