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Abstract Background In the UK, annual influenza vaccination is currently recommended for adults aged 16–64 years who are in a clinical at-risk group. Despite recommendations, rates of vaccine uptake in the UK have historically been low and below national and international targets. This study aims to analyse vaccine uptake among adults in clinical at-risk groups from the 2015–2016 influenza season to the present. Methods A retrospective analysis of influenza vaccine coverage in the UK was conducted using data extracted from publicly available sources. Clinically at-risk individuals (as defined by Public Health England), including pregnant women, aged 16–64 years, were included in this study. Results Influenza vaccination coverage rates across the UK in adults aged 16–64 years in a clinical at-risk group have been consistently low over the past 5 years, with only 48.0, 42.4, 44.1 and 52.4% of eligible patients in England, Scotland, Wales and Northern Ireland receiving their annual influenza vaccination during the 2018–2019 influenza season. Influenza vaccine coverage was lowest in patients with morbid obesity and highest in patients with diabetes in 2018–2019. Coverage rates were below current national ambitions of ≥75% in all clinical risk groups. In these clinical at-risk groups, influenza vaccine coverage decreased between 2015 and 2019, and there was considerable regional variation. Conclusions Uptake of the influenza vaccine by adults aged 16–64 years in a clinical at-risk group was substantially below the national ambitions. As a result, many individuals in the UK remain at high risk of developing severe influenza or complications. Given that people who are vulnerable to COVID-19 are also at increased risk of complications from influenza, during the 2020–2021 season, there is a heightened need for healthcare professionals across the UK to address suboptimal vaccine uptake, particularly in at-risk patients. Healthcare professionals and policymakers should consider measures targeted at increasing access to and awareness of the clinical benefits of the influenza vaccine.

Novel tools and methods for monitoring marine environments can improve efficiency but must not compromise long-term data records. Quantitative comparisons between new and existing methods are therefore required to assess their compatibility for monitoring. Monitoring of shallow water coral reefs is typically conducted using diver-based collection of benthic images along transects. Diverless systems for obtaining underwater images (e.g. towed-cameras, remotely operated vehicles, autonomous underwater vehicles) are increasingly used for mapping coral reefs. Of these imaging platforms, towed-cameras offer a practical, low cost and efficient method for surveys but their utility for repeated measures in monitoring studies has not been tested. We quantitatively compare a towed-camera approach to repeated surveys of shallow water coral reef benthic assemblages on fixed transects, relative to benchmark data from diver photo-transects. Differences in the percent cover detected by the two methods was partly explained by differences in the morphology of benthic groups. The reef habitat and physical descriptors of the site—slope, depth and structural complexity—also influenced the comparability of data, with differences between the tow-camera and the diver data increasing with structural complexity and slope. Differences between the methods decreased when a greater number of images were collected per tow-camera transect. We attribute lower image quality (variable perspective, exposure and focal distance) and lower spatial accuracy and precision of the towed-camera transects as the key reasons for differences in the data from the two methods and suggest changes to the sampling design to improve the application of tow-cameras to monitoring.