Swine-flu vaccination uptake is falling short of GP pay thresholds, despite renewed emphasis on the importance of protection against the virus by the Department of Health.
Only 39% of people considered to be "at-risk" have received the jab, along with 22% of pregnant women. There needs to be an uptake of at least 50.7% to lower the threshold of patient experience indicators in the 2009/10 Quality and Outcomes Framework.
The 8% of healthy children protected against swine flu so far do not count towards the national agreement for H1N1 vaccination payment.
However, despite overall case numbers being too low to estimate, swine flu is still causing deaths and hospital admissions, the DH warned.
A total of 360 people have died since the swine flu pandemic hit the UK, and currently 211 patients are admitted to hospital with the illness, with 103 needing critical care.
Sir Liam Donaldson, the chief medical officer for England, said: "When the virus returns in the 2010 flu season, those who develop complications or die will be doing so from a vaccine preventable disease. I strongly advise that those eligible for the vaccine who have not yet had it, get the jab and protect themselves."