Communication failures risk derailing the mass roll-out of a potential covid-19 vaccine in England, family doctors warned after they were blindsided by a government announcement on free flu shots for the over-50s.

Ministers announced last week that people aged 50-64 will be able to get a flu vaccination from Dec. 1, but doctors complained they were not told in advance and were deluged with calls from patients demanding appointments. Some practices are still not able to get hold of enough flu vaccine for the over-65s, let alone younger patients.

“There’s always this underlying feeling of chaos,” said Lizzie Toberty, a spokeswoman for the Doctors’ Association campaign group. “Our worry is that if we’re having problems delivering flu vaccines which we deliver to a limited number of people every year, then how can we be confident if we organize a covid-19 program that the supply chain is definitely going to be there?”

The row raises serious questions about the government’s handling of immunization programs as the National Health Service prepares for the roll out of a coronavirus vaccine, if approved by regulators, to tens of millions of people across the country.

The NHS Confederation, which represents health care organizations, said family doctors are under “phenomenal strain” — carrying out around 1.25 million appointments a day while preparing to deliver a covid-19 vaccination program “at very short notice.”

In a letter to Health Minister Jo Churchill, it said “poorly executed communications from the department on important matters such as this simply does not help in these trying times.”Richard Vautrey, a spokesman for the British Medical Association doctors’ union, said while it was always intended the flu campaign would eventually be extended to 50-64 year-olds, doctors have a right to be given “adequate notice” ahead of any public announcement.

The Department of Health said in a statement there have been “regular communications” with doctors on the flu vaccine, and further deliveries will be arriving throughout November, December and into the new year.

There is “a real disconnect” between central government and health workers on the ground, Toberty said. “We need to urgently improve the level of communication.”