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Flu at-risk group is under review


By Emma Wilkinson

Government advisers will consider proposals to expand the at-risk groups eligible for annual influenza vaccination to include a raft of new categories.

All patients with current or recently active cancer, those who have had a stroke and those with psychotic illnesses and chronic neurological disorders should all be added to the list of high-risk groups, recommends a new GP-led study that will be scrutinised by the Joint Committee on Vaccination and Immunisation.

The study, led by Dr Douglas Fleming, a member of the JCVI influenza sub-group, concluded that extending the annual vaccination programme to these additional groups would bring the number of at-risk under-65s eligible to a total of 4.3 million in England and Wales (see box).

Dr Fleming, director of the RCGP Birmingham research unit and a GP in the city, said: 'This [policy] is kept under constant review and I was making suggestions for areas we could consider for the under-65s.'

He recommended that patients with malignancy should be added to the at-risk category because many cancer treatments weaken the immune system and those with diseases of the central nervous system should be immunised because they are much more likely to be admitted to hospital than healthy individuals.

Dr Fleming said the aim of the paper was to promote discussion of the balance between the costs and benefits of immunising additional high-risk groups.

Co-author Dr Alex Elliot, primary care scientist at the unit, said: 'The aim was to make people aware the recommendations have maybe become a bit old-fashioned and need changing to keep up with what's going on in general society since the last morbidity study.

'There's a lot of other groups who should be considered, such as people with malignancy. There are people under 65 who fit into these risk groups who shouldn't be ignored even if they're a minority group.'

Dr John Canning, secretary of Cleveland LMC, said: 'It would have to be evidence-based and there has to be resources in place. But it's fair for us to consider.'

He added: 'We would need to be forewarned. There needs to be discussion early. And it's important they link it in with the QOF, which is evidence-based and part of the reward mechanism.'

The study was published early online in Vaccine.ewilkinson@cmpinformation.comHow many would qualify?Numbers of high-risk patients under 65 who would be eligible for flu vaccination per 10,000Respiratory 1,140Circulatory 466Diabetes and endocrine 471Renal 24Liver 20Cancer 190Immuno-compromised and others 547Total 2,311

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