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Independents' Day

Flu and Covid-19 vaccines will need to be given separately, says deputy CMO

GPs will not be able to co-administer Covid-19 and flu jabs due to safety concerns, the deputy chief medical officer for England has said. 

Professor Jonathan Van-Tam, also a medical adviser on the Joint Committee on Vaccination and Immunisation (JCVI), told MPs yesterday that he is optimistic that some Covid-19 vaccine will be available before Christmas.

But he added it was unlikely this could be co-administered at the same time as the flu vaccinations – an ambition set out by health secretary Matt Hancock last week.

He told the House of Commons Health and Social Care Committee: ‘I’m cautiously optimistic that we will have some vaccine this side of Christmas.'

But he added: 'If we do, we will not have any data on whether it can be given at the same time as flu vaccine - and likely we will have to delay or separate those two vaccines apart in terms of the staging at which we give them to the relevant patients.’

It comes as guidance from the RCGP warned that vaccination programmes this winter could take twice as long for GP practices to carry out because of Covid-19 infection control measures.

GPs have been warned to ‘gear up for a major expansion of the winter flu programme’ as part of the QOF arrangements for 2020/21, with reports the Government may look at vaccinating everyone over the age of 50.

Professor Van-Tam also told the select committee hearing on management of the coronavirus outbreak that in the first instance it may be most appropriate to give Covid-19 vaccine to targeted groups of patients.

The JCVI has already done some work on developing an algorithm to determine who is most likely to suffer complications or death from coronavirus, he explained, as a way to potentially direct an immunisation programme.

The JCVI has previously signalled this would include NHS staff and vulnerable groups.

He told MPs: ‘Targeting a very small proportion of the very highest risk will deal with a very large amount of the population who have the mortality loaded against them at the moment.’

In guidance on delivering mass vaccinations during Covid-19, the RCGP said running flu and Covid-19 vaccination programmes at the same time posed logistical challenges for GPs, with infection control procedures potentially doubling the time it would take to deliver every vaccine.

Each vaccine could take 4-6 minutes to deliver rather than the usual 1-3 minutes and would have 'significant implications' for how long it takes to vaccinate a population unless more staff are available to carry out jabs.

Delivering both vaccination programmes will require ‘detailed planning and preparation’ and coordination as well as clarity on who should be vaccinated and when, it said.

The news comes as news broke this week that the Covid-19 vaccine being developed by scientists at the University of Oxford has been found to induce 'a strong immune response' with 'no early safety concerns', following the first two trial stages.

The UK Government agreed a deal in May with AstraZeneca to make up to 30m doses of the Oxford vaccine available by September for the UK, as part of an agreement to deliver 100m doses in total, should it prove safe and effective.

It also comes as GPs look set to face unprecedented flu vaccine shortages, and as one key supplier will be unable to get a third of stock to practices until November.

Readers' comments (13)

  • More work? What a surprise. What about the QoF relaxation?

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  • We dont even have a covid vaccine yet. Not sure how this is even news.

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  • Why would co-administration be a problem?
    This is the argument used for separate MMR vaccines and it has no basis in science.
    If we don’t have the evidence then we go with the most pragmatic option which is co-administration to improve uptake.
    After all, maybe co-administration is safer than separate vaccines. If we don’t have the evidence how would we know?

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  • Took Early Retirement

    Let's say that 50million people WANT a Covid jab. (Some are saying 2 will be needed.) I have also heard that there will be no single-dose vials like flu. So it will need to be drawn up. So, unlike flu, you will end up with c 12/hour. (Assuming you don't have to don separate gloves for each person.) That would be 4.2 million hours of work for just one shot. EXTRA hours of course. Given the number of GPs in the UK is around 41,000 (not FTE though) that's around 100 extra hours per GP. OF course, some will be shared with nurses but it gives you a flavour of the size of the problem. Let's say the govt wants it given over 3 months; so about 33 hourse per month EXTRA in Jan-Mar 2021. I can't see it happening. Can you? Maybe PULSE would like to ask the DOH! how they are planning it? (PLANNING??? The DOH!????)

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  • Dear Dr Van Tam, which one is not safe?

    I think I still have 2 arms.
    or do you just mean that we wnt have enough of them at the same time to do both at once?

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  • Vinci Ho

    The reality is :
    (1) Delay of delivery of the usual amount of flu vaccines is already imminent . The government and NHSE/I must be transparent about what is the contingency plan NOW for acquiring more vaccines for an ‘expanded’ campaign .
    (2) Exactly who will be responsible for administering these new Covid 19 vaccines ( beware that one dose may not be enough as the hitherto scientific evidence showed) ? If GP practices are the ones to administer , they need additional protection in all aspects : time , manpower ,money and more importantly, protection against Covid 19 .
    (3) Any other models involving other medical professionals to administer Covid 18 vaccination need to be included to allow flexibility at local levels . Patients and the public are to be well ‘educated’ about the purpose, safety and logistics of this dual vaccination campaign. The government must lead this education of the public .

    The so called recovery plan will have to make way for at least a period of time before winter arrives , to ensure a rapid completion of this historic vaccination programme ( flu and Covid 19) .
    This is the final chance for this government to redeem for the indefensible mistakes it made during the first wave of the pandemic.

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  • I agree with justmyopinion
    I cant see any scientific evidence to support seperate administration.
    adult-Flu is normally inactivated vaccine and most covid vaccines being developed are not live so this appears to be non sense unless ive missed something

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  • As long as they pay the usual fee, then I'm all in for this. Just the small matter of giving something rushed through without usual evidence of safety/efficacy etc, but if HMG want it, and the patient wants it, and we get paid for giving it, then yes, let's do it.

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  • It will be a big mistake if NHSE links the two vaccines. One is well established, making the implementation of our flu campaign easier. The other is not out yet and as such it has not passed the test of time. Worse, the anti-vaxxer "eccentrics" (I'm trying not to offend anyone here) are carrying out through social media, a sustained assault against the C19 future vaccine, and, sadly, we have started to hear from some confused patients (unprintable) tales.
    NHSE, please let us get on with our flu programme, or we will fail our targets.

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