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GPs advised to order next year's flu vaccine before NHS finalises programme

Public Health England has urged GPs to order next winter's flu vaccines, despite the fact NHS England's final guidance on which vaccine to use is still pending.

PHE said GPs should go ahead and order the same two types of vaccine they are using this flu season.

But the Government’s vaccination advisory committee is saying that a new vaccine - quadrivalent influenza cell culture vaccine (QIVc) – could be just as effective and used across all adults.

With NHS England’s vaccine guidance yet to be published, meaning QIVc could still be an option, GP experts are calling on NHS England to release guidance ‘as soon as possible’, so as to avoid the ‘difficulties’ faced by practices this year.

This comes after Pulse revealed that GPs and pharmacists have been left with more than two million flu vaccines to administer within two weeks, in order to meet NHS England's target of vaccinating all over-65s before December 'when flu season usually hits'.

Ahead of the 2018/19 flu season, which started on 1 September, practices were advised to administer the quadrivalent vaccine (QIV) to patients aged 18-65 and the adjuvanted trivalent flu vaccine (aTIV) to patients aged over 65.

However, issues were caused by the phased deliveries of the aTIV, which saw almost 70% of GPs experience a shortage of the vaccine, forcing them to turn away vulnerable older patients as a result.

Despite this, PHE told GPs, in a letter released this week, that ‘both of the vaccines that were recommended for the 2018/19 season will continue to be recommended for next year'.

‘Please begin ordering currently licensed vaccines as set out above; ordering of these licensed vaccines should not be unnecessarily delayed. For the new, currently unlicensed vaccines, please wait for confirmation from NHS England that they are eligible for reimbursement before ordering,’ it added.

This comes after the Joint Committee on Vaccination and Immunisation (JCVI) released preliminary advice suggesting that a new vaccine – QIVc - could be used in all adults.

JCVI meeting minutes, published last week, said for adults over the age of 65, QIVc is ‘considered equally suitable for use in the elderly along with aTIV’ and ‘preferable to the available standard egg based QIV’.

In at-risk adults under 65, and children contraindicated to live attenuated influenza vaccine (LAIV), QIVc is ‘considered equally suitable for use along with QIV’.

QIVc was used last flu season in the US, but it is not yet licenced in the UK - although it could be by the end of 2018 according to PHE.

South London GP Dr Azeem Majeed, who also heads up the primary care and public health department at Imperial College London, said: ‘It seems that PHE are recommending the same flu vaccines for next winter. 

'I guess that given the logistics of ordering vaccines and planning delivery programmes, it would be difficult to make a sudden change in vaccination policies. The change this year caused some disruption to flu vaccine programmes.

‘In the longer term, it would logistically better to have one flu vaccine but that would depend on data showing that this policy would be as effective at preventing flu as having different vaccines for younger and older adults. The JCVI minutes mentioned that this data was lacking at present.’

BMA GP Committee clinical and prescribing lead Dr Andrew Green is now calling for NHS England to release its flu vaccine guidance.

He said: ‘It is vital that NHS England decides as soon as possible its recommendations for next year’s vaccination programme, as their failure to do so in a timely fashion this year was the main cause of the difficulties GPs and patients faced.’

PHE flu vaccine advice in full

Both of the vaccines that were recommended for the 2018/19 season will continue to be recommended for next year. Both vaccines are currently licensed and available to order for use in the UK:

  • the quadrivalent inactivated vaccine (QIV) will continue to be recommended for 18 to 64 year olds in clinical at-risk groups and other eligible groups, including frontline health and social care workers
  • the adjuvanted trivalent inactivated vaccine (aTIV) will continue to be recommended for individuals aged 65 years and over.

Please begin ordering currently licensed vaccines as set out above; ordering of these licensed vaccines should not be unnecessarily delayed. For the new, currently unlicensed vaccines, please wait for confirmation from NHS England that they are eligible for reimbursement before ordering.

Source:  PHE

Readers' comments (5)

  • Potentially a catastrophe in the making. What happens if NHSE suddenly decides that a difference vaccine is needed -- and refuses to reimburse the one that's actually been ordered? It strikes me that this is the NHS at its disorganised best: with, of course, the GPs as the fall guys, stuck in the middle.
    May I point out to those in NHSE that 'leadership' means 'deciding firmly what to do, and supporting the troops up to the hilt while they do it' (and also taking the flak/cost/reputational hit if it all goes wrong).

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  • Yes well that really worked for us this year - not. Fool me once ...

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  • Sally 3:37pm - I'll second that. We will be waiting for NHS England's final guidance.

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  • Planning for next year - that is optimistic - no guarantee that current partners will still be GPs this time next year. It is one way to boost GP retention though I suppose.


    Anyone like to sign up to buying another 20 years of pension contributions into the NHS scheme - come on its only 20 years - you’ll probably be dead by then anyway.

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  • Sound like NHSE will to get their fingers out of their collective backside and show the 'leadership' they aspire too and lead.I for one will not take financial risks on this.What raise in funding did we get again this year.f@@@@@f NHSE.

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