Practice dilemma: Overseas flu vaccine
A patient wants you to administer a flu vaccine she had bought in Russia. What should you do?
When administering a drug or writing a prescription you are responsible for ensuring that the treatment is clinically indicated and appropriate, that there are no contraindications and that the patient has been made aware of any potential risks or side-effects associated with it.
If you are unable to read or understand the labelling on the vaccine, your practice is not in a position to do this and should refuse the patient's request. You should also be aware that drugs from an unidentified and unverifiable source may be counterfeit and potentially dangerous if administered.
Furthermore, drugs brought in from outside the EU may not be licensed for use in the UK and before agreeing to administer the vaccine in these circumstances, you should ensure that you comply with the GMC guidance for off-label prescribing. This includes satisfying yourself that the drug in question better serves the patient's needs than an appropriately licensed alternative, and that there is sufficient evidence for its safety and efficacy, and obtaining fully informed consent from the patient.
You should discuss with the patient her health concerns and the reason for her request and provide appropriate advice and reassurance. If clinically indicated you may be able to offer her vaccination with a UK licensed product with which you are familiar, although you should advise her that if she does not fit the eligibility criteria for free vaccination she may have to pay for it.
Dr Janet Page is a medicolegal adviser at the Medical Protection Society