GPs in Scotland are having to restrict the use of the newly introduced flu vaccine to the over-75s after the Government failed to secure enough stock of the vaccine.
It counters advice from the Joint Committee on Vaccination and Immunisation that the more effective adjuvanted trivalent flu vaccine (aTIV) introduced for the first time this year should be used in all patients over the age of 65.
An estimated half a million 65 to 74-year olds in Scotland will instead be offered the trivalent inactivated vaccine, a letter to health professionals said.
Those aged 18-64 who fall into high-risk groups will receive the quadrivalent inactivated flu vaccine.
The news comes as GPs and pharmacies in England have been told to swap stocks between them amid supply issues for the aTIV, forcing the Government to temporarily suspend regulations regarding movement of medicines. Unlike in Scotland, where the NHS centrally sources the vaccines from suppliers, English GP practices do so directly.
Flu vaccine is procured centrally in Scotland and orders had already been placed before the JCVI issued its updated advice late last year.
Supply problems with aTIV have also been reported in other areas of the UK after the manufacturer was quickly forced to upscale production in response to the JCVI recommendations.
Deliveries are being carefully staggered with advice to prioritise the over-75s for vaccination.
First Minister Nicola Sturgeon told the Scottish Parliament that the supplier of the aTIV vaccine had been unable to guarantee them sufficient supply.
‘The group where the advice says the protection from this vaccine will be greatest is the over-75s, and that is the group that is being prioritised.
‘Other groups get protection from the flu vaccine that will be available for them.’
In a letter to the Chief Medical Officer, BMA Scotland said they were concerned that the aTIV vaccine would not be available for 65-74 year olds this year given that last year’s vaccine had clearly not been as effective in older patients as had been hoped.
‘The JCVI described the vaccine effectiveness as just modest overall and indeed low against some strains of flu,’ the letter said.
‘This had serious knock on consequences, first and foremost for patients, but also for the ability of our health services to cope with demand.’
The BMA said failure to procure the new vaccine meant ‘a large group of some of the most vulnerable adults will not have access to the most effective vaccine available to them this winter’.
Dr Lewis Morrison, chair of BMA Scotland and a geriatrician, said: ‘Of course we hope that the vaccine supplied this year is effective and it is important to emphasise that people should get their flu jab.
‘But there are legitimate questions to be asked on how the position that we see in Scotland has arisen.
‘While it would seem little can be done to rectify things for this year, it is also important that any lessons are taken on board for the future.’
The Scottish Government said this year’s flu vaccination programme would offer free immunisation to two million people across the country.
A spokesperson said: ‘During 2018 and 2019 a new vaccine (aTIV) for everyone aged 65 and over will be rolled out.
‘In line with expert clinical advice, the vaccine will be offered this winter to people aged 75 and over.’
In Northern Ireland, where flu vaccine is also procured centrally, there had been some early logistical problems in getting vaccine out to practices but the Public Health Agency said the majority of practices would have received their initial orders by the start of October.
NI GPC chair Dr Alan Stout said: ‘It is causing a problem at practice level where practices have had to organise and book clinics depending on the deliveries and supply but practices are generally very good at being flexible and responsive.’