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GPs asked to spread out pneumococcal vaccine over year due to shortages

Shortages of pneumococcal vaccine mean that GPs will be unable to offer it alongside flu vaccine in some groups of patients, Public Health England has advised. 

GPs have been told in the latest issue of PHE’s vaccine update to alter their plans for administering pneumococcal vaccine by spreading vaccine appointments for PPV23 in lower priority groups such as the healthy over 65s throughout the year.

It comes after supplier MSD advised officials that there will be limited supplies of PPV23 vaccines until their next delivery, which is expected in January 2020.

The BMA has warned that shortages are becoming an ‘increasing frustration’ for both patients and GPs. 

The update for the pneumococcal vaccine said: ‘The supply constraints affecting PPV23 vaccine will make it unlikely that practices will be able to offer the vaccine alongside influenza vaccine to all eligible patients in lower priority groups (e.g. healthy people aged 65 years and over).

‘Practices should therefore plan to offer PPV23 to this group throughout the year rather than aligning immunisation to take place alongside the flu programme.

‘This will help to ensure demand for vaccine is more consistent across the year and that stock can be ordered in small quantities to cover the requirements each month, thus also reducing the risk of wastage.’

Practices are being asked to use any stocks they have in priority groups, such as those newly diagnosed with eligible conditions followed by those in moderate priority groups who have never received the vaccine.

If no vaccine is available, records need to be flagged to call patients in for a future appointment.

The advice added: ‘Any PPV23 dose that the surgery is able to access should be offered opportunistically to high and moderate priority groups attending an appointment at the surgery who have never received PPV23 and are due this vaccine.’

However, Dr George Kassianos, immunisation spokesperson for the RCGP, said it would not be long before vaccine supplies would be restored but pneumococcal vaccination does not have to be done in flu season.

He said: ‘The current enhanced service for PPV23 runs from 1 April 2019 to 31 March 2020. The offer of the PPV23 alongside the influenza vaccine is purely because we see the at-risk patients for flu vaccination and they are very similar for both PPV23 and flu vaccination.’

It comes as the vaccine has been added to an extended list of medicines banned from parallel export from the UK, which also includes MMR.

A statement from the Department of Health and Social Care said the step was taken to protect supplies of MMR for private patients and those wanting the vaccine outside routine NHS immunisation and that supply issues are not affecting the national immunisation programme.

There are now 31 medicines banned from parallel export in response to supply problems with metformin and alogliptin recent additions to the list.

BMA GP Committee chair Dr Richard Vautrey said: ‘We saw a shortage in the PPV vaccine last year and this problem is becoming an increasing frustration for both practices and patients. The measure to restrict export of the vaccine and improve availability for practices in England is sensible.

‘Though supply issues are nothing new, it is something we are now having to deal with more and more which just adds more to the workload burden carried by GPs and their practice teams.

‘The Government must do much more to ensure that problems with the manufacturing and supply of medicines are promptly addressed so that patients have access to timely care.’


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