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GPs told to carry out child flu vaccination programme in three-month window

Public health chiefs have told GPs they must vaccinate children aged between 2-4 years within a three-month window this winter because the chosen vaccines will expire midway through the flu season.

Experts from Public Health England (PHE) said in guidance for this year’s flu immunisation programme that it was ‘highly likely’ central stocks of the chosen Fluenz vaccines will have expired by the end of January, despite the vaccination programme expanding to include all 2-4 year olds this year.

The guidance also told GPs they must focus their efforts on improving uptake of the flu vaccine in patients with liver or neurological diseases.

GP leaders said that increased numbers of patients could be left unimmunised as a result of the short time-frame for immunising children.

The update stated: ‘Vaccine has been ordered to cover the period over which historically the flu vaccine has been administered, extending from September to mid-December.’

‘It is highly likely that all the Fluenz Tetra® supplied centrally will have expired before the end of January 2015. In the light of this it will be important to ensure that efforts are made to vaccinate children before the Christmas holidays.’

Last year, stocks of the vaccine had a similar expiry date, and some practices said they were struggling to vaccinate two- and three-year olds as a result.

Dr Richard Vautrey, a member of the GPC negotiating team and a GP in Leeds, told Pulse that patients could be left unimmunised and GPs could see their QOF achievement hit by failure to provide adequate stocks of vaccine.

Dr Vautrey said: ‘There’s an increasing problem, as more patients fall into the cohort for immunisation with Fluenz, it means that increasing numbers of patients will be left unimmunised unless practices use their own supplies of the alternative vaccine for those patients.’

He added: ‘This year, it’s been extended to 2-4 year olds. So it’s a bigger group and it’s bound to have a much bigger impact because it then impacts on QOF targets for immunisations as well. So it’s important that the vaccine is available throughout the flu season.’

‘We were told that with the extension of the scheme, to include a greater number of patients, they would ensure there was a considerable supply right through the immunisation program, right through to the end of March. It’s a manufacturing issue, and that’s simply not good enough.’

The public health update also urged GPs to concentrate their vaccination programmes on patients with liver or neurological diseases.

Average uptake of the flu vaccine in the under-65s clinical risk groups has been stuck at about 50% for the past three years. But it is even lower in patients with chronic liver disease, in whom uptake was around 43% last flu season, while coverage in those with neurological disease was 49% last year, despite them being among the most at risk of dying from the complications of flu.

A spokesperson for PHE told Pulse: ‘For a number of years now around only half of patients in at-risk groups have been vaccinated and increasing uptake in these groups is important because of the increased risk of serious illness should people in these groups catch flu. 

‘However, we know that establishing the true uptake rate is hard because of difficulties in determining the denominator and therefore this year we decided to take a different approach which is to ask that particular attention is focused on those in at risk groups who are most at risk of death from flu but who have the lowest uptake rates amongst the at risk groups (that is those with chronic liver and neurological disease, including those with learning disabilities).’ 

PHE declined to comment on what additional resources or support GPs could get to help boost uptake in these groups, but said it wanted to see coverage upped to that of other clinical risk groups.

The spokesperson added: ‘We would expect vaccine uptake in those with chronic liver and neurological disease (including learning disabilities) to reach levels closer to those being achieved for other at risk groups who have a higher level of uptake.’