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Shingles vaccine shortage blamed on GPs ‘multiple ordering’ as Public Health England imposes further restrictions



Public Health England has placed a further restriction on orders of the shingles vaccine after blaming GPs for causing stocks to run out temporarily by placing multiple orders.

PHE last month restricted practices to ordering just five doses of the Zostavax shingles vaccine at a time because of a temporary delay in the supply of vaccine from the manufacturer. But stocks ran out regardless as a result of practices placing multiple orders to get round the five-dose cap, PHE claimed in a vaccine update.

The public health body confirmed to Pulse that the vaccine is available again from the ImmForm website, but while the shortage continues it is placing an additional restriction of 25 vaccine doses per practice per week in an attempt to prevent any worsening of the situation.

However, the RCGP’s immunisation lead has hit back at the claims, saying that GPs have had ‘good reason’ to over-order following problems with flu vaccines in the past.

A statement from PHE said: ‘While the delays continue, a restriction on the quantity of vaccine which can be ordered per week is in place. Customer orders are currently being capped to 25 doses per week per practice. We expect disruption to the supply of shingles vaccine to continue until normal supplies are restored by the manufacturer Sanofi Pasteur MSD.’

The Government introduced the national shingles vaccination programme in September this year for people aged 70 years, along with a catch-up programme for people over 70 starting in those aged 79 years. This was in line with JCVI advice that the Zostavax vaccine is cost-effective for reducing shingles and post-herpetic neuralgia in the 70–79 years age group.

But PHE said that there were problems with practices stockpiling the vaccines. Its September update stated: ‘Multiple ordering to circumvent the cap has presented a number of challenges both for the distributor in distributing those orders, and for PHE in managing the remaining stock.’

PHE urged GPs not to stockpile the vaccine to prevent wastage and reminded GPs they have until the end of August 2014 to complete the vaccinations in their 70- and 79-year-old groups.

The PHE update added: ‘Please do not stockpile the vaccine as the vaccine is expensive and it is important to minimise wastage. Please note that the vaccine can be administered to the two eligible cohorts at any time between 1 September 2013 and 31 August 2014.’

But Dr George Kassianos, RCGP immunisation lead and a GP in Berkshire, questioned why PHE could not have stopped multiple ordering if stocks had fallen so low and said GPs ‘had good reason’ to be wary of running out of vaccines ‘after their experience with the pandemic influenza vaccine initial supplies’. 

Dr Kassianos said: ‘If any practices put in multiple orders, ImmForm would know instantly and Public Health England can stop the vaccines being dispatched, so why blame GPs?’

‘GPs have good reasons to want to put in multiple orders. We still remember getting 500 doses of the epidemic influenza vaccine per practice – so practices got 500 doses if they had 15,000 patients or 2,000 patients. How can GPs forget?’

Dr John Hughes, chair of Manchester LMC, said the shortages were not causing a problem and said some GPs may have over-ordered vaccine because they had been confused about which age groups to vaccinate.

He said: ‘It is not really a problem, because we’re only treating 70- and 79-year olds. I think what’s happened is some practices have misunderstood, thinking they have to do everybody between 70 and 79 all at once, and have stockpiled. That plus a bit of a production problem has caused the difficulty.’

Dr Hughes added: ‘There is not a huge demand for it because it hasn’t been greatly publicised and there is no big panic because we have until next year to get them done.’  

A spokesperson for Sanofi Pasteur MSD said: ‘It is the case we have had some initial temporary delays in the vaccine supply. We are working hard to resolve them and we are confident we will do this. All the deliveries we have planned to make will be made and so far we have delivered 500,000 doses so there is stock out there for GPs to start vaccinating people.’