Flu Vac 2018/19 - Which vaccine should be used and delivery of vaccines
Which vaccines should be used?
The LMC recognises the conflicting advice that has been issued about which influenza vaccines practices should be using. Details below have now been released by NHS England and this should be considered as the definitive advice. ( flu vaccination supporting data )
The aim is to use the most effective vaccine for the population
- Why adjuvanted influenza vaccine (aTIV) for people over 65 years of age (Fluad)?
This vaccine has been licensed in Europe and the USA since 2015 and data indicates that it is more highly effective than non-adjuvanted vaccines in the elderly.
The adjuvanted trivalent vaccine (aTIV) should be used for all patients aged 65 and over and this is the most effective vaccine for this age group.
- Quadrivalent influenza vaccines (QIV) for under 18s - 65s at risk & healthcare support workers.
This vaccine will be used in the childhood vaccines and is the most effective in this age group. Healthcare workers are also likely to benefit from protection against the additional B strain.
Quadrivalent influenza vaccines (QIV) contain;
- two influenza A strains and
- the two main influenza B strains
Including both B strains should provide better protection than the single strain B contained in the previously used trivalent vaccines (TIV). Influenza B is relatively more common in children than older age groups, the main clinical advantage of quadrivalent vaccines is in childhood.
- Live attenuated quadrivalent influenza vaccine (LAIV) for children aged from 2 years to less than 18 years (unless contraindicated).
The live attenuated quadrivalent influenza vaccine (LAIV) should be given to children aged from 2 years to less than 18 years unless contraindicated. Further information on this programme can be found on the PHE national flu immunisation programme page.
The use of the live quadrivalent LAIV in children should not only protect the age group where flu infection is most common but also by preventing transmission from children to others. It also reduces circulation of influenza B across the whole population and thus indirectly protect them.
The live attenuated quadrivalent influenza vaccine (LAIV) is not licenced for use in those aged 6 months to two years. Eligible at-risk children are recommended to receive an age appropriate inactivated quadrivalent influenza vaccine (injected).Further information on this programme can be found on the PHE national annual flu immunisation programme page.
Delivery of vaccines
During the 2018/19 season, adjuvanted influenza vaccine (aTIV) will be delivered to providers using a phased delivery system with orders expected to be delivered in a 40:20:40 ratio (Sept/Oct/Nov).
All influenza vaccines for children aged 6 months to less than 18 years are purchased centrally by Public Health England and should be ordered via ImmForm.
This includes the live attenuated quadrivalent vaccine (LAIV) and inactivated vaccines for children for whom the LAIV is medically contraindicated or otherwise unsuitable.
Availability of vaccines – update:
If you are a provider of flu vaccination for children through general practice or the schools programme in England, please take some time to read the information contained in this link.