Flu Vaccinations 18/19
Many practices have contacted the LMC seeking help and advice with regard to what flu vaccines they should order for the winter of 2018. There has been conflicting advice issued by some regional teams of Public Health England and NHS England.
Recently definitive advice has been issued by NHS England at a national level.
Patients in the at-risk groups who are aged less than 65 years should be offered Trivalent or Quadrivalent flu vaccinations.
When selecting the best vaccine for their population practices may wish to take into consideration that NHS England - Wessex has noted that modeling concludes that the benefit of using quadrivalent vaccine compared with trivalent is ‘more substantial in at risk adults under 65 years of age, including pregnant women’.
Patients aged 75 years or more should be the offered Adjuvant Trivalent.
The recent NHS England national guidance suggests that the use of adjuvant trivalent flu vaccine should be a priority for those aged 75 years and over, given that the non-adjuvanted inactivated trivalent vaccine has showed no significant effectiveness in this group over recent seasons.
However it is worth noting that based on available evidence, Joint Committee Vaccinations and Immunisations (JCVI) concluded at its October 2017 meeting that adjuvant trivalent flu vaccine is more effective and highly cost effective in those aged over 65 years compared with the non-adjuvant or ‘normal’ influenza vaccines currently used in the uk for this age group.
With this in mind, the LMC believes that patients aged between aged 65 – 74 should ideally be offered the Adjuvant Trivalent Flu Vaccination if there are sufficient supplies but if not, they should be offered the Quadrivalent Flu Vaccination.
We appreciate that this is a significant change in position.
The LMC’s advice is that practices should look at their uptake this year and estimate the demand for the over 65s and over 75s and then ensure you order sufficient vaccine in the appropriate group. This will unfortunately mean all practices will need to review their flu vaccine orders, if these have been placed.
GPC has asked us to feed back any problems that practices have with changing their vaccine orders in light of this new guidance. So please let us know if this affects you.
Dr Nigel Watson
Churchill House, 122-124 Hursley Rd
Hants. SO53 1JB (Registered Office)