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General practice expected to face ‘unprecedented’ flu vaccine shortages

by Costanza Pearce, Isabel Shaw, Nicola Merrifield
26 June 2020

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Manufacturers have said they may not be able to provide flu vaccines being ordered for this winter, following an ‘unprecedented’ surge in demand worldwide.

In the UK, the Department of Health and Social Care has been looking at whether to expand the influenza vaccination programme, but has still not reached a decision. 

But recent reports indicate the Government is considering including all patients aged over 50 in the cohort eligible for flu vaccination this year – meaning around 10 million extra vaccinations, according to the Health Service Journal.

GPs have warned that even without the over-50s potentially being vaccinated, many practices do not have enough supplies now to meet the additional demand from more existing eligible patients coming forward as a result of Covid-19 pandemic creating more awareness.

They said flu vaccines might have to be ‘rationed’ if stocks cannot be guaranteed and have demanded reassurance from the Government that there will be enough supply.

The BMA has called for NHS England to ‘facilitate’ additional flu vaccine supply directly with manufacturers and ensure there is enough to go round.

Sanofi – which supplies flu vaccines for under 65s and at-risk groups – told Management in Practice’s sister title The Pharmacist that in recent weeks it has ‘observed an unprecedented increase in influenza vaccine demand worldwide’.

A spokesperson said: ‘We are currently maximising the number of vaccine doses that we can make available, facing the exceptional increase in demand’.

However, the manufacturer acknowledged that it ‘may not be in a position to meet all additional demands’ for the vaccine.

The company told our other sister publication, Pulse, it was currently operating a waiting list for any extra orders as it had sold all of its existing stock – but stressed it was still early in the manufacturing process.

A spokesperson for GlaxoSmithKline added that it expect demand to ‘outpace manufacturing supply’.

They said: ‘Due to increased demand, GSK is looking at all opportunities to produce and distribute more flu vaccine doses for 2020 and the coming years, but we expect demand to continue to outpace manufacturing capacity. 

‘Due to long production times and short shelf-life, it is very difficult to quickly adjust manufacturing capacity to match changes in demand.’

Meanwhile, both Seqirus – which supplies vaccines for over 65s – and AstraZeneca told The Pharmacist that due to very high demand they are increasing manufacturing as far as possible.

A spokesperson for Seqirus told Pulse it has not stopped taking requests, but believes the vast majority of GP practices have already placed their orders.

GP leaders said they are not reassured there will be enough supplies. 

Sir Sam Everington, chair of Tower Hamlets CCG, said: ‘I am not reassured stocks will be available until the Government and manufacturers can guarantee on the 1st October that we have a flu vaccination for every single at-risk person and member of staff in the health service, care homes and local authorities.

‘If they haven’t got sufficient numbers then it will be rationed.’

He also called for the Government to ‘underwrite the cost’ and hold additional vaccines as central stock to prevent GPs from taking on the ‘risk’ of over-ordering if stocks become available and then not being paid.

‘Flu, Covid and the winter is a nightmare situation,’ he added.

Dr Farzana Hussain, GP in east London and clinical director of Newham Central PCN, added that she is concerned there will already be a ‘huge stock problem’ due to increased uptake of the vaccine locally.

She said: ‘I don’t think we will have enough – even if we don’t have the extra cohorts confirmed.

‘In my own practice, when I order I account for the people that won’t turn up – the DNAs. But this year we will have more people turning up. I myself know I haven’t bought enough for my entire influenza cohort – if this year all of them come, which I think they will, I will be running out.’

She added: ‘With the added demand from existing patients – even before any extra cohorts, if they are added – will be a problem.’

A BMA spokesperson said: ‘Practices should plan for the season as usual, as per NHS England and Improvement’s guidance. If more supplies are required at a later stage we expect NHSE/I to facilitate this process directly with manufacturers.’

The DHSC has yet to release details on any possible expansion to this year’s flu vaccine cohort.

A spokesperson said: ‘We have already indicated in the annual flu letter published last month that the flu programme may be expanded this season.

‘Any changes will be communicated to providers in good time ahead of the coming flu season and GPs will be able to order additional vaccines if needed.’

As it stands, those who qualify for the NHS-funded flu vaccine include all children between 2-10 years old, those in clinically at-risk groups between the ages of six months and 65, pregnant women, people living in care homes, and all health and social care staff.