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GP practices and pharmacies told to ‘swap stocks’ amid flu vaccine supply issues

by Elisabeth Mahase
24 September 2018

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NHS England has encouraged GP practices and pharmacies to ‘shift around’ flu vaccine stock as distribution issues spread to both types of vaccine.
Practices which were already struggling to source the adjuvanted trivalent flu vaccine (aTIV) recommended for over-65s this season are now also affected by delayed deliveries of the quadrivalent vaccine (QIV) for patients aged 18-65.
The UK’s main supplier of QIV, Sanofi Pasteur, said they were hit by a manufacturing issue, including problems with packaging, delaying deliveries to around 1,000 GP practices by two weeks.
Sanofi said deliveries of QIV should be received by the end of the month, while no delivery issues have been highlighted with regards to its main rival Mylan.
Sanofi UK managing director Hugo Fry said: ‘Unfortunately right at the beginning of the deliveries we had about a two-week delay for the first deliveries.
‘So there were a few thousand deliveries that were one or two weeks delayed, which is regrettable. But we will have caught all that back up by the end of the month, by the 28 September.’
Practices have already been told they will receive aTIV deliveries in a phased process over three months, meaning they risk running out inbetween deliveries, and causing concerns they could miss out on vital funding.
However, some practices have been unable to source any aTIV at all, despite being told by NHS England that there are sufficient stocks. NHS England suggested this could be in part because some GPs and pharmacies had ordered more than they needed.
In response, NHS England suggested GP practices and pharmacies should arrange to swap stocks to ‘ensure’ patients got their vaccine.
A spokesperson said: ‘We expect there to be a level of coordination by the CCGs and regional teams, to make sure where there are supply issues in an area because of higher anticipated demand or they haven’t ordered enough, they can shift it around to make sure people can get vaccinated.’
NHS England said new guidance would be released shortly on how vaccines can be safely moved between practices and pharmacies.
It comes as GPs have been told to ask patients to return at a later date or signpost them to local pharmacies if they do not have the right vaccine for their age group.
Pharmacy chain Well confirmed today that it is supporting a number of GP practices by allowing them to refer patients to its pharmacies to get vaccinated. 
Although the BMA has advised that practices can administer QIV to over-65s as a last resort, if the vaccine is unlikely to become available in their area, NHS England has said payment will be subject to checks whether this was genuinely the case.
GPC member and Doncaster LMC medical secretary Dr Dean Eggitt said: ‘I will be very surprised if pharmacies will want to share the stock with us. We are competitors in this. GP practices want to vaccinate as many patients as possible, and so do pharmacies. Pharmacies get paid to do this so there is very little advantage to the pharmacies in giving us their stock.
‘I think this is abdication of responsibility from NHS England which is irresponsible. I think they have created a problem which they are walking away from, and are passing it to clinicians on the frontline who are too busy seeing sick people. If they want the flu vaccination programme to be successful this year, they need to help us.’
He added: ‘The disorganisation that we have seen in this year’s flu campaign is nothing short of an avoidable national scandal.
‘If this year’s flu campaign turns out to be successful in supressing the illness and saving lives, it will be as a result of monumental effort on behalf of grass roots providers to whom we will all owe a debt of gratitude.’
Doncaster GP Dr David Coleman, whose practice is affected by aTIV supply issues, said: ‘We have 2,000 patients aged over 65 and are particularly concerned about our 200 vulnerable housebound and care home patients. While the local pharmacies have a supply of the aTIV, we understand they are not planning to offer a service for housebound patients.’
Dr Coleman’s practice is currently negotiating with a pharmacy to try and obtain stock, but he said if this does not happen the practice could face an £8,000 loss through dispensing fees, which he said would be ‘frustrating in these financially challenging times’.
Ahead of this flu season, which officially started 1 September, practices were advised to administer the quadrivalent vaccine (QIV) to patients aged 18-65 and the adjuvanted trivalent flu vaccine (aTIV) to patients aged over 65.
BMA GP Committee chair Dr Richard Vautrey said: ‘When practices or pharmacists run out of stock, this will ensure that there is collaboration between practices and pharmacists in the local area. We know that towards the end of the flu campaign some practices run out but still need to provide vaccinations to their patients whereas other still has stock that’s left over.
‘Practices have raised concerns about sharing that stock because of legal restrictions, but I think the advice and guidance that NHS England will be providing – which we have been seeking – should allay those anxieties and allow common sense to prevail.’
A spokesperson for aTIV supplier Seqirus said: ‘We started our first phase of deliveries earlier this month and remain on track to meet the timetable for all other phases as confirmed in our communications with customers.
‘We experienced some processing challenges during the ordering period due to the sudden high volume of requests however we believe the majority of these issues have been resolved.’
Seqirus added that although it has been unable to fulfil late orders ‘due to high global demand’, there ‘will be sufficient quantities of FLUAD [aTIV] available across the UK to vaccinate this vulnerable population’.
This story was first published on our sister publication Pulse.