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GP practices asked to order alternatives as QIVr flu vaccine unavailable – and adult flu campaign to start 3 October

by Rima Evans and Emma Wilkinson
13 June 2024

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Practices have been advised they should order alternative vaccines from an approved list, after Sanofi has said its recombinant quadrivalent influenza vaccine (QIVr) would not be available for this year’s flu programme.

In addition, the start date for the 2024/25 adult flu vaccination campaign has been confirmed as 3 October, NHS England announced in this week’s primary care bulletin.

A letter updating practices on plans for the 2024/25 flu vaccine programme said Sanofi had communicated to the UK Health Security Agency (UKHSA) that its QIVr would not be available.

‘Providers should order alternative vaccine for adults based on the 2024 to 2025 influenza vaccine recommendations of the JCVI,’ the letter from NHS England, the UKHSA and Department of Health and Social Care continued.

For older adults (those aged over 60 years), this includes use of the high-dose quadrivalent influenza vaccine (QIV-HD), which will be available in 2024 to 2025 in the UK market (see also table below).

The QIV-HD vaccine is also produced by Sanofi and is one of six available of a list that includes the nasal flu vaccine for children.

‘Alternatively, further orders of other first line vaccines, the adjuvanted quadrivalent influenza vaccine (aQIV) for those aged 65 years and older and cell-based quadrivalent influenza vaccine (QIVc) for those under 65 years, should be made,’ the letter advised

As QIVr is only licensed for those aged 18 and over, there is no impact on the children’s vaccination programme, practices have also been told.

Suzanna McDonald, head of flu programme at UKHSA, said: ‘An alternative adult flu vaccine for the 2024/25 programme will be available this year after being notified by the manufacturer that the vaccine originally procured by providers will not be available. 

‘The alternative is one of the vaccines recommended by the Joint Committee on Vaccination and Immunisations and the flu programme will be delivered as scheduled. 

‘GPs and flu vaccine providers may also order other JCVI approved vaccines as alternatives.’

Professor Azeem Majeed, a GP and professor of primary care and public health at Imperial College London, said: ‘The unavailability of the Sanofi vaccine should have a limited impact on the flu vaccination programme as long as a sufficient number of an alternative vaccine are available and practices are aware of the alternative vaccines that can be offered.

‘In past years, vaccine supply has generally not been a problem with the flu vaccination programme.’

A Sanofi spokesperson said: ‘Unfortunately, during the manufacturing process of doses for the 2024-2025 influenza season, the manufacturing site for our recombinant flu vaccine, Supemtek®, experienced an unforeseeable issue resulting in a significant loss of product. As a result, we are unable to supply recombinant quadrivalent influenza vaccine (QIVr) to customers in time for the influenza season starting in the autumn of 2024/25. This is an isolated occurrence that only impacts Supemtek, and not any other Sanofi vaccines or medicines.

‘We, at Sanofi, understand and acknowledge the impact this situation could have on those in the UK who would have received the vaccine, as well as health services.

‘We are committed to working in close partnership with the UK Health Security Agency, the NHS and other stakeholders to reduce the public health burden of infectious diseases in the UK. To this end, we have developed a mitigation plan to ensure that an adequate supply of appropriate flu vaccines is available for the upcoming 2024/25 influenza season.

‘Influenza can cause severe complications across major organ systems. Sanofi is committed to ensure people have access to the influenza vaccines that have been recommended by the JCVI and will be reimbursed by the NHS.’

Meanwhile, NHS England has confirmed that this year flu vaccinations for adults will commence on 3 October.

Pregnant women and children should receive their jabs from September 1, as had been previously announced in March (see also below).

In a bulletin sent out this week, NHS England said that despite the JCVI having ‘not yet advised what will be required of a possible COVID-19 vaccination programme beyond 31 August 2024’,  providers should still plan for any COVID-19 campaign to start alongside the main flu campaign.

‘Eligible cohorts will be confirmed following Government’s consideration of JCVI advice,’ it said.

PCNs and other providers that wish to participate in this year’s Covid vaccination programme are being reminded there is a new sign-up process. They must complete an online form on the NHS Business Service Authority webpage by 23:59 on 27 June.

What vaccines can now be offered to adults based on JCVI advice?

Aged 65 years and over: aQIV or QIV-HD. QIVc may also be considered if others are unavailable.

Aged 18 to 64 years in eligible groups:

For those aged 18-59 years – QIVc

For those aged 60-64 years – QIVc or QIV-HD.

QIVe may also be considered if others are not available.

Timings and eligibility for free NHS flu vaccine

The following should be vaccinated from 1 September, 2024:

  • pregnant women
  • all children aged 2 or 3 years on 31 August 2024
  • primary school aged children (from Reception to Year 6)
  • secondary school aged children (from Year 7 to Year 11)
  • all children in clinical risk groups aged from 6 months to less than 18 years. 

The following should be vaccinated from 3 October, 2024:

  • those aged 65 years and over
  • those aged 18 years to under 65 years in clinical risk groups
  • those in long-stay residential care homes
  • carers in receipt of carer’s allowance, or those who are the main carer of an elderly or disabled person
  • close contacts of immunocompromised individuals
  • frontline workers in a social care setting without an employer led occupational health scheme including those working for a registered residential care or nursing home, registered domiciliary care providers, voluntary managed hospice providers and those that are employed by those who receive direct payments (personal budgets) or personal health budgets, such as personal assistants.

Source: DHSC and UKHSA