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GP practices can now order a single flu vaccine for all adults, says NHS England

by Elisabeth Mahase
25 January 2019

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GP practices can now order a single flu vaccine for all patients over the age of nine for the next flu season, NHS England has announced.
The new vaccine – QIVc – was licenced for use in the UK last week, and has been ruled safe and effective in all age groups over 9 years by the Government’s vaccination advisory body.
In a letter, published on 23 January, NHS England told practices they can order QIVc, alongside the previously available aTIV and QIVe – which were used in 2018/19 for over 65s and under 65s at risk, respectively.
This comes after Public Health England told practices in November to re-order the same two types of vaccine as they have been using this season, for 2019/20.
PHE’s advice was given despite the Joint Committee on Vaccination and Immunisation (JCVI) saying the new vaccine – QIVc – could be used across all adults, and that licencing was expected.
In the updated influenza vaccine letter, NHS England’s national medical director Professor Stephen Powis said: ‘As stated in the previous letter, the vaccines recommended for the 2018/19 season continue to be recommended for the 2019/20 season.’
‘In addition, QIVc, Flucelvax Tetra, is now licensed for use in the UK for patients aged nine years and upwards,’ he added.
The letter said the JCVI considers QIVc ‘equally suitable’ to QIVe and aTIV.
It said: ‘Providers should order currently licensed vaccines, aTIV, QIVe and QIVc for the 2019/20 season for their populations in eligible groups. These three recommended vaccines will be eligible for reimbursement by NHS England.’
Richard Miller, practice manager at Great Bentley Surgery in Colchester, said: ‘[NHS England] had already confirmed that we should – and most practices have – order the same variants that we used this year.
‘The latest communication contradicts itself. It starts saying that the recommendation is to order the same as this year, but then the last paragraph says that we can use the new one too.’
Ahead of the 2018/19 flu season, which started on 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.
However, issues were caused by the phased deliveries of the aTIV – supplied by Seqirus – which saw almost 70% of GPs experience a shortage of the vaccine, forcing them to turn away vulnerable older patients as a result.
The new vaccine (QIVc), which was used in 2017/18 US flu season, will be supplied by Seqirus.
Problems were also experienced by GPs with their orders of QIVe. Supplier Sanofi Pasteur reported packaging issues back in September, which delayed deliveries to around 1,000 GP practices by two weeks.
The issues led to the Government’s medicines watchdog putting a temporary regulatory change in place to enable GP practices and pharmacies to swap flu vaccine stocks, a solution encouraged by NHS England. 
This story was first published on our sister publication Pulse.