For the third year running, GPs have been told to expect delayed deliveries of the flu vaccine.
The latest setback has been caused by a low yield of one of the three viral strains chosen by WHO for inclusion in this year's vaccine. As a result, all manufacturers are behind schedule.
Dr David Salisbury, director of immunisation at the DoH, said he hoped that the 15.2 million doses ordered for this year would eventually be delivered. But practices could have fewer doses than expected in September, when patients start to be called in for their annual flu jab.
GPs should allocate the supply according to clinical priority, giving the first doses of vaccine to patients over 65 years, followed by those in clinical at-risk groups, he said.
Berkshire GP Dr George Kassianos, spokesman for immunisation at the RCGP, agreed: 'The priority is the over-65s. By doing them we would get most of those at risk.
But Dr Nigel Higson, a Brighton GP with an interest in virology, disagreed: 'That is a silly statement. The priority group is everybody. I think we've just got to call in people in appropriate numbers to suit the number of vaccines we've got.'
Dr Salisbury said that most UK flu outbreaks occur after the New Year, so a delayed vaccination schedule would only pose a problem if there was an unusually early flu season.
However, Birmingham GP Dr Douglas Fleming, member of the Joint Committee on Vaccine and Immunisation's influenza subcommittee, said in the past the most serious flu outbreaks were established before the end of the year, and it was important that vaccinations took place by mid-November.
'The length of the delay is critical, but whatever its duration, GPs will have to intensify vaccinations,' he said.
Vaccine manufacturers have yet to confirm when and how much vaccine they can deliver.