GP leaders warned that poor uptake has left practices potentially with unused stocks of vaccine, and hit out at the decision to allow pharmacies to compete with practices to offer the jab. A decline in uptake of flu jabs at GP practices has also been attributed to competition with pharmacies.
Only 35% of eligible patients attended their practice to receive an urgent catch-up dose of the recently instated MenACWY vaccine in its first phase, Public Health England (PHE) data show, with around 133,000 children missing out.
Practices receive £7.64 per dose plus an additional £2.12 to recognise the tight timeframe for implementation of the programme – totalling a potential £9.76 per dose missed out for two thirds of the eligible patients.
The first phase of the catch-up programme ran from August 2015 until the end of March 2016. Patients born between 1 September 1996 and 31 August 1997 were eligible to receive a dose of the vaccine at their GP practice.
Most school pupils will receive the MenACWY vaccine at school, as it now replaces the MenC booster given during either year 9 or 10.
The Joint Committee on Vaccination and Immunisation (JCVI) decided to add it to the national immunisation programme in response to the rising number of meningococcal W cases.
Older teenagers still in school who missed the chance to receive the MenACWY vaccine in school were directed to get the vaccine through their GP practice in separate phases when they enter school year 13.
But in the first phase of the scheme only 35% of those eligible took up the offer. The vast majority – 81% – of all vaccinations were given during the first two months of the scheme, August and September. Coverage from the end of September to end of March increased from 29% to 35%.
GP vaccination programme
In a report on the scheme, PHE said the relatively low coverage in the target group ‘highlights the challenges of a GP-delivered vaccination programme in this age group’.
Despite the poor uptake – a new scheme began in April targeting pupils in the school year below the first cohort (born between September 1997 and August 1998). Patients in the first cohort who were not vaccinated can still request the jab from their GP until they turn 25.
RCGP immunisation lead Dr George Kassianos said vaccination rates at GP practices had reduced across the board, and warned that the decision to offer the flu vaccine in pharmacies may have had knock-on effects.
‘Something happened last year that may have caused a significant but predictable change in the rate of immunisations, not just for the MenACWY, which is admittedly low, but for the influenza vaccination rate too,’ he said.
‘I have seen GP practices through the last flu vaccination season no longer being as enthusiastic as in previous years. The common denominator was the sudden announcement last July by PHE that pharmacists will be competing with GPs in vaccinating eligible patients against influenza.
‘Pharmacists see patients monthly, GPs don’t. When asked if they would like the flu vaccine, patient after patient was giving the same answer – they "had it at the chemist". It does not take long to make the GP practice teams feel undermined.
‘This has affected not just influenza immunisation, but possibly MenACWY. In addition, many practices were left with unused flu vaccine supplies they could not return to the manufacturers for a refund.’