Previous guidance had recommended that there should be at least a seven-day gap between the flu and COVID-19 jab being given. However an updated standard operating procedure (SOP) for PCN-led vaccination sites, published on 14 January, now says that other vaccines can be given at the same time as COVID-19 jabs.
The section of the SOP on vaccinating housebound patients has also been updated to reflect new advice on transporting the Oxford/AstraZeneca vaccine between patients' homes.
The SOP says that 'ideally' COVID-19 vaccines should not be given 'if any other vaccination has been received within the last seven days'. However, it adds 'adjacent or co-administration can occur where this would cause delay or reduce access to either influenza or COVID-19 vaccine for certain patient groups e.g. care homes, housebound patients and hard to reach or vulnerable groups'.
Current advice in the Green Book says that there is no evidence of safety concerns when co-administering the COVID-19 vaccines with other vaccines. It advises that ideally there should be a seven-day gap 'to avoid incorrect attribution of potential adverse events'.
However it also says that if eligible patients present for a COVID-19 vaccine after having another jab 'vaccination should proceed to avoid any further delay in protection and to avoid the risk of the patient not returning for a later appointment'. The same advice applies for other vaccines where the COVID-19 vaccine is received first.
The updated guidance in the SOP on housebound patients clarifies that vials of the Oxford/AstraZeneca vaccine can be moved between houses as long as the contents are used within six hours. Previous guidance had suggested that it was not possible to move the vaccine after a vial had been punctured.
Vials should be stored at between 2°C and 8°C until their contents are first used and they can then be stored between 2°C and 25°C during the six hours they are in use.
GPs should 'decontaminate the vial and secondary packaging using an alcohol wipe' after each vaccination and before returning it to the bag for onward transportation, the guidance says.
A previous version of the SOP had also said that all housebound patients required a 15-minute observation period, however this requirement has been removed from the latest guidance. GPs are now advised that they only need to undertake an observation period for the Oxford/AstraZeneca vaccine if it is clinically indicated.