Practices should refer adult patients to hospital or NHS Occupational Health Services to receive the hepatitis B vaccine, Public Health England (PHE) has said, after agreeing with the GPC that practices should bow out of providing the service to help preserve dwindling stocks.
The strict measures come in light of a worldwide shortage of hepatitis B vaccine, caused by problems with the manufacturing process, which has ‘severely impacted UK supply’.
A letter sent by PHE informed practices that general practice will not be able to order any adult hepatitis B vaccine stock ‘until further notice’.
GPC clinical and prescribing lead Dr Andrew Green said removing GPs from the supply chain would help simplify the process of prioritising those at greatest risk of contracting the virus, and other services were ‘best placed to prioritise demand’.
The risk of contracting hepatitis B in the UK is very low, and vaccination is usually only offered to patients at high risk of being exposed to blood or other bodily fluids of an infected person.
High-risk groups include babies born to mothers who are infected with hepatitis B, sexual partners of infected individuals, healthcare workers and people who inject drugs.
With only limited stocks on hand, healthcare professionals are advised to prioritise patients who have already been exposed to a known infected source over those who have had contact with an unknown source or looking to receive as a preventative measure.
PHE said this priority system will continue until at least the beginning of 2018 and will be ‘kept under review’.
It added that the measures would help ‘preserve adult and paediatric hepatitis B vaccine stock for those at the highest risk and with the greatest ability to benefit’.
The restrictions do not affect the combined vaccine that includes hepatitis B routinely given to babies at two, three and four months. This is not affected by the shortage and should still be provided by GPs.
Hepatitis B vaccine
Dr Green said: ‘While supplies of Hepatitis B vaccine are so short it is vital that doses are used to cover those at most risk of infection, and it is right that supplies are protected for the NHS.’
He criticised an alert detailing the restrictions on the NHS central alerting system (CAS) for not highlighting that GP practices will not be responsible for providing the vaccine during the shortage.
‘The CAS alert should have been clearer that the responsibility for immunising patients at risk rests with the bodies that have had their supplies protected.
‘The BMA’s GP committee believes that removing GPs from the supply chain makes this process simpler and will help GPs who otherwise might find themselves being asked to administer vaccines they cannot obtain.
‘Hospital trusts and NHS Occupational Health Services are in particular best placed to prioritise demand. GPs will continue to provide vaccination to at-risk new-borns who thankfully are not affected by this shortage.’