GPs split over best way to deliver flu and COVID jabs amid lack of guidance

GPs are struggling to decide how to deliver flu and COVID-19 booster jabs this autumn amid continued uncertainty around co-administration.

Vaccination (Photo: Mike Kemp/In Pictures/Getty Images)
Vaccination (Photo: Mike Kemp/In Pictures/Getty Images)

In June, the government suggested that over-70s, clinically vulnerable patients and health and care staff could be offered COVID-19 booster jabs from 1 September alongside flu vaccination, with further groups to follow.

The flu enhanced service specification said ‘early evidence’ supported the delivery of both vaccines at the same time, with final advice from the Joint Committee on Vaccines and Immunisations (JCVI) due to be published ‘before September’.

But GPs are still waiting on final confirmation - and with a booster campaign as well as the start of this year's flu vaccinations just weeks away practices are opting for different approaches to their vaccine set ups.

COVID booster jabs

In west London, GPonline understands that practices prefer a ‘hub and spoke’ model to allow delivery of COVID-19 booster jabs,from individual practices across the patch - but are awaiting confirmation around transportation and storage requirements.

All practices in Liverpool - bar one - have signed up to deliver COVID-19 booster jabs. But Liverpool LMC revealed that GPs are unconvinced about co-administration. The LMC said confirmation over co-administration was needed weeks ago - and many practices are now deciding to keep flu and COVID-19 booster administration separate so that they can press ahead with planning.

As GPs wait to find out whether flu and COVID-19 jabs can be offered in parallel, further uncertainty came after a member of the Joint Committee on Vaccination and Immunisation (JCVI) suggested last week that booster jabs may only be necessary for the most vulnerable patients, rather than the larger numbers proposed in interim advice.

Primary care networks

GPonline understands that practices in West London are considering using a hub and spoke model to deliver booster jabs this autumn, which would involve 'baby packs' of jabs being sent out to individual practices - acting as pop-up vaccination sites - from a designated PCN hub.

A spokesperson for Londonwide LMC said that some GPs in the capital are looking to operate a two-tier model in which patients just needing a COVID-19 and flu vaccine are directed to a PCN vaccination hub, whereas those with other care needs could see their registered GP and potentially receive the jabs in their usual practice.

GPs in London have also argued that the flu and COVID-19 jabs both need to be recordable in practice IT systems, warning that having to duplicate entry of patient details - for example if the two vaccines had to be recorded in separate systems alongside each other - could ‘slow down' vaccinations.

Expanded flu campaign

NHS England has previously ruled out the administration of COVID-19 booster jabs at individual practice level, and was accused by the BMA of ignoring the voice and preferences of GPs.

Liverpool LMC secretary Dr Rob Barnett told GPonline that many practices in the area had expressed a desire to run the flu and COVID booster campaigns separately amid ongoing confusion.

He said: ‘The problem for practices at the minute is that they don’t know the definition of co-administration. So, it could mean both jabs in the same season, one week apart. Or it could mean one in each arm, or it could mean two jabs into one arm.

‘A lot of people are saying they'd rather do [the flu and booster shots] separately. If practices have got well and trusted processes for flu, what they don't want is to get that somehow confused.

Housebound patients

‘In terms of vaccinating the housebound, there is a general hope that common sense is going to prevail, so you're only going in once, rather than twice...but I think certainly, having spoken to a few practices and a few PCNs, it is very likely that we'll just run a continuation of what we've got or had in the past.'

GPonline understands that most GP practices have signed up to deliver booster jabs this autumn, and have been looking at how they can co-administer third doses alongside flu jabs should this be approved.

GPs warned in July that government plans to vaccinate 35m people against flu this year had left practices facing a 'planning nightmare', with the majority delivering parallel booster campaigns.

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