The government announced in July this year that the flu vaccination campaign would be extended beyond the usual at-risk groups to cover more than 30m people - making it the largest in NHS history.
The flu vaccination DES published in September said the expanded campaign would only go ahead 'subject to vaccine supply' - but the government has now confirmed that there is 'enough flu vaccine supply to vaccinate 30m people throughout this year’s flu season in England'.
Confirmation that the expanded flu vaccination campaign will go ahead raises huge questions over GP workload - as practices prepare to take part in a COVID-19 vaccination campaign under an enhanced service deal that will also be in place from 1 December.
More than 11m patients have been vaccinated against flu already during the 2020/21 campaign - with Public Health England reporting 'uptake is the highest it has ever been at this point in the season for those aged 65+ and in 2- and 3-year-olds'. Uptake in at-risk groups is also higher than at this time last year, although among pregnant women uptake has dipped.
The decision to invite patients aged 50-64 for flu vaccination from 1 December adds a further 11.5m patients to the eligible cohort just as practices are preparing to roll out the COVID-19 vaccination programme. NHS England confirmed on 20 November that practices should plan to deliver flu vaccination to 'as many people as possible in this cohort...prior to delivery of the COVID-19 vaccine'.
UK vaccine taskforce chair Kate Bingham told MPs earlier this month that 14m doses of COVID-19 vaccine could be available before the end of 2020 - and the deal agreed between the BMA's GP committee and NHS England has been put in place so that vaccination can be rolled out 'before Christmas' if vaccines are approved by the MHRA.
Ms Bingham told MPs on 4 November that 10m doses of the Pfizer/BioNTech vaccine - found in final trial data to be 95% effective - were expected to be ready before the end of 2020, and the manufacturer has said it will submit the product for approval 'within days'. The further 4m doses expected this year are of the Oxford/Astra Zeneca vaccine, which has also reported promising early results and is expected to publish data from its phase 3 trials imminently.
GPs have already raised significant concerns over workload implications around the COVID-19 vaccine plans, warning against 'unrealistic expectations' - particularly given NHS England's expectation that general practice will remain 'fully open and accessible' while delivering the vaccine.
General practice is already experiencing extremely high workload - with a report from LMCs suggesting GPs at an average practice are working around 50% more hours per week than at this time last year.
GP practices are being invited to order flu vaccine from a central government supply of more than 7m doses to carry out vaccinations in 50- to 64-year-olds, and pharmacies will also be able to vaccinate patients in the extended cohort.
Confirmation of the expanded campaign comes less than 24 hours after GPonline reported comments from NHS England officials suggesting the NHS intended to press ahead with vaccinating patients aged 50-64.
NHS England's primary care bulletin on 20 November said practices and pharmacies 'should begin planning now...ordering additional stock and organising appointment slots'. It highlights the need for practices to continue vaccinating at-risk groups alongside the 50-64 cohort, and the need to maintain routine childhood vaccinations.
Health and social care secretary Matt Hancock said: 'This winter is like no other, and we have to worry about the twin threats of flu and COVID-19.
'COVID means getting a flu jab is more important than ever this year. So we are delivering the largest ever flu vaccination programme. Free vaccinations for 50- to 64-year-olds will now be available from GPs and pharmacies starting from 1 December.'
BMA GP committee chair Dr Richard Vautrey said: 'GPs and their practice teams have already worked hard and effectively to protect millions of their patients through the biggest ever flu vaccination campaign and we will now be able to extend this important scheme to protect even more people. GPs have responded rapidly and professionally to the pandemic since its outbreak and are continuing to do so, as acknowledged and commended by Matt Hancock only a few days ago.
'This campaign will not only protect individuals from the potentially serious consequences of catching flu but also help to keep pressure off the NHS at a time when it is under enormous pressure because of COVID-19.'
A statement from the DHSC said that 'rollout of the flu vaccine to over 50s is separate to any future COVID-19 vaccine rollout and people will be able to receive the flu and COVID-19 vaccinations in parallel', adding that 'the NHS is well equipped to administer both'.
Guidance on the COVID-19 vaccination plans has made clear that flu vaccination cannot be administered at the same time as COVID-19 vaccines - suggesting that practices should 'plan on the assumption that there needs to be at least seven days between the flu vaccination and COVID-19 vaccinations'.
The Joint Committee on Vaccination and Immunisation has said that care home residents and staff, followed by health and social care staff and patients aged over 80 will be first in line for COVID-19 vaccination.
Patients vaccinated with the Pfizer/BioNTech vaccine will require two doses, three weeks apart to be protected - but the Oxford vaccine may require just a single dose depending on trial results.