Do we need flu adverts this year?

Last winter's flu season turned chaotic when rumours emerged that some practices were running low on vaccines.

Catch it. Bin it. Kill it: the DoH relaunched its hygiene campaign last year but should it do so again? (Image: NHS)
Catch it. Bin it. Kill it: the DoH relaunched its hygiene campaign last year but should it do so again? (Image: NHS)

Slow early uptake among at-risk patients was followed by a late surge in demand, which led to some practices running out of vaccine altogether.

The BMA laid the blame for the shortages firmly at the DoH's door. It said the late surge in demand was 'linked to the government's decision not to run the normal flu vaccination advertising campaign in England'.

Although vaccine uptake rates were comparable with 2009/10 by the end of the last flu season, the DoH was forced to release hundreds of thousands of doses of old 2009 H1N1 pandemic vaccine to plug the gaps.

Catch it. Bin it. Kill it
It also had to relaunch its 'Catch It. Bin It. Kill It' hygiene campaign as flu continued to spread and, in the aftermath, fingers were pointed at GPs for not ordering sufficient supplies. Even with several months' hindsight, it is unclear whether the lack of a flu awareness campaign caused the shortages and whether failing to reinstate it could cause shortages this winter.

David Behan, DoH director general of social care, local government and care partnerships, has revealed that there are no plans at present to run a flu awareness campaign in England this winter.

Most GPs insist they ordered more than enough vaccine last year for all their at-risk patients.

Nevertheless, the government has been sufficiently worried about the situation to commission a review of whether future vaccine supplies should be centrally procured.

The plans were met with hostility by doctors. The BMA said it was 'extremely concerned' by the government's proposal and that there was no evidence it would improve uptake.

What is clear is that the devolved nations all believe early awareness campaigns are vital.

The Scottish government will launch its campaign on 3 October. The Welsh government's will begin by the end of September, targeting its message at local radio and online.

In Northern Ireland, a campaign will start on 29 September.

A spokeswoman for Northern Ireland's Public Health Agency said that, although uptake rates had improved in recent years, there was 'no room for complacency'. An early campaign was vital to ensure people came forward early and got the 'full benefits' of the vaccine, she said.

But GPC Scotland chairman Dr Dean Marshall, BMA negotiator on flu planning, isn't so sure. 'It's always been an issue whether what we spend on campaigns is value for money. There's not a great a deal of evidence to suggest big TV campaigns make a big difference to uptake rates,' he says, in contrast to the BMA's official line.

Targeting local campaigns
The resources needed to run a national campaign would be better spent if they were diverted to targeted, local campaigns instead, he says.

His view is shared by Dr Maureen Baker, the RCGP's health protection lead. 'I don't think one could attribute shortages of vaccine later in a flu season to the lack of a DoH media campaign early in the flu season,' she says.

'After all, by that time the vaccine has already been ordered and delivered to GPs.'

To prepare for the coming season, Dr Baker suggests practices ensure at-risk patients are vaccinated 'as early as possible'. If shortages do then re-emerge, the majority of vulnerable patients would already be protected, she says.

Dr Baker and Dr Marshall both stress that pregnant women, included in at-risk groups for the first time last year, should be a priority.

Uptake among this group was 38% last winter. Although Dr Marshall says this was 'not bad' as GPs were starting from a low position, he admits it needs to improve.

'That takes everyone in the NHS to play their part,' he says, including dialogue between midwives and GPs.

The jury is still out over the need for an awareness campaign. But it seems certain that, should vaccine supplies falter again, GPs will be in the firing line once more.

This could further strengthen the government's resolve - and argument - for taking control of supplies away from GPs.

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