The Medicines and Healthcare Products Regulatory Agency (MHPRA) has said supplies of the adjuvanted trivalent flu vaccine (aTIV) - recommended for the first time this year as the preferred vaccine for patients aged 65 and over - should be shared between GP practices and pharmacies to ‘ensure that the sufficient stock of vaccine is distributed to reflect actual demand’.
GPonline reported earlier this month that some GP practices had been unable to secure orders of aTIV.
Normally, medication can only be passed between providers where a wholesaler licence exists. However, the MHRA has confirmed that it does not want to ‘prevent supply’ and that clinicians will now be ‘able, and expected, to work with other surgeries and pharmacies to safely move vaccine stock between locations’ in cases where providers face ‘short supply’ or ‘no supply’ of the aTIV vaccine.
The MHRA has warned that vaccines can only be transferred between locations under the following circumstances:
- The surgery that is holding the excess stock can give an assurance that the vaccine has been held properly in the correct temperature controlled conditions.
- Confirmed record keeping of temperature monitoring is available.
- The surgery that requests the aTIV is able to verify the assurances given.
- The vaccine can be transported appropriately under the right conditions.
Supply problems
GPC clinical and prescribing lead Andrew Green told GPonline: ‘It would be very unfortunate if patients were to miss out on effective flu vaccination due to lack of supplies if vaccines were available elsewhere, and this is welcome guidance to allow some flexibility in distribution.
‘However, any practices using this mechanism must be careful to follow it in its entirety in order to ensure that their arrangements will stand scrutiny.’
Seqirus, the manufacturer of aTIV, has confirmed that there is sufficient availability of the vaccine to meet anticipated demand this winter.
A spokeswoman for Seqirus said the company had processed more than 8,500 orders for the aTIV vaccine, known as FLUAD, from practices and pharmacies across the UK, totalling almost 9.3m doses. A total of 7.8m doses are destined for GP practices, she said.
‘We experienced some processing challenges during the ordering period due to the sudden high volume of requests, however we believe this impacted a relatively small number of orders and that the majority of issues have been resolved,’ the spokeswoman said.
Vaccine uptake
‘Based on previously reported influenza vaccination rates for people aged 65 years and older, and the total number of doses we will be supplying, there will be sufficient quantities of FLUAD available across the UK to vaccinate this vulnerable population.
Data from NHS Digital show there are currently about 10.3m patients aged 65 and over registered with a GP practice in England. In the 2017/18 flu season, uptake among over-65s was 73% - if this uptake is maintained, 7.5m patients will receive the jab in 2018/19.
The NHS has also stated that, although aTIV is the preferred vaccine, QIV can be offered ‘in exceptional circumstances’ to patients aged 65 and over.
Last week, Lloyds Pharmacy had to suspend its flu vaccination service temporarily following a ‘misinterpretation’ of NHS guidance, amid concerns that the 2018/19 flu season is set to be more ‘complex’ than in previous years.
