NHS England has written to GPs and community pharmacists, urging them to to ensure their influenza vaccine orders for the 2018/19 season use the most effective vaccines for the population.
The clinical evidence available to GP practices and community pharmacists from the Joint Committee on Vaccination and Immunisation (JCVI) and published in the Green book in October (for quadrivalent vaccine) and December (for adjuvanted trivalent vaccine), ahead of orders being placed for 2018/19, is clear that for the 2018-19 winter season, GP practices and Community Pharmacy providers should offer:
- The quadrivalent vaccine (QIV) for 18-65 year olds who are at risk. In light of an independent cost-effectiveness study into QIV undertaken by Public Health England and considered by JCVI, the Green Book was updated in October 2017 to provide the advice that QIV is the best option for 18-65 at-risk groups in the 2018/19 season. It is also used for the childhood programme
- The adjuvanted trivalent vaccine (aTIV) for all 65s and over. Given aTIV was only licensed for use in the UK in August 2017, this was not an option for the 2017/18 season. However, the JCVI advice is that this is now the best option for 2018/19 for 65+ age group.
The letter said that while clinicians are professionally responsible for forming their own clinical judgements on whether a particular individual should receive the flu vaccine due to a variety of other factors, use of these more effective vaccines in the 2018/19 season is clearly in the best interests of patients, particularly given the association of flu with increased mortality.
It added that GPs and community pharmacy contractors should review all orders (provisional and firm) for the 2018-19 season, and ensure these are in line with the evidence-based clinical view – that is, under 65s in at-risk groups, including pregnant women to receive QIV, and 65-year-olds and over to receive aTIV for the 2018-19 flu season.
NHS England is able to confirm that there will be additional funding available in 2018/19, to support the use of adjuvanted trivalent vaccine and quadrivalent influenza vaccine.