Flu Vaccination Advanced Service 2018/19
UPDATE: Guidance on ordering for 2019/2020 service
On 20th November, PHE published a joint letter from NHS England and DHSE, giving guidance to pharmacists and GPs for the ordering of flu vaccines for 2019/20. Following this letter, guidance has been changed.
Guidance includes the following:
- Standard Trivalent vaccines (TIV) are NOT to be used in the next season
- Quadrivalent inactivated vaccine (QIVe) and adjuvanted trivalent inactivated vaccine (aTIV) from the current scheme will continue to be recommended for use, again QIVe is recommended for 18-64s in at risk groups and aTIV for over 65’s
In addition, it was anticipated that a further two products would be licensed for use during the ordering window.
The cell-based quadrivalent vaccine, QIVc, (suitable for 18 to 64 years and 65 years+) has been deemed suitable for the vaccination service 2019/2020. Flucelvax® Tetra, is now licensed for use and contractors can consider ordering this for 2019/20 Flu Vaccination Service.
However, the a high dose trivalent vaccine (TIV-HD) (suitable for 65 years and over) will NOT be commissioned by NHSE due to the high sale price. Although licensed , you are advised NOT to purchase this product for the Advanced flu service as [highlight]it will not be reimbursed.[/highlight]
Read the joint letter ALONGSIDE updated guidance before you make any decisions on ordering for next year’s service.
[highlight]UPDATES: INADVERTENT ADMINISTRATION OF INCORRECT VACCINE FOR PATIENT AGE GROUP[/highlight]
Public Health England (PHE) has updated its inactivated influenza vaccine guidance for healthcare practitioners with the most significant change being the process to follow when individuals have inadvertently been given a flu vaccine type that is not recommended for their age group.
Advice is as follows:
- inform the patient of the error and its potential implications;- advise the patient that although the quadrivalent influenza vaccine (QIV) and adjuvanted trivalent influenza vaccine (aTIV) will offer some protection to all age groups, individuals aged 65 years and over (particularly those more than 75 years of age) may not respond as well to the QIV as they would to the aTIV, and individuals aged under 65 years will not benefit from the opportunity to make protection against an additional flu strain if they have been given aTIV;
- following a discussion about the risks and benefits, advise the patient that they could, if they wish, be given a second dose of the vaccine they should have had; the clear benefit is the additional protection that may be offered by the correct vaccine, but they should be alerted to the potential increased risk of a local or systemic reaction. Although there is no data available on the safety and effectiveness of administering a second flu vaccine shortly after the first in adults, this advice is based on general principles of vaccination, experience of flu revaccination following cold chain and administration incidents and information about the high dose flu vaccine used in the United States (which contains four times the amount of antigen that is in a single dose of QIV or aTIV);
- if a decision is made to offer the vaccine the patient should have received, it is recommended that this is done as soon as possible after the first dose was given and ideally within a week. This will enable protection to be made as soon as possible. It can, however, still be given if more than a week has elapsed.
This advice also applies to those who have inadvertently been given non-adjuvanted trivalent influenza vaccine (TIV).
A PGD Addenum has been published following the above advice, click here to view or see in the document section below.
National: There is no requirement to register with NHSBSA before providing. However, you MUST to ensure that the NHS section on NHS choices is ticked
London: If you have not already done so, please click here to register with Sonar for the London service.
If you are registered for the London Vaccination service, please see the following documents for PPV. Once you are familiar with the information from the SLA, you can begin providing PPV as per SLA.
All new/other pharmacies interested in providing a year around PPV and seasonal Flu and ACWY (Until end of Dec 2018) can sign up at: https://www.sonarinformatics.com/home/eoi
For the London Vaccination service, you MUST work under a private PGD. If you do not have one, Sonar has a flu and adrenaline PGD, please contact them directly on phone: 020 8743 9440.
Note the following section of the London service spec in relation to the PGD. (August 2018)
3.1) The Service will be known as the London Pharmacy Vaccination Service 2018/19 and is a supplementary service to the National NHS England Flu service under the advanced services of the contractual framework. This local London service can be provided by any pharmacy in London that is also signed up to delivering the National Advanced Flu service. The pharmacy contractor is required to offer eligible patients the opportunity of receiving a flu vaccination at the location. The cost will be met by NHSE London. The vaccine is to be administered by an appropriately trained pharmacist under the authority of a private PGD.
Briefings and Guidance
- NPA – Vaccine type decision making flowchart
- PSNC Briefing- Flu Vaccination Service 2018/19: Adjuvanted trivalent inactivated influenza vaccine (aTIV)
- PSNC Briefing- Pharmacist checklist for the Flu Vaccination Service (September 2018)
- PSNC Briefing- Flu Vaccination: Responsive Lines for LPCs (August 2018)
- PSNC Briefing- Flu vaccination: The benefits of a community pharmacy service (August 2018)