The letter reminds practices that the vaccines they order should be in line with recommendations from the joint committee on vaccination and immunisation (JCVI) and Public Health England.
As such, practices should be providing the following vaccines in 2018-19:
- Over-65s should be offered the adjuvanted trivalent vaccine (aTIV) - which was unavailable for the current flu season because it was only licensed for use in the UK from August 2017.
- Patients aged 18 to 65 in at-risk groups (including pregnant woment) should be offered the quadrivalent vaccine (QIV).
NHS England said that practices should review all orders for the 2018-19 season to ensure they are in line with these recommendations. Practices need to place their orders by 29 March 2018.
NHS England also confimred that there would be extra funding available to support use of the adjuvanted trivalent vaccine and quadrivalent vaccine and said suppliers had confirmed that they will be able to meet demand. If practices have difficulties placing or amending orders they have been advised to contact their local NHS England team.
The letter from NHS England primary care director Dr Arvind Madan and national medical director Professor Stephen Powis, also says all advice from CCGs on vaccine ordering must be in line with the JCVI advice. Any existing CCG guidance that does not fit with this should be amended 'immediately', it warns, 'taking into account the small window of opportunity availble for GPs to revise their ordering by switching to the clinically optimal vaccines that are now available'.
What is the adjuvanted vaccine?
Data presented at the European Scientific Working group on Influenza (ESWI) in September 2017 found that switching to an adjuvanted vaccine in adults aged 65 or over could help prevent 175,000 cases of influenza in the UK.
This is turn could slash GP visits from elderly patients by 21,800 a year and help prevent 1,700 deaths, the researchers added.
Modelling suggests the adjuvanted vaccine is more effective in the elderly compared with traditional flu vaccines, especially during years where there is a mismatch between the flu strains in the vaccine and those circulating in the real world.
It uses an adjuvant which helps the body’s immune system develop a strong response to flu, and has been specifically designed for people over 65 whose immune systems are weakening. Elderly patients’ weakened immune systems mean normal vaccines do not always produce an optimal immune response causing them to lose antibodies after vaccination.