Community pharmacies and GP surgeries should “urgently review” their vaccine orders to ensure they meet “at least national ambitions and previous uptakes rates, whichever is highest”, NHS England and Improvement (NHSE&I), Public Health England (PHE) and the Department of Health and Social Care (DH) said in a joint letter to contractors today (May 14).

Primary care providers should make sure there is enough stock across their primary care network and should adjust their orders with their suppliers if necessary, according to the letter.

Increased demand

Chief medical officer for England Professor Chris Witty, PHE medical director and director for health protection professor Yvonne Doyle and NHSE&I national medical director Professor Stephen Powis, who co-signed the letter, said they realise “the flu immunisation programme is likely to be more challenging because of the impact of COVID-19”.

“We anticipate that concerns about COVID-19 may increase demand for flu vaccination in all groups this year, and some in at-risk groups may have concerns about maintaining social distancing when being given the vaccine,” they wrote.

The national health bodies also expect “universal vaccination of health and care workers” and said more guidance on this would be shared “in due course”.

The “most vulnerable”

The pandemic makes planning for the flu service more difficult due to “the uncertainties of staff absences” and social distancing measures, Professors Witty, Doyle and Powis said.

However, they added that in the healthcare sector “we must do all we can” to protect those most at risk from flu, who are likely to also be “most vulnerable to COVID-19”.

“Providers should aim to schedule their immunisation services to match vaccine supply, usually from September, and complete vaccination by the end of November, where possible,” the letter said.

The list of groups eligible to receive the flu jab free of charge in 2020/21, under the NHS-funded flu vaccination programme, is the same as last year. However, this might change if the programme is expanded, according to the letter.

“Discussions to consider expansion of the flu programme for this autumn are underway, and we will write again with any changes in due course,” the professors said.

Alastair Buxton, director of NHS services at the Pharmaceutical Services Negotiating Committee, told C+D today that there will “undoubtedly be some changes to the way in which the NHS flu vaccination service is delivered this year in response to the COVID-19 pandemic and new social distancing requirements”.

“As usual, we will be negotiating those details with NHSE&I as soon as they are in a position to do so. In preparation for the 2020/21 season, at its meeting next week PSNC will be considering how the flu vaccination service might work differently in community pharmacies this year,” he added.

The recommended vaccines for the 2020/21 service are the adjuvanted trivalent influenza vaccine (aTIV) or the quadrivalent influenza vaccine (QIVc), if the aTIV is not available – for those aged 65 and over. Under-65s at risk should be administered the QIVc or, as an alternative, the egg-grown quadrivalent influenza vaccine (QIVe).