In a letter sent to GPs and community pharmacists yesterday (February 5), NHS England asked “clinicians” to “ensure their influenza vaccine orders for the 2018-19 season use the most effective vaccines for the population”.

The adjuvanted trivalent vaccine (aTIV) is “now the best option for all 65s and over”, while the quadrivalent vaccine (QIV) is “the best option for 18-65 at-risk groups”, according to the letter – signed by NHS England's national medical director and its director of primary care, as well as Public Health England's medical director.

“While clinicians are professionally responsible for forming their own clinical judgements…use of these more effective vaccines in the 2018-19 season is clearly in the best interest of patients,” NHS England said.

NHS England confirmed that “additional funding” will be allocated to clinical commissioning groups and local NHS England teams to help “support the use of” the recommended vaccines.

“Over-reliance” on suppliers

City and Hackney local pharmaceutical committee (LPC) CEO Hitesh Patel raised concerns on Twitter yesterday that there could be “very little” of the vaccines available, as there is currently only one manufacturer for the aTIV – Seqirus – and just two manufacturers – Mylan and Sanofi Pasteur – supplying QIV.

"We usually have a lot more suppliers [for flu vaccinations], but NHS England is putting all its eggs in three baskets" by relying on just these manufacturers, he told C+D this afternoon.

"It just needs a paperwork delay, or one of the manufacturers going offline", to cause a shortage, he stressed.

"I'm hoping NHS England has some resilience planning in place."

In its letter, NHS England said: “Suppliers have confirmed that there will be enough vaccine to meet demand”, and stressed it has “guaranteed to extend the order dates and maintain the same prices” up until the order deadline of 5pm on March 29.

“We are asking GPs and community pharmacies to ensure that flu vaccine procurement for 2018-19 is aligned with the clinical evidence base,” NHS England said in the letter.

“If, after review, orders need to be switched to alternative medicines, we are asking that this is done promptly.”

Alliance Healthcare "in discussions" with suppliers

Alliance Healthcare told C+D this afternoon that it "is currently in discussions with manufacturers" regarding the availability of the vaccines.

"It is anticipated we will be sourcing both QIV and aTIV vaccines for supply during the 2018-19 season," the wholesaler added.

AAH had not responded to C+D's request for comment by time of going to press.

Community pharmacies in England have so far delivered over one million vaccinations as part of the 2017-18 national pharmacy flu service, according to the Pharmaceutical Services Negotiating Committee.