Ordering and use of appropriate flu vaccines

Published on: 16th August 2018 | Updated on: 15th March 2022

On 5th February 2018, NHS England issued a letter to all community pharmacies and general practices giving final advice on ordering flu vaccines for the 2018/19 season.

The guidance, in a letter from NHS England’s National Medical Director and Director of Primary Care, and Public Health England’s Medical Director asks GPs and community pharmacy contractors to ensure their influenza vaccine orders for the 2018/19 season use the most effective vaccines for the population.

The letter says the clinical evidence is clear that for the 2018/19 winter season, GP practices and pharmacy contractors should offer:

  • the adjuvanted trivalent vaccine (aTIV) for all 65s and over; and
  • the quadrivalent vaccine (QIV) for people in the 18 to under 65s at risk group.

The letter also states 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;
  • vaccine suppliers have confirmed that there will be enough adjuvanted trivalent vaccine and quadrivalent influenza vaccine to meet demand;
  • orders for these vaccines will need to be placed by 12th April 2018;
  • there is no change to the way in which contractors will be reimbursed for vaccines administered – the system will be the same as for the current 2017/18 service; and
  • if pharmacy contractors encounter any difficulties from a manufacturer placing or amending an order, they should advise their local NHS England team.

The letter also contains the answers to a number of frequently asked questions, including on changing or switching vaccine orders.

Flu vaccination service guidance

Further guidance for contractors and general practices on providing the Flu Vaccination Service was issued by NHS England in August 2018, with support from Community Pharmacy England and the British Medical Association (BMA). The guidance sets out key information required to provide the Flu Vaccination Service 2018/19, including prioritising patients for vaccination and how to address common patient queries regarding the service.

An accompanying letter, jointly issued by NHS England, Community Pharmacy England and the BMA, reminds general practices and community pharmacy teams of the clinical recommendations on the most effective flu vaccine for 2018/19 for different patient groups. For the 2018/19 flu vaccination season, aTIV (Fluad, Seqirus) should be offered to all those aged 65 and over, whilst adults aged under 65 in clinical at-risk groups should be offered a QIV.

The guidance sets out a three-phased prioritisation approach to vaccinating patients aged 65 years and over:

  1. First priority should be given to those aged 75 years and over or those in a care home.
  2. Second priority should be given to those aged 65-74 years in a clinical risk group.
  3. Third priority should be given to those aged 65-74 years NOT in a clinical risk group.

Community pharmacy teams should use this information to inform the provision of vaccines from September to November 2018, but where the appropriate vaccine is available, and an eligible patient presents at the pharmacy seeking vaccination, they should be vaccinated at that point. If the recommended vaccine is not available, the patient should be asked to return when the vaccine will be available.


Letter from NHS England, Community Pharmacy England and the BMA

NHS England guidance

Community Pharmacy England Briefing 050/18: Flu Vaccination Service 2018/19: Adjuvanted trivalent inactivated influenza vaccine (aTIV)

Frequently asked questions

Frequently asked questions relating to the ordering and use of appropriate flu vaccines can be found on the Flu Vaccination FAQs page.

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