Pharmacists may have two further options when vaccinating patients aged over 65 years against flu in 2019/2020, NHS England has advised.
The letter, which was sent on 20 November 2018, advises pharmacists that they will again be asked to administer the quadrivalent inactivated vaccine (QIV) for people aged 18–64 years and the adjuvanted trivalent inactivated vaccine (aTIV) for patients aged over 65 years during the 2019/2020 flu season.
However, two new vaccines — a cell-grown quadrivalent vaccine (QIVc) and a high-dose trivalent vaccine (TIV-HD) — were found to be “suitable for use” by the Joint Committee on Vaccination and Immunisation but have yet to be licensed in the UK.
The letter said that QIVc, which is cultured on mammalian cells rather than eggs, could potentially be used by pharmacists for all patients aged over 18 years, while the TIV-HD could also be used for patients aged over 65 years.
This would give pharmacists three options when vaccinating patients aged over 65 years, including the currently licenced aTIV.
According to the letter, the new vaccines are expected to be licensed by December 2018. However, NHS England has told clinicians to refrain from ordering them until further notice.
NHS England advised clinicians to “begin ordering currently licensed vaccines”, adding that the “ordering of these licensed vaccines should not be unnecessarily delayed”.
It added: “For the new, currently unlicensed vaccines, please wait for confirmation from NHS England that they are eligible for reimbursement before ordering.”
Pharmacists have been forced to turn patients away after staggered deliveries of the aTIV vaccine left pharmacies and GPs short of supplies this flu season.
Nat Mitchell, pharmacist and director of JWW Allison and Sons pharmacy in Cockermouth, Cumbria, who has already ordered his vaccines for 2019/2020, told The Pharmaceutical Journal that having more vaccination options could “solve this problem about having vaccines in stock because we’ve got three chances of getting the over 65 vaccine”. But he said: “The issue I have, potentially, is whether one vaccine is seen to be more effective than another.”
Mitchell added: “I’m quite happy there’s another option, I just hope we get the support to say that if we’re supplying adjuvanted vaccine that it is under guidance — it’s not that it’s any less effective than the other ones.”
As of 22 November 2018, pharmacists have provided nearly 1.09 million flu vaccines since the beginning of September 2018, according to data from the Pharmaceutical Services Negotiating Committee — more than 170,000 more vaccines than were given by pharmacists this time in 2017.