Community pharmacy flu
vaccination services- preparing
for 2014/15
The national flu programme
Jo Yarwood
Programme Manager - Immunisation
Public Health England
Vaccine uptake since 2000
65 and over (under 65 ‘at risk’)
3
Year
England (%)
Scotland (%)
Wales (%)
2000–01
65.4
65
39
Northern
Ireland (%)
68
2001–02
67.5
65
59
72
2002–03
68.6
69
54
72.1 (55.8)
2003–04
71.0
72.5
63
73.4 (63.8)
2004–05
71.5 (39.9)
71.7 (39.3)
63
72.7 (65.2)
2005–06
75.3 (48.0)
77.8 (46.3)
68
76.8 (80.9)
2006–07
73.9 (42.1)
75.2 (37.8)
*
75.1 (71.2)
2007–08
73.5 (45.3)
74.3 (44.4)
64
75.7 (68.3)
2008–09
74.1 (47.1)
76.3 (47.8)
60 (41)
76.8 (74.0)
2009–10
72.4 (51.6)
75.0 (53.4)
64 (49)
77.0 (80.0)
2010–11
72.8 (50.4)
75.3 (56.1)
65.8 (48.6)
74.9 (78.7)
2011-12
74.0 (51.6)
76.6 (59.7)**
67.7 (50.0)
77.0 (81.7)
2012-13
73.4 (51.3)
76.5 (55.9)
67.7 (49.7)
75.0 (80.2)
Flu uptake
4
Year
2012/13
2013/14
65 and over
73.4%
73.2%
Under 65 at risk
51.3%
52.3%
Pregnant women
40.3%
39.8%
All 2 year olds
n/a
42.6%
All 3 year olds
n/a
39.6%
HCW
45.9%
54.8%
Getting vaccinated in pharmacies
• 89K people got the jab at Boots
• just over 20% of these were in a risk group
• they could therefore have got a free NHS jab.
• processes should be in place for GP records to be updated
• do these immunisations go unrecorded on GP systems?
5
•
it may be that the official vaccine uptake figures produced, particularly for the under 65 at
risks who are more likely to be in employment and less likely to see their GP, underestimate
the true vaccine uptake figures.
•
http://www.pjonline.com/news/research_highlights_opportunity_for_pharmacy_to_fill_gap_in_flu_vaccinations?
The risk of the risk groups
Number of fatal flu cases
(%)
Mortality rate per 100,000
population
Age-adjusted relative
risk*
4.0
0.4
11.3
(9.1-14.0)
Baseline
4.8
18.5
Chronic heart disease
213
(59.8)
143
(40.2)
19
(5.3)
32 (9.0)
3.7
Chronic respiratory
disease
59
(16.6)
2.4
10.7
(7.3-15.7)
7.4
(5.5-10.0)
Chronic liver disease
32
(9.0)
26
(7.3)
71
(19.9)
42
(11.8)
15.8
378
0.8
In a risk group
Not in any risk group
Chronic renal disease
Diabetes
Immunosuppression
Chronic neurological
disease (excluding
stroke/transient ischaemic
attack)
Total (including 22 cases
with no information on
clinical risk factors)
6
2.2
20.0
14.7
48.2
(32.8-70.6)
5.8
(3.8-8.9)
47.3
(35.5-63.1)
40.4
(28.7-56.8)
Health care workers
7
8
Vaccine uptake in all pregnant women
9
Year
England (%)
2010-11
2011-12
2012-13
38.0
27.4
40.3
Scotland
(%)
65.6*
41.1
54.0
Wales (%)
39.6
31.7
61.6
Northern
Ireland (%)
N/A
58.4
64.6
10
So, what’s new?
11
Flu programme extension
Aim to offer annual vaccination for all children age 2-16
2013/14
Routine 2 and 3 yr olds
Pilot yrs 0 - 6
Potential plan for next three years –
2014/15 Routine 2,3 and 4 yr olds Pilot yrs 0 – 6 &
7&8
2015/16 Extend where indicated
2016/17 Extend where indicated and then
?JCVI assessment
12
Pilot sites and uptake
Site
Cohort
Vaccinated
% Uptake
Bury
16773
10528
62.8
Cumbria
36289
13528
37.3
Gateshead
14895
7784
52.3
Havering
20545
13408
65.3
Leicester
54966
28600
52.0
Newham
30730
14207
46.2
SE Essex
24723
17509
70.8
Total
198921
105564
53.1
What went well?
• Well accepted by children
• Well accepted by parents
• Schools collaborated well
• Nurses enjoyed working with the children
• Pharmacists as joint providers
• Self administration
14
What was hard?
• Administrative burden (consent, screening for high risk etc.)
• Generally hard work
• Workforce capacity
• Working across boundaries
• Porcine gelatine
15
What vaccine should be used?
Vaccine type
Live attenuated
intranasal vaccine Fluenz®
Authorised age
indication
Children aged two to
under 18 years (see
precautions and
contraindications)
Dose
Singleapplicationineach
nostril of 0.1ml
Children NOT in clinical risk
groups only require one dose
of this vaccine.
Children in clinical risk groups
aged two to under nine years
who have not received
influenza vaccine before
should receive a second dose
of vaccine at least four weeks
later.
16
Inactivated
intramuscular
vaccine (number of
different brands)
Children aged six
months and older and
adults, although some
of the vaccines are
not authorised for
young children – see
table 19.6
Inactivated
intradermal vaccine
- Intanza® 9µg
Inactivated
intradermal vaccine
- Intanza® 15µg
Adults aged 18 years
to 59 years
Adults aged 60 years
and older
Single injection of 0.5ml (see
note above)
Children aged six months to
under nine years who have
not received influenza vaccine
before should receive a
second dose of vaccine at
least four weeks later.
Single injection of 0.1ml
Single injection of 0.1ml
Acknowledge - EVERYBODY
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