NHS Flu Vaccination – Exclusions
Patient/Staff Guidance
Over 65s and 18-65 clinically at risk
 Registered with a GP NOT in Warwickshire, Coventry, Hereford or Worcester
 Patient already vaccinated since 31.08.2014
 Previous Severe reaction to a flu vaccination
 Patient has a bleeding disorder (this DOES NOT include well controlled on aspirin, warfarin or similar)
 Frontline Healthcare workers (employer or Occupational Health must provide vaccination or pay for private vaccine)
 Patient confirmed allergic to eggs (refer to other provider/GP for Optiflu or low ovalbumin vaccine if not available)
 Patient under 18
 Patient 18-65 years old but NOT in a clinically at risk group
(* See overleaf for clinical at risk groups)
Aged 12 - 18 (Fluenz nasal spray)
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Patient under 12 years old (unless in school year 7 & 8 pilot) or over 18 (see above)
Registered with a GP NOT in Warwickshire, Coventry, Hereford or Worcester
Patient 12-18 years old but NOT in a risk group (* See overleaf for clinical at risk groups EXCEPT ASTHMA or ASPLENIA)
Asthmatic (refer to GP)
Egg allergy (refer to GP)
Immune-deficient due either to illness or medication (refer to GP)
Undergoing Salicylate therapy eg for rheumatoid arthritis or similar (refer to GP)
Has close contacts who are severely immune-compromised (refer to GP)
Previous severe reaction to vaccines (refer to GP)
Taking antiviral therapy currently or recently (refer to pharmacist)
Pregnant (refer to GP)
Patient already vaccinated since 31.08.2014
NB School years 7 & 8 are automatically entitled to vaccine (see pharmacist for exclusions)
*At risk groups
Definition
Required evidence: At least 1 of the
following
Aged sixty five years or over
"Sixty-five and over" is defined as those aged 65 and over on 31 March 2015
(i.e. born on or before 31 March 1950).
GP invite letter Prescription Pharmacy records ID with
age
Chronic obstructive pulmonary disease (COPD) including chronic bronchitis
and emphysema; bronchiectasis; cystic fibrosis; interstitial lung fibrosis,
pneumoconiosis and bronchopulmonary dysplasia (BPD)
GP invite letter Prescription Pharmacy records
Chronic Respiratory Disease and asthma that requires continuous or repeated
use of inhaled or systemic steroids or with previous exacerbations requiring
hospital admission
Chronic heart disease
Congenital heart disease; hypertension with cardiac complications; chronic
heart failure; individuals requiring regular medication and/or follow up for
ischaemic heart disease
GP invite letter Prescription Pharmacy records
Chronic renal disease
Chronic renal failure; nephrotic syndrome; renal transplantation CKD 3 or
worse
GP invite letter Prescription Pharmacy records
Chronic liver disease
Cirrhosis; biliary atresia; chronic hepatitis
GP invite letter Prescription Pharmacy records
Chronic neurological disease
Stroke; transient ischaemic attack (TIA); clinicians should consider on an
individual basis the clinical needs of their patients including individuals with
multiple sclerosis and related or similar conditions; or hereditary and
degenerative disease of the central nervous system
GP invite letter Prescription Pharmacy records
Diabetes
Type 1 diabetes; Type 2 diabetes requiring insulin or oral hypoglycaemic
drugs; Diet controlled diabetes
GP invite letter Prescription Pharmacy records
Immunosuppression
Immunosuppression due to disease or treatment; patients undergoing
chemotherapy leading to immunosuppression; asplenia or splenic dysfunction;
HIV infection; individuals treated with or likely to be treated with systemic
steroids for more than a month at a dose equivalent to prednisolone 20mg or
more per day.
GP invite letter Prescription Pharmacy records
Asplenia or dysfunction of the spleen
This also includes conditions such as homozygous sickle cell disease and
coeliac syndrome that may lead to splenic dysfunction
GP invite letter Prescription Pharmacy records
Early stage pregnancy GP invite letter
Prescription
Hand held maternity notes
Pregnant women
Carers
Pregnant women at any stage of pregnancy (first, second or third trimester)
Those who are in receipt of carer’s allowance, or those who are the main carer
of an elderly or disabled person whose welfare may be at risk if the carer falls
ill
Late stage pregnancy Self reporting
Hand held
maternity notes
GP invite letter or Carer’s allowance
Checklist
To be kept in consultation room and double checked prior to vaccination
IM Injection
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Over 65 – DOB on or before 31 March 1950
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Has current febrile illness (come back when recovered)
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Ever reacted to a vaccine previously (assess and refer if necessary)
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Confirmed allergy to egg or chicken protein (give Optiflu or refer to GP if unavailable)
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Egg allergy without anaphylaxis (give low ovalbumin vaccine (appendix 9) or refer to GP if unavailable)
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Allergy latex (check which vaccine to use – refer to GP if unavailable)
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Allergic to plasters
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Bleeding disorders (refer)
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Pregnant – (must be NHS service NOT private)
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Mastectomy – use opposite arm if possible
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Check vaccine visually
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Record vaccine details BEFORE vaccinating
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Give leaflet and advise re side effects
Fluenz nasal spray
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Ensure responsible adult remains in consultation room throughout and signs consent form
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Blocked nose or febrile illness – postpone and return when recovered
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18 years + (vaccinate under IM PGD) or under 12 (refer unless school year 7 or 8)
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Asthmatic – refer to GP
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Pregnancy (refer to GP)
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Egg allergy of any description (refer to GP)
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Clinically immune-deficient (refer to GP)
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Salicylate therapy (refer to GP)
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Antiviral therapy currently or in last 2 days (return at least 48 hours after last dose)
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Close contacts that are severely immune-compromised (refer to GP)
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Previous reaction to the vaccine (refer to GP)
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Record vaccine details BEFORE vaccinating (If 12+ and in clinical risk group, record as part 2 LES NOT as pilot, even if in school
years 7 & 8)
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Give leaflet and advise re side effects
PILOT – school years 7 & 8
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Check DOB falls between 1st September 2001 and 31st August 2003
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Exclusions as above