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Should healthy people be allowed a flu jab?

Fergus Walsh | 12:10 UK time, Tuesday, 11 January 2011

Finally it seems there is someone to blame for the shortage of seasonal flu vaccine. It is the worried well.

The new chair of the Royal College of GPs, Dr Clare Gerada, believes healthy people are compounding the flu vaccine shortage among some doctors in England, by buying it privately from pharmacies and supermarkets. In an article in the Daily Telegraph she is quoted as saying there should be a study to find out how many healthy people had had the jab privately, to gauge "whether there should be a law that they are not allowed to have it."

So the Telegraph had its headline: "Worried well should be banned from having flu jab says leading GP". The story was the lead on the Today programme on Radio 4 at 7am.

Then Dr Gerada was interviewed on Today - you can listen to it here - and her first words were:

"I am not necessarily suggesting it should be banned". Did that mean she was POSSIBLY suggesting it? I was confused. She continued: "We should be targeting those most at need and those who aren't in the risk groups should wait until those who are get what they require to prevent them becoming seriously ill."

Dr Gerada explained that when GPs start to run low of flu vaccine they write prescriptions which patients take to the pharmacy. But this year some pharmacies had run out, in part because healthy people had asked for the jab in response to a lot of reports about flu in the media.

I spoke to Dr Gerada and asked about her apparently far stronger comments to the Telegraph. She said: "I have no recollection of saying that people who are not in risk groups should be banned. Nor would I pass an opinion on whether there should be a law. I don't think people should be banned from buying it".

I also spoke to Stephen Adams, Medical Correspondent of the Telegraph, who co-wrote the story and he is sticking by his quotes.

But let's leave all that to one side.

It's worth reminding ourselves how we got here. GPs in England have received all the doses of flu vaccine that they ordered. It is their responsibility to order enough vaccine for their patients and has been for years. Usually they send many doses back to the manufacturers. Next winter, Dr Gerada has said they will need to factor in greater demand. Those orders need to be made before the end of March, because it takes several months to make the vaccine.

In an ideal world, everyone in an at-risk group should have been immunised in October or November. There is no point in playing Russian roulette with flu. Get immunised early. Having said that, there have been comments on this blog from people in the priority groups for the vaccine who said they tried to get an appointment without success and others have told me they were never called for a jab by their GP.

An effective early immunisation round in October-November would also mean that any shortage of flu vaccine could be remedied more easily. European manufacturers still have stock which is unlabelled and unpackaged in November which could have been assigned to the UK market. By January all the doses are in vials and it is a major task to re-label, by hand, flu doses with, say, a German or Italian label and patient leaflet.

Another point is that pharmacies, supermarkets and private companies order their stocks of flu vaccine completely separately from the NHS. They do that, largely to supply a demand from healthy people who would rather not get the flu. This has happened for years.

Dr Gerada made that point that supermarkets have not been in the flu jab market for long and she knew of one which had announced the availability of vaccine over the in-store public address system - I wonder if there was a Buy One Get One Free Deal?

The system in Scotland, where there is no shortage of flu vaccine, is different. My understanding is that pharmacies order the jab centrally rather than individual GP practices. Perhaps there are lessons here for England.

Finally, I watched a brief Commons debate on flu yesterday. The Secretary of State for Health in England, Andrew Lansley was asked whether he had had the jab. He replied that since a stroke in 1992, he now falls into the priorty groups for vaccination and has been immunised. Nice to see Mr Lansley leading by example.



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