Written evidence submitted by Public Health England and NHS England (FVP0003)
The latest data on vaccination uptake was the final monthly survey undertaken up to 31 January 2018 for the various target groups compared to the previous season. Percentage of uptake for different cohorts is below:
Cohorts | % Uptake 2017/18 | % Uptake 2016/17 |
65+ Under 65 (at risk only) All Pregnant women (including those in risk groups) All 2 year olds All 3 year olds HCW Reception (age 4-5) Year 1 (age 5-6 yrs) Year 2 (age 6-7 yrs) Year 3 (age 7-8 yrs) Year 4 (age 8-9 yrs) | 72.6 48.9 47.2 42.8 44.2 67.6 62.6 60.9 60.3 57.5 55.7 | 70.4 48.7 44.8 38.9 41.5 63.0 33.9 57.6 55.3 55.3 N/A |
Further data, including information on geographical variation, is available online at:
Further data on flu vaccination numbers are available in Annex A.
A decade ago, the UK had no paediatric programme and an uptake in health care workers of approximately 15%. As shown above we now have uptake of nearly 70% in health care workers and we have vaccinated seven birth cohorts of children with another cohort being added in the 2018/19 season.
As cohort sizes increase more individuals have to be vaccinated in order to achieve the same percentage uptake as in previous years.
Overall it is estimated that approximately 1.5 million persons have been vaccinated this season compared to the same time point last year
For the children’s programme up to 18 years of age, Public Health England (PHE) is responsible for procurement of vaccine. All vaccine for eligible children two to 18 years of age is quadrivalent (whether live attenuated influenza vaccine (LAIV) or influenza, inactivated vaccine (IIV).
PHE has not collected data on trivalent/quadrivalent use for the 2017/18 season for the adult vaccine programme. We do have high level information on total supply of vaccine which indicates a sizable proportion of the vaccine ordered from suppliers was quadrivalent.
PHE has completed a mid-season estimate of flu vaccine effectiveness. This does not stratify by vaccine type in adults.
More information is available at: http://www.eurosurveillance.org/content/10.2807/1560-7917.ES.2018.23.9.18-00086
The UK’s mid-season results for this flu season (2017/18) can be summarised as:
These mid-season results are consistent with findings of reduced effectiveness of vaccine in the elderly, which has led to recommendation to offer adjuvanted vaccine for over 65 year olds in the 2018/19 season.
Please note that this data is provisional with wide confidence intervals. Much more precise information will be available at the end of this flu season.
PHE did not collect vaccine uptake in care home residents and staff for the 2017/18 season. An ad-hoc survey undertaken for the 16/17 season indicated that most care homes who responded did not have systems in place to gather information on vaccine uptake amongst staff. Given the low proportion of homes that were able to provide coverage data, the uptake results need to be treated with caution and remain unpublished.
(a) What financial incentives operate on GP practices which could potentially influence their selection of trivalent or quadrivalent vaccinations to procure, and what measures are taken or being considered to tackle any perverse incentives [Q32]
All general practice (GP) and community pharmacy contractors commissioned to provide seasonal flu vaccination are responsible for procuring and purchasing vaccine for those age 18 years and over eligible for flu vaccination. As stated in the answer to Q32, orders are placed several months ahead of the flu season and the choice of vaccine is informed by the guidance available at the time of ordering. Providers access information on available flu vaccines from the annual flu letter and ‘The Green Book’.
For the 2017-18 season, there were five manufacturers/suppliers of trivalent flu vaccine and two of quadrivalent flu vaccine for providers to choose from. There is no recognised difference between the vaccines available within each of these groups and at the time of ordering for the 2017-18 season the additional cost effectiveness analysis on quadrivalent vaccine that resulted in the change in NHS England advice for 2018-19 ordering was not available.
General practices purchase directly from a manufacturer, supplier or wholesaler. NHS England are not informed of any discounts offered on vaccines purchased by GPs. General practices claim back the cost of vaccines used at the list price for the vaccine, as set out in the Statement of Financial Entitlements.
For 2018-19 flu season NHS England have issued clear guidance on which vaccines should be offered by GPs and community pharmacy. This is because of the new evidence of the additional benefit and cost effectiveness of quadrivalent vaccine for those aged under 65 years in clinical risk groups and the availability of the more effective adjuvanted trivalent vaccine for those aged 65 years and over.
(b) When end-of-season data are expected to be available [Q21]
End of season data are expected to be made available around mid-May, after the pre-election period of sensitivity. A copy will be provided once published.