The Royal College of General Practitioners (RCGP), UK, states that although it is in favor of individuals wanting to protect their own health by “buying” the flu jab OTC (over-the-counter), it is crucial that the high risk groups, such as pregnant women, patients with weakened immune systems, people with asthma and some other conditions are vaccinated while supplies are limited.

The RCGP stresses that a GP’s job is to care for patients and not to legislate. The College says it is not asking for a law stopping individuals from taking decisions regarding their own health and paying for the vaccine, neither does it criticize pharmacists on how they operate. However, an enormous number of people who are not in high risk groups for jabs are coming forward this year – something that needs to be factored in when the size of future stocks are estimated.

In a letter to GPs (general practitioners) in the United Kingdom, Dr Maureen Baker CBE,Health Protection Lead, RCGP and Dr Clare Gerada, Chair, RCGP, wrote:

“We hope you had a good holiday and that if you were working, particularly in an out-of-hours centre, you were not too overwhelmed. Here we continue our weekly bulletins to ensure GPs and their teams have the latest information available regarding seasonal flu. Vaccination continues to be the most important method of protecting those in at-risk groups and we would urge GPs to continue to target these groups.

We are sure you are also aware that there has been discussion on whether it would be appropriate for children under 5 to receive seasonal flu vaccine. This matter has recently been discussed by the Joint Committee on Vaccination & Immunisation (JCVI) and their letter to the CMO can be found on the DH website here.”

The RCPCH (Royal College of Pediatrics and Child Health) has voiced concern at how the current influenza epidemic hitting the UK seems to affect certain age groups. The RCPCH is urging parents to make sure all children at high risk get vaccinated. High risk children include those with respiratory difficulties, reduced immunity and diabetes. Both the RCPCH and RCGP say that GPs should not automatically assume a flu diagnosis when a child comes in with signs of respiratory compromise, but admit the child for assessment.

Although some reports have come in of local vaccine shortages, the RCGP in its letter to GPs wrote “but the RCGP is not aware of a major national issue.” GPs are urged to continue offering flu jabs to all their at-risk patients. Doctors are being encouraged to share resources so that vaccines are available where they are most needed.

They also wrote (to GPs):

“In our first bulletin we suggested that practices assess their vaccine stocks and proactively continue to contact patients in at-risk groups to come forward. We are aware of increased public demand generally but we believe it is important to prioritise available stocks of vaccine for at-risk groups. Colleagues are once more encouraged to share resources to liaise with local colleagues, or the PCT, and explore opportunities to make vaccine available in places where it is needed most.

From this week all routine reporting of flu figures (RCGP, HPA, ITU) will be published at the same time – 2pm on Thursdays. This should make for a more integrated approach to reporting.”

There is also a warning from the RCGP to GPs about short-term shortages in Tamiflu suspension supplies, due to high demand. GPs are being asked to use Tamiflu suspension only on infants aged less than 12 months. Older children should be given capsule tamiflu – parents, guardians, and caregivers (UK: carers) need to be taught how to empty capsules into a suitable diluents, with proper dosage volumes according to age and weight. This contingency should make sure supplies will last.

Dr. Keith Ridge, UK’s Chief Pharmaceutical Officer, wrote in a letter to doctors:

“The manufacturers (Roche) have ordered additional quantities of Tamiflu 12mg/ml Oral Suspension. I have also asked specific licensed NHS hospital pharmacies to begin manufacturing Oseltamivir 15mg/ml Oral Solution. This is the same product that was used in the swine flu pandemic and is derived from oseltamivir powder, secured as part of the national stockpile. It may also be possible for a pharmacy to prepare a solution suitable for administration to children from Tamiflu capsules.”

“2010/11 Seasonal Influenza: Update on supply and availability of antivirals for children under 1 year of age”
Dr Keith Ridge – BPharm MSc PhD DSc(Hon) FRPharmS – Chief Pharmaceutical Officer

Written by Christian Nordqvist