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Flu jabs to be offered to all children

Not enough nasal vaccine to start imms programme until at least 2014

Louise Prime

Wednesday, 25 July 2012

All children are to be offered flu vaccination free of charge, the Department of Health has announced this morning. But the immunisation programme won’t be extended until at least 2014, because until then there won’t be enough of the recommended nasal flu vaccine from the manufacturer.

The DH has accepted the Joint Committee on Vaccination and Immunisation’s advice that all children aged 2-17 years should be immunised against flu.

The Committee had, at Andrew Lansley’s request, examined the evidence for extending the NHS flu immunisation programme beyond the currently eligible high-risk children with asthma, heart condition or cerebral palsy, to include all healthy children.

The JCVI concluded that the anticipated benefits of a comprehensive programme, such as greater herd immunity and a 40% drop in the number of people affected by flu, outweigh the ‘significant challenges’ of delivering it.

The greatest of these will be sourcing sufficient quantities of the authorised live attenuated intranasal influenza vaccine (Fluenz). The JCVI recommended this vaccine, which is already used in the US, because it is more effective than inactivated vaccines in children and has a good safety profile. But AstraZeneca, the only manufacturer, will be unable to deliver the required amounts until at least 2014.

The programme, predicted to cost more than £100m, will involve offering up to 9 million children the vaccine, which will need to be given during a 6-8-week period ahead of the flu season. So another issue that remains is who will deliver the vaccine – school nurses, of whom there are currently far too few to deliver the programme, or other suitably trained people.

The JCVI suggested that pre-school-age children will need to be reached through general practice.

It concluded: “Until the extension to the programme can be implemented, the committee recommends that the influenza vaccination programme should continue to target all those aged 65 years and older and those aged six months to below 65 years in the influenza clinical risk groups (including pregnant women) for whom the burden of influenza is greatest.

“Increases in vaccine uptake in clinical risk groups are likely to be cost effective and should remain a priority, particularly for the youngest age groups where influenza vaccine uptake is poorest.”

Chief Medical Officer Professor Dame Sally Davies said: “There are significant challenges to delivering a programme that requires up to nine million children to be vaccinated during a six week period and we will look at the recommendations in detail to decide how best to develop and deliver the programme.”

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