Organising & Delivering Flu Immunisation Clinics

1. Ordering Vaccine

H1N1 Monovalent Vaccine

GlaxoSmithKline “Pandemrix”

1 dose vaccine in a 10 dose vial (add adjuvant).

Required for:-

Those immunocompromised at any age Children aged 6 months to 5 years “At Risk”

If they have not received the H1N1 vaccine previously.

Should be ordered from the Pharmacy Distribution Centre in Govan as per previous arrangements, unless practice already has some stored locally.

1. Ordering Vaccine

Seasonal Flu Trivalent Vaccine

2 doses required for those children under 13 :-

“At Risk” Those immunocompromised.

who have not previously received a Seasonal Flu vaccine.

Children Under 5 should not be immunised using Enzira or CSL Biotherapies Generic Influenza vaccines (by Wyeth/Pfizer).

One vaccine brand, “Fluvirin”, contains only traces of Thiomersal from the production process, the others do not contain any Thiomersal. To note if pregnant women ask.

Available from your normal Community Pharmacist

1. Ordering Vaccine

Please check vaccine stock availability with your Pharmacist before arranging large immunisation clinics to ensure enough vaccine.

Egg Allergies

H1N1 Pandemrix and most Seasonal Flu vaccines are cultured using eggs. If a patient has a history of a severe and life-threatening allergy to eggs, please contact Public Health on 0141 201 4917.

2. Identifying Immunisation Cohorts

Group 1: All aged 65 years & over (excluding those immunocompromised)

Campbell software for GPASS practices and “Rule Sets” for EMIS or Vision practices will identify all aged 65 INCLUDING those immunocompromised.

Therefore, practices can run their Over 65s list and an Immunocompromised list, cross-reference and invite.

Or, to avoid delay, invite all Over 65 for a dose of Seasonal Flu vaccine and invite them back again 4 weeks later if required.

2. Identifying Immunisation Cohorts

Group 2: Seasonal flu at risk groups (excluding those immunocompromised)

National, standard software such as Campbell for GPASS practices and “Rule Sets” for EMIS or Vision practices.

Any alternative method of cohort identification carries the risk of excluding certain categories of patients, which will detriment patients & negatively impacting the vaccine uptake rate for that practice – practice cohorts are calculated by HPS/Government using national standards.

Note: Campbell & Rule Sets depend on up to date and accurate Read Code recording.

2. Identifying Immunisation Cohorts

Group 3: All immunocompromised people

National, standard software such as Campbell for GPASS practices and “Rule Sets” for EMIS or Vision practices.

Any alternative method of cohort identification carries the risk of excluding certain categories of patients, which will detriment patients & negatively impacting the vaccine uptake rate for that practice – cohorts are calculated using national standards.

Campbell & Rule Sets depend on up to date and accurate Read Code recording.

2. Identifying Immunisation Cohorts

Group 4: Pregnant Women

Details of women who have been immunised with the H1N1 monovalent vaccine between 24th May and 30th September at maternity centre immunisation clinics will be sent to practices by Friday 8th October.

1st Antenatal Clinic invite letters will include from Monday 27th September, paragraph on Seasonal Flu, strongly recommending immunisation at GP Practice.

Midwifery staff will recommend immunisation at GP Practice.

Pregnancy & Flu Posters will be distributed to 5 maternity centres and 21 community “spokes” as well as GP practices.

2. Identifying Immunisation Cohorts

Group 4: Pregnant Women

Pregnant Women will not be included in Campbell software Seasonal Flu lists.

Can be identified in practice electronic systems or manual records – depending on practice approach e.g. practice may apply Read Code for “Pregnancy”. In this case, a query in GPASS/EMIS/Vision may be run.

Practices can also use the stand alone version of SCI Gateway to identify all referred women under their practice to maternity services – details are provided as an Appendix to Dr Ahmed’s letter sent to all practices.

Pregnant Women must of course be identified regularly between October and March as and when they become pregnant.

2. Identifying Immunisation Cohorts

Any issues identifying any of the cohorts, please contact the GP IT Mentoring Team via the Servo support number on 0844 863 1244.

3. Immunisers

PGDs are available from Gillian Halyburton.

Healthcare Support Workers cannot provide vaccinations under PGDs - Patient Specific Directions (PSDs) only.

Children under 1 year should be vaccinated in the antero-lateral thigh.

Trivalent and Monovalent vaccines can be co-administered with any other vaccine (and of course togther as per flow diagram).

Practices should have received A3 & A4 colour decision flow diagrams for reference, as well as Flu & Pregnancy posters.

National Guidance: Green Book can be downloaded from the Department of Health’s website here (Chapter 19):-

http://www.dh.gov.uk/en/Publicationsandstatistics/Publications/ PublicationsPolicyAndGuidance/DH_079917