Vaccination is offered annually in the UK to groups who are at a higher risk of serious illness with flu, such as those with pre-existing medical conditions, children, and over sixty-five years olds through annual flu vaccination programmes in England, Scotland, Wales and Northern Ireland. Vaccination provides protection both to the individual and the wider community and is the most effective protection available against the serious effects of flu. In our Report we focus on the flu vaccination programme in England.
The 2017/18 winter period saw the most severe flu outbreak since 2010/11. NHS Improvement have estimated that up to 4,000 beds each day could have been used by flu patients, and that at the peak of the season up to 500 patients were admitted with flu per week—significantly more than in previous winter flu seasons. There had been reports that some of the hospitalisation rates could have been reduced by the use of the quadrivalent vaccination rather than the trivalent vaccination in the 2017/18 season. However, we heard that the data did not did not support the use of the quadrivalent vaccine in all eligible groups last flu season, and we are convinced by arguments made to us that whilst the B-Yamagata strain was responsible for a significant burden of disease, use of the quadrivalent vaccine in all individuals would not have made a huge difference to the additional burden placed on frontline staff in the NHS.
We welcome the changes introduced to the flu vaccines for the 2018/19 season. The quadrivalent vaccine is being offered to all eligible adults this season, and the over sixty-fives are being offered the adjuvanted vaccine, which is estimated to lead to a 20% improvement in vaccine effectiveness in this group.
It is a professional duty for healthcare workers in hospitals to be vaccinated each year and we welcome recent action taken to improve these rates and ensure that high risk clinical departments have 100% vaccination rates. However, despite the 2017/18 season having the highest flu vaccination uptake ever in healthcare workers, significant variation remains. Some hospital trusts only achieved 30 to 40% uptake, whereas others achieved over 90%. The Government should undertake a review to establish whether flu vaccination should be mandatory for certain categories of healthcare workers.
One area where we were particularly concerned was vaccine uptake rates amongst social care workers. There is no existing system of effectively monitoring uptake in this group in England, and surveys undertaken by Public Health England have had both poor response rates and have shown poor vaccine uptake results. We believe it is as much a professional duty for frontline staff working in the social care sector to be vaccinated as it is for healthcare workers. The Government should review this and determine how uptake data can be collected from care homes. The Care Quality Commission should take action where poor immunisation rates (or poor recording of uptake) could impact on standards of infection prevention and control. There should be an expectation of full coverage amongst staff working with individuals who are most at risk from serious illness from flu.
We heard that there was a lot of work going on internationally looking at the development of a universal flu vaccine. We heard that a licensed clinical product may be several years away. We call on the Government to ensure that it continues to support and invest in the development of important new medical products, including new and more effective vaccines. Looking to the future, we also urge the Government to take account of the future relationship with the European Medicines Agency and the impact this could have on flu vaccination in the UK as part of preparations for the UK leaving the European Union.
Published: 18 October 2018