Millions at risk of flu complications went unvaccinated in England

Chief medical officer for England demands big increase in take-up for 2011-12 ‘flu season’, warning health authorities to order enough supplies now

More than five million people potentially at risk of health complications from flu went unvaccinated in England over the winter. Hundreds of thousands of frontline health workers also had no jab, leaving them open to infecting vulnerable patients.

The chief medical officer for England, Dame Sally Davies has demanded big increases in take-up for the 2011-12 “flu season”, warning GPs and health authorities that they should be ordering enough supplies of vaccine now.

There were problems with stocks over the winter, even though vaccination rates often fell well short of those recommended by international bodies.

Figures suggest that while the vaccine uptake for people aged 65 and over was nearly 73%, for all those with chronic diseases, except babies under six months, it was barely over 50%, 37% for pregnant women and just short of 35% for health and social careworkers.

Davies said: “It is important that GPs place their orders with manufacturers as soon as possible if they have not done so already.”

Local practices and their NHS primary care trusts should also compile registers of patients vulnerable to flu and have robust “call and reminder” systems to “maximise uptakes” and meet public health targets, she wrote in a letter to the health service.

A total of 560 deaths in the UK were associated with confirmed influeza infection in the 2010-11 season.

The most recent figures show vaccination of over-65s in England fell short of the 75% target set by the World Health Organisation – a figure last reached in England in 2005-06.

It is thought only 6.1 million of the almost 9.1 million in this group in England have been innoculated.

For under-65s with conditions such as heart, kidney and liver disease and those with diabetes, the 50.2% vaccine rate fell well short of the 75% target recommended by the European Union, with only 2.8 million of an estimated 5.6 million people in this category getting a jab.

The EU recommends that at least 75% of pregnant women should be given the flu vaccine, leaving England well short in this category. Of more than 1 million frontline health and social care staff, only 360,000 were vaccinated.

Davies told local trusts they must reach or exceed the targets in all the non-staff categories by 2013-14.

“In addition to those patients who can attend a surgery or clinic to receive a vaccination, primary care trusts (PCTs) will want to assure themselves that appropriate plans are in place to offer vaccination to those who require home visits; those who are in long term care; and those who are not registered with a GP practice,” she said.

“GPs will not be able to identify all pregnant women on a register at this stage. Therefore, PCTs will want to ensure the involvement of maternity services so that GPs and midwives are working together to identify existing pregnant women and any newly pregnant women throughout the flu season so that no eligible patients are missed out.”

NHS employers should have sufficient vaccine for their staff as they would not – apart from their own practice staff – be included in GP calculations for the vaccine. Although the low take-up figure in 2010-11 was an improvement on the previous year, “there is still significant room for improvement”, Davies said.

In January, the government revealed it was considering removing the responsibility for flu vaccine orders from GPs and relying on central purchases instead, even though that would have gone against the thrust of plans to give GPs more power over the NHS budget.

Davies’s letter demonstrates there will be no change, this year at least.