Important Londonwide CEO message, volume 2, number 12 - 11 December 2009
This update covers:
- New Vaccine Dose For Under 5s
- What you need to do under the LES agreement with NHS London
- What if there are no PGDs for under 5s? How on earth will you cope?
This agreement ensures that the job of vaccinating patients remains in Real General Practice and isn’t hived off to any other willing provider.
Thanks for your co-operation and support.
- New Vaccine Dose for Under 5s
As of yesterday, the dose for under 5s is 1 single 0.25ml shot of Pandemrix. This includes the chronic illness patients EXCEPT the immuno-suppressed – here the dose is unchanged at TWO shots.
For egg-allergic patients, the dose of Celvapan remains unchanged.
Please refer to the JCVI advice at the end of this message. - What you need to do under the LES agreement with NHS London
The agreement provides for payment at £5.25 per vaccine given. You will be paid in line with the DES agreement, but you will not be required to operate a call and recall system. You will simply be asked to provide the NHS number of vaccinated patients, and totals given.
The LES paperwork is now available to download. - What if there are no PGDs for under 5s? How on earth will you cope?
PGDs are not required in order to permit experienced GP Nurses to be able to vaccinate. This is often misunderstood, especially by those believing that they have to be signed and returned to the PCT. Unlike Trust-employed nurses, sign-up is not required by GP Nurses either by the PCT or by the NMC. PGDs, where they exist, are a useful a guideline which describes safe practice and can be used as such. GPNs are covered by the practice provided a guideline is in place and the doctors have instructed GP Nurses to use them. Where they exist, PGDs can be those guidelines. Where they do not exist, for example in under 5s, common sense applies and points you towards JCVI advice, the latest of which appears below. That is all that is needed.
JCVI updated advice on H1N1v vaccination 8 December 2009
The committee considered new advice from the European Medicines Agency1 on the use of Pandemrix in young children based on data from the manufacturer showing a higher rate of fever in young children following a second dose. The committee also considered preliminary data on the reactogenicity of H1N1v vaccines from a paediatric trial coordinated by the Health Protection Agency.
The committee concluded that for children offered Pandemrix, one dose (that is half the adult dose) should be given to children aged over 6 months and below 10 years that are healthy or in the clinical at risk groups as defined previously by the JCVI2 with the exception of children who are immunocompromised. Immunocompromised children in this age group should receive two doses (both half the adult dose) of Pandemrix that are given at least 3 weeks apart. Advice on the use of Pandemrix in children aged 10 years and above and adults remains that previously given by the committee.