Influenza and the annual vaccine ordering challenge for practices

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Kenny Gibson, Head of Public Health Commissioning (London) and NHS England London’s lead on flu vaccinations shares his tips for anticipating the cycle of winter illnesses and getting the best value when buying in vaccine stock.

There has been a positive shift in our population’s approach to vaccines. More and more people are seeing the benefits of getting their vaccines – especially the influenza vaccine – to protect themselves, their families and their communities.

There are three important cycles we need to recognise:

1. The annual cycle of winter virus

  • Mid-November onwards we see increasing rates of rhinovirus; adenovirus and other winter respiratory viruses – let’s call them winter respiratory viruses, since they are not flu.
  • Late-December we tend to see InfluenzaA coming into UK and reaching a peak in mid-February.
  • Late-December we see norovirus spreading like wild-fire, mainly due to poor hand hygiene during and after our festive season when little ones carry more than Christmas presents to grandma and grandpa in the care home – Merry Christmas everyone.
  • Early-January we tend to find InfluenzaB (mild in adults, but deadly in children) – although this year this arrived worrying early.
  • Influenza A&B can still be found in some unvaccinated citizens as late as March, which is why we vaccinate pregnant women until the end of March.

2. The annual cycle of influenza vaccine production

This cycle is predicated on evidenced-based global health protection science by the World Health Organisation and the UK Joint Committee on Vaccinations and Immunisations. Their webpages are full of technical-bits, but the important dates are February each year when manufacturers begin to develop the UK vaccine. However, as noted, the risk is that the vaccine strain changes and so they must be ready to divert production to include another strain.

3. The annual cycle of supplier’s promotion of their product to practices

This cycle is predicated on supplier and practice incentives:

  • The earlier a supplier representative can confirm a practice will be buying from them, the more likely that rep will make a bonus-payment.
  • The sooner a practice places an order, the early they know they can claim the £1.50 management fee for each influenza vaccine ordered.

This process is unique for influenza vaccines ordered by GP Practices because other influenza vaccinators get their stock from national suppliers where there is no pressure on cost per vaccine:

  • School nursing who give nasal fluenz;
  • District Nursing who vaccinate housebound;
  • NHS Trusts who vaccinate staff.

Community pharmacies do their ordering in February or later and get a better deal per vaccine dose.

More often as not, these three cycles I reference above will also be affected by the debate on which influenza vaccine is most cost-effective; this is the situation we have faced each year since 2012 with the advent of multiple types of influenza vaccine.

This debate can be confusing for the public and practices to understand and so, in summarising this year’s ordering advice, as of 15 February 2018, GP Practices should move to order the following vaccines, as per attached letter:

  • aTIV for 65s-year-old and over
    Orders for the adjuvanted trivalent inactivated flu vaccine (FLUAD® manufactured by Seqirus) can be placed by contacting Seqirus: Tel: 01530 454288. Email:
  • QIV for all under 65s
  • Nasal Fluenz Spray for all 2 & 3 years infants and 9-18 years old children and young people at risk

Apart of these three cycles, we all need to remember why every at-risk adult, every carer, every NHS and care sector employee and every 2-9 year olds needs to have their influenza vaccine. A vaccine will not stop you contracting the influenza virus, but by having the vaccine you are less likely to spread the deadly virus and far more likely to recover within days rather than two to three weeks. It is our duty-of-care to protect our patients and communities.

If you want to read more on this, please visit For Jude For Everyone’s website or find them on Instagram.

The new Londonwide LMCs’ Buying Group offers practices flu vaccine at a discounted rate. Note: this offer is entirely provided by Londonwide LMCs and our partners and is not connected to or endorsed by NHS England London.

Last updated : 06 Mar 2018