As part of efforts to streamline spending and enhance resource allocation within the healthcare system, the NHS has chosen to cease providing the free vaccinations for all, which were initially introduced in 2020. Approximately 12 million British citizens will not have access to free flu vaccinations and Covid-19 boosters during the upcoming winter, according to NHS.
Furthermore, the NHS plans to defer flu vaccine distribution to October, aiming to heighten protection for those aged 65 and older and other eligible groups in the high-risk winter months. However, this has stirred panic among pharmacies, given their advanced planning based on the initial start date of September 1 for vaccinations.
On Tuesday (Aug. 8), the Joint Committee on Vaccination and Immunisation (JCVI) released NHS guidelines indicating that Covid-19 booster shots, starting from autumn, will not be provided to individuals aged 50 to 64 who are in otherwise good health. Similar guidance had already been released for flu, rendering 12 million middle-aged Britons ineligible for free jabs, JCVI said.
Prior to the pandemic, influenza vaccinations were available to healthy adults aged over 65, alongside children and younger adults with medical conditions. Amidst the pandemic, the distribution of flu vaccinations was expanded to include individuals aged 50 to 64, in alignment with the criteria for Covid-19 boosters.
However, last winter saw a decline in the uptake of flu and Covid-19 vaccinations among individuals aged 50 to 64. In England, only 40.6 per cent of this age group received a flu vaccine in 2022-23, down from 45.7 per cent the previous year. Last winter, the Covid-19 booster uptake for 50-to-64-year-olds reached six million people, or 51.7 per cent, a decrease from 77.6 per cent the year before.
Flu vax start now in October
NHS plans to postpone vaccine distribution until October, strategically aiming to enhance protection for individuals aged over 65 and other eligible groups during the high-risk winter months. The JCVI emphasised the need to maximize winter protection through early December administration of jabs, as outlined by NHS England.
"The COVID-19 virus remains present, and we anticipate its broader circulation during the winter months, leading to a rise in illness cases," said Dr Mary Ramsay, Director of Public Health Programmes at the UK Health Security Agency. "The booster is available for individuals at greater risk of severe illness, and by opting for the booster vaccine this autumn, you will enhance your protection prior to the winter season, when respiratory viruses typically surge."
"I've approved the JCVI's advice on the 2023 autumn booster program to protect the most vulnerable from Covid," said Health Secretary Steve Barclay. "NHS England will soon confirm details for accessing the booster vaccine. If invited, including those yet to receive their first jab, please come forward promptly."
The NHS England is also poised to unveil its vaccination strategy shortly, which includes halving eligibility to target 26 million individuals, thus considerably expediting the rollout.
Pharmacy sector urges NHS to reconsider its decision
On August 8th, Community Pharmacy England reached out to Neil O'Brien, the Minister for Primary Care and Public Health, as well as Vaccines Minister Maria Caulfield, seeking their intervention in the proposed alteration of the Flu Vaccination Service's start date.
"Pharmacy owners have procured vaccines and begun scheduling September flu vaccinations, following past seven-year protocol and NHS's early autumn vaccination recommendation," said CPE. "Our Committee advocated for the traditional September 1 commencement based on data, but the recent NHS announcement disregarded it. This decision increases the real risk of overwhelming pharmacy owners and teams with winter's workload and vaccine costs. This avoidable and unacceptable situation shouldn't burden pharmacies or service providers."
In line with the CPE, the Company Chemists' Association noted that pharmacies scheduled 100,000 September flu vaccine appointments. The CCA said that around 25 per cent of pharmacy NHS flu vaccines are administered in September. “Altering the start date, with numerous patient appointments already scheduled, will significantly burden pharmacies.”
“Planning commences prior to Christmas annually, encompassing workforce needs, logistics, and anticipated patient demand,” said Dr Nick Thayer, head of policy at the CCA. “Community pharmacies are committed to delivering optimal care to safeguard patients and their families from influenza. Implementing fundamental changes to the flu programme at this stage poses significant risks, straining already stretched pharmacies and their teams. NHSE should take this into consideration and initiate the program as initially planned for September's outset."
Meanwhile, the CCA has recently urged NHSE to investigate DSPs violating NHS contracts, which is resulting in the closure of local pharmacy stores.
"Delaying the commencement date would needlessly disrupt an established and effective NHS program," said Nick Kaye, chair of National Pharmacy Association. "Last year, millions opted for flu vaccinations at pharmacies. If this alteration proceeds, numerous appointments will be cancelled, and stocked supplies will be squandered. The temporary personnel enlisted for the September service will have to be released. Those aiming to safeguard themselves promptly from this severe illness are now compelled to wait."
Kaye further said its disappointing that NHS England is reducing the Covid-19 fee and simplifying the flu payment. “The decrease in fees for Covid-19 jabs is particularly disheartening, considering the pharmacy sector's significant contribution during the pandemic. The service's complexity and cost haven't diminished. In terms of operations, finances, and the reputation of pharmacies as accessible hubs for preventive care, altering the framework in this manner is a detrimental step."
"Collectively, this significantly demoralises pharmacy contractors already under pressure, who have demonstrated their effectiveness in delivering these critical clinical services," he added.
Winter warnings
The NHS' recent move comes despite warnings discussed in a recent NHS England board meeting, revealing the expected severity of the upcoming flu season in Britain.
JCVI said flu shots will continue to be available for toddlers, primary school children, pregnant women, care home residents, and social care workers. Privately, flu vaccinations can be obtained from local pharmacies for approximately £20.
Amid summer's challenging conditions and fading immunity, a new Covid-19 variant, Eris (or EG.5.1), has emerged, leading to increased hospital admissions. Derived from Omicron, Eris was classified as a variant in the UK in July and now accounts for 10 per cent of Covid-19 cases. It stands as the UK's second most prevalent variant, with Arcturus constituting almost half of all infections, according to the UKHSA.
All this leads to a broader question: Is the government taking a significant risk by discontinuing free vaccines for potentially vulnerable groups in its cost-saving endeavour?
