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September 2018

Scottish Government blocks aTIV for under-75s

The Scottish Government has sparked controversy in its plans for the seasonal flu programme this winter by recommending the newly-introduced adjuvanted trivalent inactivated flu vaccine (aTIV) only for patients aged 75 and over.

Adults aged 65-74 should continue to be offered the conventional trivalent vaccine – a move which some general practice nurses have described as ‘indefensible’.

One nurse, who asked for her name to be withheld, told Practice Nurse: ‘We are being asked to give a less effective flu vaccine to one of the most vulnerable groups of patients.’

Scotland’s chief medical and nursing officers’ letter to healthcare professionals says that the quadrivalent vaccine (QIV) should be used for patients aged 18-64 with at-risk conditions, pregnant women, children for whom the intranasal vaccine (LAIV) is contraindicated, and frontline healthcare staff. Only the group aged 65-74 will be given TIV.

This is in contrast to the rest of the UK, where aTIV is recommended for all patients over 65 – albeit that the first priority for the new vaccine should be the over-75s. (See page 12 – 13)

A Scottish Government spokesperson said: ‘Over the next two years we will be phasing in a new vaccine for everyone aged 65 and over. In line with expert advice, this will be offered from this winter to those aged 75 and above and from next winter (2019-20) to all those aged 65 and above.

‘This vaccine is currently produced by only one company, who were unable to give a guarantee on supplying the new vaccine for all over-65s in time for this year.

‘All those aged 65 to 74 will continue to be offered the current flu vaccine which will help protect them from flu.’

As Practice Nurse reported last month, The Green Book states that ‘the conventional, non-adjuvanted vaccine provides little benefit’ in older adults. NHS England has accepted the recommendation to introduce aTIV for over-65s because this group is ‘disproportionately at risk of hospitalisation for flu-related complications.’

September 2018