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Vaccine update: issue 343, October 2023

Published 3 November 2023

Applies to England

© Crown copyright 2023

This publication is licensed under the terms of the Open Government Licence v3.0 except where otherwise stated. To view this licence, visit nationalarchives.gov.uk/doc/open-government-licence/version/3 or write to the Information Policy Team, The National Archives, Kew, London TW9 4DU, or email: psi@nationalarchives.gov.uk.

Where we have identified any third party copyright information you will need to obtain permission from the copyright holders concerned.

This publication is available at https://www.gov.uk/government/publications/vaccine-update-issue-343-october-2023/vaccine-update-issue-343-october-2023

The nights are drawing in and the autumn festivals of light along with Halloween, and bonfires beckon. Some may be going on holiday to see relatives and friends or to have some winter sun.

Whether you are going abroad or home, getting your routine vaccinations and making sure children, young adults, pregnant women, and older adults are up to date is more important than ever.

We know that our vaccinators have been working hard all year to improve uptake in the routine and selective programmes and this has resulted in millions of people being protected against infectious diseases, but the latest UK quarterly data and commentary on coverage achieved by the UK childhood immunisation programme, published on 26 September, shows that there is still more to do as uptake and coverage continue to decline.

Practices and immunisation teams have working hard to identify those who have missed their vaccines and those due to attend appointments all year round. To make sure that we protect our most vulnerable people, every vaccine matters, and timing is important. Offering vaccinations in the evenings and at weekends, for example, can really make a difference to busy families who may not be able to take time off work, school or studying.

Giving information in the correct format as part of any interaction with patients and the public in relation to immunisation can also be effective in encouraging them to take up the vaccines. Remember there are a vast range of resources on the Health Publications website that can be ordered in different formats and languages to support these conversations. Make sure you have registered today.

NHS England have recently confirmed that the lifesaving NHS winter vaccination programme has delivered more than 10 million flu jabs and 7 million COVID-19 vaccines to people most at risk across England in just over 5 weeks, making this the fastest NHS flu vaccine roll out on record.

This is a fantastic achievement, and all involved should be justly proud of the work that they are doing to support this, but it is still early days and like the tortoise and the hare, speed is not always the wining factor.

It is important to continue to encourage those in risk groups, pregnant women, and those with busy lives to make time to have these and all the other vaccines they are due, to make sure that they and those that they care about are protected not just by the flu and COVID-19 vaccines over the winter months, but by the wider immunisation programme for life. So please keep up the momentum and ensure that we get everyone eligible offered these vaccines before we get into the cold, dark days of winter.

Finally, shingles vaccines can sometimes be forgotten when the national focus is on winter vaccines. We launched the new expanded Shingles programme on 1 September and want to encourage anyone who is eligible for their shingles vaccines to come forward. It is a complex programme, but you can see the shingles calculator below which is a helpful tool to have saved to your desktop to use to make it easier to determine when someone is eligible for their first or second doses.

New resources

Don’t ignore the signs: meningitis and septicaemia

New look ‘Don’t ignore the signs’ resources describe the warning signs of meningitis, so that teenagers and young people, those entering a new college or university in particular, know what to look out for if someone falls ill. They also remind young people that they are eligible for the free MenACWY vaccine until age 25 to help protect them from some of the main causes of meningitis and septicaemia.

This leaflet can be downloaded and or ordered from HealthPublications using product code: IM23DISL1

This leaflet is available translated into the following languages for order and download: Albanian, Arabic, Bengali, Bulgarian, Chinese (simplified), Chinese (traditional), Estonian, Farsi, French, Greek, Gujarati, Hindi, Italian, Latvian, Lithuanian, Nepali, Panjabi, Pashto, Polish, Portuguese, Romanian, Romany, Russian, Somali, Spanish, Tagalog, Tigrinya, Turkish, Twi, Ukrainian, Urdu and Yoruba.

A poster is also available to display in school, college, heath and social settings. It can be downloaded and or ordered from HealthPublications using product code: IM23DISP1

A guide to the MenACWY vaccine

This leaflet explains the MenACWY vaccine that protects against 4 types of meningococcal disease (group A, group C, group W and group Y) which can cause severe illness including septicaemia.

The MenACWY vaccine is routinely offered to those aged 13 and 14 in school year 9 and young people remain eligible until aged 25. Anyone who has missed their MenACWY vaccination should catch up as soon as possible through their school immunisation team or their GP practice. Particularly before attending a new college or university.

This leaflet can be downloaded and or ordered from HealthPublications using product code: YPMACWY1EN.

This leaflet is available translated into the following languages for order and download: Albanian, Arabic, Bengali, Bulgarian, Chinese (simplified), Chinese (traditional), Estonian, Farsi, French, Greek, Gujarati, Hindi, Italian, Latvian, Lithuanian, Nepali, Panjabi, Pashto, Polish, Portuguese, Romanian, Romany, Russian, Somali, Spanish, Tagalog, Tigrinya, Turkish, Twi, Ukrainian, Urdu and Yoruba.

Updated routine immunisation schedule and translations

Following the schedule revisions in September 2023 to include changes to the human papillomavirus (HPV) and shingles programmes.

A flyer with quick links to all of the translations is available to download from HealthPublications using product code: RS1-Poster. Now including Nepali.

Translated versions of the schedule are available to download as a PDF in:

 Albanian, Arabic, Bengali, Bulgarian, Chinese (simplified), Chinese (traditional), Dari, Estonian, Farsi, French, Greek, Gujarati, Hindi, Italian, Latvian, Lithuanian, Nepali, Panjabi, Pashto, Polish, Portuguese, Romanian, Romany, Somali, Spanish, Tagalog, Tigrinya, Turkish, Twi, Ukrainian, Urdu, Yiddish and Yoruba.

New pregnancy: protect you and your baby translations flyer

Providing quick access via QR codes to the many available translations of the Pregnancy: how to help protect you and your baby leaflet which explains:

  • the flu vaccine
  • the whooping cough (pertussis) vaccine
  • the rubella (German measles) vaccine

These vaccinations are recommended for women who are pregnant. Rubella vaccination is also recommended for women who require protection before becoming pregnant again.

Paper copies of this leaflet are available free to order or download in the following languages:

English, Albanian, Arabic, Bengali, Bulgarian, Chinese (simplified), Chinese (traditional, Cantonese), Estonian, Farsi, French, Greek, Gujarati, Hindi, Latvian, Lithuanian, Panjabi, Pashto, Polish, Portuguese, Romanian, Romany,Russian, Somali, Spanish, Tagalog, Turkish, Twi, Ukrainian, Urdu and Yiddish.

Shingles eligibility

The shingles eligibility calculator is a useful tool to assist in determining if a patient is eligible for their shingles vaccine and can be used by all healthcare and support staff. Download and save the xlsx file to use and share.

The calculator can be downloaded from HealthPublications using product code: 2023142.

This tool is not patient facing, the new patient information materials including posters, leaflets and supplementary materials are available on GOV.UK and to order from the Health Publications website.

Best Practice: Birmingham NEC

Lesley McFarlane and Yves-Pearl Hurley were incredibly pleased to meet so many enthusiastic health professionals from across the country at Best Practice in Birmingham this month. They were sharing the range of publications available to support the Immunisation programmes and answering queries and had the privilege to talk with over 600 delegates at the show and were impressed by the passionate responses on the issues surrounding delivering immunisations and increasing vaccine update across the country.

They were really impressed with some of the anecdotes from delegates about using our resources and other outreach initiatives that were being developed and implemented. If you have an example of where and how you or your team are working to increase vaccine uptake on a local level or more broadly we would love to hear from you an feature your work in our ‘How we did it’ feature in ‘Vaccine update’ to champion the hard work of immunisers and good examples of best practice.

To get in touch, email: yves.p.hurley@ukhsa.gov.uk

We will be at a number of other events before the end of the year, if you happen to be at any of them do come along and have a chat to the team, collect some resources and learn more about ordering from our Health Publications website for free. We will be at events including the:

Vaccine supply

Routine vaccination programme

Attention all customers – Christmas 2023 and New Year 2024 deliveries warning notice for routine immunisations:

Christmas and New Year Day bank holidays

Due to the Christmas and new year bank holidays, there will be no deliveries or order processing by Movianto UK on Monday 25, Tuesday 26 December 2023 and Monday 1 January 2024. See the table below for revised order and delivery dates, and the exceptions for off-shore customers.

Note that there is a separate article for school providers of LAIV which also covers delivery schedules.

For customers with standard delivery day of Monday, note that after Monday 18 December, your next available delivery day will be Monday 8 January.

You are reminded to be prepared for the break in deliveries and to order accordingly. Make sure you have sufficient room in your fridge for any additional vaccine you wish to stock over this holiday period, bearing in mind the recommendation that only 2 to 4 weeks of vaccine stock be held at any one time.

Christmas and New Year holiday orders and deliveries

Exceptions to the timetable overleaf for off-shore customers are as follows:

  • Isle of Wight and Isle of Man: customers should refer to the schedule changes in the main table
  • Jersey: no deliveries arriving on Wednesday 27 December. Orders for deliveries arriving on Thursday 28 December will have an earlier cut-off of Thursday 21 December. Orders for deliveries arriving on Wednesday 3 and Thursday 4 January will have earlier cut-off dates of Thursday 28 and Friday 29 December, respectively
  • Guernsey: no deliveries arriving on Wednesday 27 December. Orders for delivery arriving on Wednesday 3 January will have an earlier cut-off date of Thursday 28 December
  • Shetland, Stornoway and Orkney: orders for deliveries arriving on Thursday 28 December and Thursday 4 January will have earlier cut-off dates of Thursday 21 and Friday 29 December, respectively

Emergency or ‘out of schedule’ deliveries cannot be arranged for failure to place orders in good time.

Christmas and new year bank holidays Monday 25 and Tuesday 26 December 2023, and Monday 1 January 2024

Delivery date Order cut-off date Order cut-off time Notes
Monday 18 December 2023 Thursday 14 December 2023 11.55AM Next Monday delivery is 8 January
Tuesday 19 December 2023 Friday 15 December 2023 11.55AM  
Wednesday 20 December 2023 Monday 18 December 2023 11.55AM  
Thursday 21 December 2023 Tuesday 19 December 2023 11.55AM  
Friday 22 December 2023 Wednesday 20 December 2023 11.55AM  
Monday 25 December 2023 Closed No deliveries or order processing Christmas Day
Tuesday 26 December 2023 Closed No deliveries or order processing Boxing Day
Wednesday 27 December 2023 Thursday 21 December 2023 11.55AM  
Thursday 28 December 2023 Friday 22 December 2023 11.55AM  
Friday 29 December 2023 Wednesday 27 December 2023 11.55AM  
Monday 01 January 2024 Closed No deliveries or order processing New Year’s Day
Tuesday 02 January 2024 Thursday 28 December 2023 11.55AM Bank Holiday in Scotland only – orders delivered on 3 January
Wednesday 03 January 2024 Friday 29 December 2023 11.55AM  
Thursday 04 January 2024 Tuesday 02 January 2024 11.55AM  
Friday 05 January 2024 Wednesday 03 January 2024 11.55AM  
Monday 08 January 2024 Thursday 04 January 2024 11.55AM  

Vaccines for the 2023 to 2024 children’s flu programme supplied by UKHSA

All flu vaccines for the 2023 to 2024 children’s flu programme are available to order by NHS providers in England via UKHSA’s ImmForm website.

UKHSA does not supply any flu vaccines for patients aged 18 years and over.

Refer to guidance from your respective health departments for arrangements in Scotland, Wales and Northern Ireland.

Vaccines and availability

The 2 vaccines available and the groups these vaccines should be ordered for are shown in the table below.

The latest and most accurate information on availability of centrally supplied vaccines for the children’s flu programme is available on the ImmForm news page at all times. It is strongly advised that all parties involved in the provision of influenza vaccines to children ensure they remain up to date with this.

Vaccine Manufacturer Available to order for
Fluenz® Tetra (LAIV) AstraZeneca All children from 2 years of age to school year 11; and Children in clinical risk groups aged 2 to <18 years[footnote 1]
Cell Based Quadrivalent Influenza Vaccine (Surface Antigen, Inactivated) (QIVc) Seqirus Children in clinical risk groups aged 6 months to <2 years; All other eligible[footnote 2] children aged 2 to <18 years for whom LAIV is unsuitable

LAIV ordering information for general practice

Ordering controls are place for general practices, to enable UKHSA to balance supply with demand. These controls work by allocating an amount of LAIV based on the number of registered eligible patients and are tailored to each practice.

Each GP practice has initially been allocated sufficient LAIV to vaccinate at least 60% of their eligible patients (all 2 and 3 year olds, plus children in clinical risk groups from age 4 to <18 years). Note that:

  • increases to these allocations may be made in response to demand and vaccine availability
  • requests for extra vaccine will be considered on a case-by-case basis throughout the ordering period.
  • requests for additional vaccine should be sent to the helpdesk helpdesk@immform.org.uk and should be sent in good time before your order cut-off. Out of schedule deliveries will be by exception only

You can view how many packs of LAIV your practice has available to order by visiting the allocation report. You will be asked to log in with your ImmForm credentials.

You will then need to select:

  1. Stock management reports, followed by

  2. Products available to order (allocation managed) report

This report is not updated in real-time and so may not account for any orders or allocation amendments made within the last 30 to 45 minutes.

Multi-branch practices and LAIV allocations

GP practices or groups that operate over multiple sites but are part of the same organisation will have a joint allocation (as in previous years), even where each site has a unique ImmForm account. This means that it is possible for one site to potentially order all of the available vaccine for the group, unless there is local agreement on how the allocated volume is shared. UKHSA recommend that this agreement is in place before ordering opens to reduce the risk of supply interruption.

LAIV ordering information for school-age providers

School providers are able to place 2 orders and receive 2 deliveries of LAIV per week, to assist in the management of vaccine volumes required across limited storage space at delivery points.

This operates on a 48-hour delivery schedule requiring the order to be placed before the 11.55am cut off 2 working days before the required delivery day. The table below illustrates the respective delivery days versus ordering day. Remember to take into consideration the bank holidays over Christmas and the New Year as this will affect your delivery day.

Order day (before 11.55am cut off) Delivery day
Monday Wednesday
Tuesday Thursday
Wednesday Friday
Thursday Monday
Friday Tuesday

Customers must ensure that the point of delivery will be open and staffed between 9am and 5pm on the delivery day when placing orders for LAIV.

This does not affect the routine ordering and delivery schedule of any other vaccines (including inactivated flu vaccines) ordered from ImmForm and is applicable to Fluenz® Tetra (LAIV) only.

A default weekly ordering cap of 450 packs (4,500 doses) per week is in place for school provider accounts. Where this cap is insufficient and a provider needs a larger weekly volume of vaccine to deliver the programme (for example where a provider covers a large area using a single account), a higher weekly cap should be requested via the UKHSA Flu Vaccine Operations team by emailing childfluvaccine@ukhsa.gov.uk. Ensure requests are sent at least 2 working days before an order is needed to be placed against the higher cap, to allow time for your account to be set up correctly. For one-off larger orders during the ordering period, requests should be made via helpdesk@immform.org.uk.

Inactivated flu vaccine ordering

The cell-based Quadrivalent Influenza Vaccine (surface antigen, inactivated) (QIVc) is available to order, in a single dose pack, for:

  • children in clinical risk groups aged from 6 months to less than 2 years old;
  • children aged from 2 to <18 years old in clinical risk groups for whom LAIV is clinically contraindicated or otherwise unsuitable; and
  • healthy children from 2 years old to those in school year 11, for whom LAIV is unsuitable (for example, due to objection to LAIV on the grounds of its porcine gelatine content)

Order controls are also in place for this vaccine as follows:

  • for GPs, there is an initial cap of 10 doses/packs per week
  • for school-age providers, there is a cap of 450 doses/packs per week

For one-off larger orders of inactivated vaccines, requests should be made via helpdesk@immform.org.uk in good time before your order cut-off.

All influenza vaccines for the 2023 to 2024 season

A list of all influenza vaccines marketed in the UK (including details of ovalbumin content) is available on GOV.UK.

ImmForm customers should report long-term changes to opening hours for deliveries

Customers should report long-term changes to the days and times when they can accept deliveries, such as routine training days and closures, by contacting Movianto UK Customer Care (email: MoviantoUK.NHSCC@movianto.com, phone: 01234 587207). This should not be used to report short-term changes due to absence or holidays.

DTaP/IPV/Hib/HepB vaccine ordering

Supplies of DTaP/IPV/Hib/HepB vaccines Infanrix hexa® and Vaxelis® are available for the routine infant primary immunisations programme. Orders for Infanrix hexa® remain unrestricted. Customers in England and Wales may order up to 20 packs of Vaxelis® per ImmForm account per week – this will vary for customers taking part in the Oxford Vaccine Group trial. Customers in Scotland should refer to their local ordering restrictions. Providers should not order more than 2 weeks’ worth of stock to minimise wastage due to fridge failures. For assistance, contact the ImmForm Helpdesk at helpdesk@immform.org.uk.

Change in schedule for the routine and eligible gay and bisexual men and other men who have sex with men (GBMSM) aged under 25 years

From 1 September 2023, the HPV vaccine programme will change from a 2 dose to a one dose HPV vaccine schedule for eligible adolescents and GBMSM aged under 25 years. Refer to the UKHSA and NHSEI bipartite letter for details.

Eligible individuals who are known to be immunosuppressed at the time of vaccination and those who are living with HIV, including those on antiretroviral therapy, should continue to be offered a 3 dose schedule as per the ‘HPV’ and ‘Immunisation of individuals with underlying medical conditions’ Green Book chapters.

HPV vaccine will continue to be available to order through ImmForm in the usual way. However, consider the schedule change when placing orders for HPV vaccine, and do not order more than 2 weeks’ worth of stock to minimise wastage due holding excess stock, or fridge failures.

Registering for a new or updating your existing ImmForm vaccine ordering account

When you register for or update an existing ImmForm account, UKHSA as a wholesaler of vaccines needs to verify the requesting customer.

Ensure you have your professional regulatory body registration number or Wholesaler Dealer Licence and an organisation code which can be verified when requesting updates or requesting a new vaccine ordering account.

For more information, see the ImmForm Helpsheet – How to register.

The EU Falsified Medicines Directive (FMD) and Delegated Regulation as applicable to UKHSA-supplied vaccines for the national immunisation programme

The EU Falsified Medicines Directive (FMD) and Delegated Regulation impose legal obligations on the EU medicines supply chain to prevent entry of falsified medicinal products into the supply chain. The Delegated Regulation was implemented in all EU member states on 9 February 2019. Following the UK’s departure from the EU, the Delegated Regulation ceased to apply in Great Britain from 31 December 2020, but continues to apply in Northern Ireland.

Information for customers in Northern Ireland

FMD-barcoded packs of routine immunisation programme vaccines that are centrally supplied by UKHSA continue to be supplied with active FMD serialisation, and should be decommissioned by end users in Northern Ireland. Customers in Northern Ireland who access centrally supplied vaccines are encouraged to review local guidance on implementation of the EU Falsified Medicines Directive.

MMR vaccine ordering

To rebalance central supplies of both MMR vaccines, consider ordering M-M-RvaxPRO® as your first choice, which is available without restriction. Customers in England and Wales who require Priorix®, for example because you serve communities that do not accept vaccines containing porcine gelatine, may order up to 20 packs of Priorix® per ImmForm account per week. For assistance, contact the ImmForm Helpdesk at helpdesk@immform.org.uk. Customers in Scotland should refer to their local ordering restrictions

Shingrix® vaccine ordering information

The shingles programme changed on 1 September 2023. Refer to the UKHSA and NHS bipartite letter for full details.

Current programme

All newly eligible individuals should be offered 2 doses of the non-live shingles vaccine Shingrix® instead of one dose of Zostavax®.

In addition to this, the eligibility for the immunocompromised and immunocompetent cohorts has changed to allow individuals to be protected at an earlier age.

The eligible cohort for immunocompromised individuals has expanded to those aged 50 years and over (with no upper age limit).

The eligible age for immunocompetent individuals has changed from 70 to 60 years of age for the routine cohort, in a phased implementation over a 10 year period. Immunocompetent individuals remain eligible until their 80th birthday.

During stage 1, from 1 September 2023 to 31 August 2028, Shingrix® should be offered to those turning 70 and 65 years on or after 1 September 2023.

During stage 2, from 1 September 2028 to 31 August 2033, Shingrix® will be offered to those turning 65 and 60 years of age, after which it will be offered routinely at 60.

Shingrix® is freely available to order without restrictive ordering controls in place, however, do not create local stockpiles; there is sufficient stock to support year round programme implementation of the programme.

Previous programme

Zostavax is no longer available to order via ImmForm. Those previously eligible for Zostavax®, i.e. immunocompetent persons age 70 or over prior to 1 September 2023, may continue to be offered Zostavax® until local stocks deplete, after which they should be offered Shingrix® (until 80th birthday).

Contact the helpdesk@immform.org.uk for ordering queries.

Non routine vaccine supply

Hepatitis A vaccine

Adult:

  • GSK: supply of Havrix Adult PFS singles and packs of 10 are currently available
  • Sanofi: Avaxim PFS singles and packs of 10 are currently available
  • MSD: VAQTA Adult is available

Paediatric:

  • GSK: supply of Havrix Paediatric singles and packs of 10 are currently available
  • MSD: VAQTA Paediatric is available
  • Sanofi: Avaxim Junior singles are currently available

Hepatitis B vaccine

Adult:

  • GSK: Engerix B PFS singles and packs of 10 are currently available
  • GSK: supply of Fendrix is currently available
  • MSD: HBVAXPRO 10 micrograms is available
  • MSD: HBVAXPRO 40 micrograms is available
  • Valneva: PreHevbri is available

Paediatric:

  • GSK: supply of Engerix B Paediatric singles is currently available
  • MSD: HBVAXPRO 5 micrograms is available

Combined hepatitis A and B vaccine

  • GSK: Twinrix Adult singles and packs of 10 are available
  • GSK: Twinrix Paediatric is currently available
  • GSK: Ambirix is available

Combined hepatitis A and Typhoid vaccine

Sanofi: Viatim is now a discontinued product and no longer available for sale.

Typhoid vaccine

  • Sanofi: Typhim singles and packs of 10 are available
  • Patientric: Vivotif is available

Rabies vaccine

  • Valneva: Rabipur is available
  • Sanofi: Rabies BP is now a discontinued product and no longer available for sale

Pneumococcal polysaccharide vaccine (PPV)

MSD: supply of Pneumovax 23 (PPV23) PFS is available.

Pneumococcal polysaccharide conjugate vaccine (PCV)

Pfizer: Prevenar 13 is currently available.

Varicella zoster vaccine

  • GSK: VARILRIX is currently available
  • MSD: VARIVAX is available
  • MSD: ZOSTAVAX is now a discontinued product

Diphtheria, tetanus, poliomyelitis (inactivated) vaccine

Sanofi: Revaxis is available.

Diphtheria, tetanus, pertussis (acellular) and (inactivated) vaccine

  • GSK: supply of Boostrix-IPV is currently available
  • Sanofi: Repevax is currently available

MMR

  • MSD: MMR Vaxpro is currently available
  • GSK: Priorix is currently available

Meningitis ACWY vaccine

  • GSK: Menveo is currently available
  • Pfizer: Nimenrix is currently available
  • Sanofi Pasteur: MenQuadfi is available

Yellow fever

Sanofi Pasteur: Stamaril is available.

Human papillomavirus (HPV) vaccine

  • MSD: GARDASIL has been discontinued (refer to ImmForm for NIP supply status)
  • MSD: Gardasil 9 is currently available
  • GSK: Cervarix has been discontinued

Cholera vaccine

  • Valneva: Dukoral is available
  • Patientric: Vaxchora is available

Japanese encephalitis vaccine

Valneva: Ixiaro is available.

Meningococcal group b vaccine

GSK: Bexsero is currently available

Diphtheria, tetanus, pertussis, hib vaccine and poliomyelitis

GSK: Infanrix IPV+Hib is currently available

Hib + meningococcal group c combined vaccine

GSK: Menitorix is currently available

Live attenuated rotavirus vaccine

GSK: Rotarix is currently available

Herpes zoster vaccine

GSK: Shingrix is currently available

  1. Unless LAIV clinically contraindicated or otherwise unsuitable. ↩

  2. Children from 2 years of age to school year 11, and children in clinical risk groups aged 2 to <18 years. ↩

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