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Vaccine update: issue 344, November 2023, pregnancy special

Published 13 December 2023

Applies to England

Maternal vaccination matters

We want to improve maternal vaccination rates and this month’s special edition brings together the resources we have to promote vaccination to those who are pregnant, in all settings including midwifery, antenatal, GP practices and pharmacies. We have produced suites of information, training slide sets and guidance designed to help health professionals to talk confidently about maternal vaccination.

We hope that all pregnant women are given the offer of vaccination including the seasonal flu, the autumn dose of COVID-19 vaccination if they are in a risk group (unless they have already had a dose of COVID-19 vaccine) and the pertussis vaccination. Opportunities to read and digest leaflet information given to those who are pregnant in the right format to meet their needs is often the start of the consent process. Time and the right accessible information is key.

We know that the most deprived 20% of the population as identified by the national Index of Multiple Deprivation (IMD) are more impacted by the burden of infectious disease and have evidence of poorer health outcomes.

Vulnerable population groups and individuals identified at a local level need to be encouraged to access vaccination appointments in suitable locations. Travel can be expensive and time and access to transportation is key to enabling attendance at clinics and GP practices offering maternal vaccination. Invitations by text or email can work for many who have access to mobile or email but phone calls and letters work better for some vulnerable groups.

Populations that need additional resources and invitations to appointments which are sensitive to their needs are ethnic minority communities; people with a learning disability and autistic people; people with multiple long-term health conditions; other groups that share protected characteristics as defined by the Equality Act 2010.

Those who are pregnant in inclusion health groups such as people experiencing homelessness, drug and alcohol dependence, vulnerable migrants, Gypsy, Roma and Traveller communities, and other socially excluded groups also need to be offered maternal vaccination and encouraged to attend appointments for their free vaccinations. It is clear that some individuals still think they have to pay for the routine and selective vaccines for example.

Taking the time to order the free paper leaflets in key languages and accessible formats such as braille and large print or sharing the British Sign Language (BSL) video or audio versions can really help to make sure you making best use of the free national resources to promote vaccination at the point of care. Giving time to ask any questions, discuss the vaccination in each appointment can build confidence and allow space for reflection.

Using the UK Health Security Agency (UKHSA) and NHS leaflets as a talking point in antenatal classes can be very helpful to fostering conversations about maternal vaccination and how it helps to protect women and their pregnancy and how passive immunity is passed on to the unborn child, giving protection from birth.

More information

If you have given the relevant vaccination leaflet, but the pregnant woman or her family would like more information, then signpost them to other trusted sources of information such as:

• the NHS website’s page on vaccinations
• the Vaccine Knowledge project
• The British Society of Immunology videos

They can learn more about vaccination and view these resources in their own time. This can help to build confidence.

It is also important to sensitively revisit the subject if a pregnant women has not taken up the offer of the whooping cough (pertussis) vaccine for example. Opinions can change and confidence can take longer to build for some people. Taking a fresh approach to the offer of vaccination and exploring the benefits to the mother and the child is helpful when discussing the risks of the disease.

Pertussis vaccination

Rates of maternal vaccination against pertussis have fallen. Adults and adolescents are considered to be the main and persistent transmitters of pertussis in the community, but the highest morbidity and mortality is among the young infants.

There is good evidence to support the safety, immunogenicity and effectiveness of antenatal pertussis vaccination to reduce the morbidity and mortality associated with neonates and young infants, before they are old enough to receive their first pertussis vaccine.

If we miss the opportunity to protect the woman and her pregnancy, we miss the opportunity to protect the infant until they can have their vaccine at 8 weeks of age.

Trust in health professionals ranks as the highest and they have a very powerful role in supporting women throughout their pregnancy, read on to find out more about what we offer to promote the national programmes.

Call for examples: Increasing local uptake of vaccines in pregnancy

If you have good examples of how you have increased uptake of maternal vaccines, we would love to hear about your work and feature it in Vaccine update. Tell us how you did it in 500 to 700 words (approximately) and email immunisation@ukhsa.gov.uk

Flu vaccination during pregnancy

Flu vaccination is now well underway this year but vaccine uptake for pregnant women is much lower than we would like it to be, with the latest monthly data from UKHSA showing that 25% of women had been vaccinated by the end of October.

Most women of child-bearing age would not be eligible for a flu vaccine unless they are in a clinical risk group. Therefore, they do not necessarily understand the need for the flu vaccine when pregnant. UKHSA’s public-facing communications promoting flu vaccination explain how pregnancy alters how the body handles infections such as flu and that pregnancy increases the risk of complications from flu for both the woman and her baby.

Pregnant women benefit from vaccination because it can:

• reduce their risk of serious complications such as pneumonia, particularly in the later stages of pregnancy
• reduce the risk of mother or baby needing intensive care
• reduce the risk of the baby being stillborn or premature
• help protect their baby who will continue to have some immunity to flu during the first few
• reduce the chance of the mother passing infection to her new baby

Most maternity services offer flu vaccination to pregnant women, who can also access the vaccine from their GP or community pharmacy. Flu vaccine can be given safely at any stage of pregnancy, from conception onwards. It is always best for flu vaccination to be given before flu starts to circulate but in the case of pregnant women in particular, who may become pregnant later in the season, vaccination should continue to be offered right up until 31 March each year.

Update to the influenza chapter of the Green Book

The Green Book Chapter 19 (Influenza) has been updated and was published on Friday 10 November 2023.

Chapter revisions include updated advice on coadministration, seasonal timing of vaccination, and trivalent vaccines. Inclusion of carers and household contacts of people with immunosuppression in table 19.4 risk groups. Addition of occupational vaccination section. Updates to disease surveillance information and vaccine uptake tables.

Prenatal pertussis vaccination coverage in England

A recent report evaluates prenatal pertussis vaccine coverage for women who delivered in the January to March 2023 quarter and estimates annual coverage for the 2022 to 2023 financial year.

The main findings were that:

• vaccine coverage was 60.7% in the 2022 to 2023 financial year, compared to 64.7% in 2021 to 2022, 67.8% in 2020 to 2021 and 70.5% in 2019 to 2020
• pertussis vaccine coverage in pregnant women for the fourth quarter 2022 to 2023 was 60.8%, which was 3.7 percentage points lower than the mean coverage for the same quarter in the 2021 to 2022 financial year
• the mean coverage for the quarter was also 6.5 percentage points lower than the mean coverage for the same quarter in the 2020 to 2021 financial year
• this observed decline in coverage has largely been driven by a decrease in London NHS Commissioning Region but is also reflected in other regions, particularly the North West and the Midlands

The complete Prenatal pertussis vaccination coverage in England from January to March 2023 and annual coverage for 2022 to 2023 report was updated on 14 November.

Resources to support maternal vaccination

Pertussis (whooping cough): vaccination in pregnancy

The whooping cough vaccination in pregnancy guide provides in-depth information on:

• why the vaccine is needed
• how maternal pertussis vaccination helps to protect babies from whooping cough
• when expectant mothers can have the vaccine
• vaccine safety and efficacy

The poster has been designed to promote the need for maternal pertussis vaccination, which is now recommended from week 16 of each pregnancy. It is suitable for GP surgeries, hospitals, maternity units, nurseries, child care centres and libraries. The leaflet on whooping cough vaccination in pregnancy (product code 3235344) and poster on whooping cough vaccination in pregnancy (product code 5246393) are available to order for free from the HealthPublications site.

Pertussis (whooping cough) immunisation for pregnant women: resources and training

View information for healthcare practitioners on pertussis (whooping cough) vaccination programme for pregnant women.

You can also download the vaccination against pertussis for pregnant women slide set.

The vaccination programme is recommended for pregnant women from 16 weeks to 32 weeks of pregnancy, although the vaccine can be offered up to 38 weeks. It is usually offered after the fetal anomaly scan. Vaccinating pregnant women between 16 to 32 weeks of pregnancy will ensure that high levels of antibodies against pertussis cross the placenta from the mother to passively protect the baby when it is born.

MMR vaccination: Have you had your MMR?

This leaflet is for mums who have just given birth. The 2 doses of the measles, mumps and rubella (MMR) vaccine will help protect them and their baby, until the baby is old enough to get vaccinated.

The leaflet is suitable for all healthcare settings including maternity units and GP surgeries.

Copies of this Have you had your MMR (maternal) leaflet can be ordered from HealthPublications with product code 3325595B.

Viral rash in pregnancy aide memoire

This viral rash in pregnancy aide memoire publication covers rash illnesses caused by parvovirus B19 (B19V), measles, rubella and chickenpox (varicella), where intervention can prevent or reduce the potential for adverse outcomes.

Characteristic features and incidence of the following rash illnesses are also discussed:

• human herpesvirus type 6 and 7 (HHV-6/7)
• enteroviruses
• Epstein-Barr virus (EBV)
• cytomegalovirus (CMV)

This guidance document is for healthcare professionals (mainly in primary care) of pregnant women with a rash or exposed to a rash. It acts as a reminder of the risk assessment and initial management of pregnant women including reporting.

Copies of this rash in pregnancy aide memoire leaflet are available free to order using product code 2903600A from HealthPublications.

Hepatitis B: screening and care in pregnancy and protecting your baby by vaccination

There is information on hepatitis B infection, screening and care in pregnancy and the vaccine that protects babies born to women with hepatitis B. There are leaflets are aimed at parents of babies who are at risk from hepatitis B virus infection through perinatal transmission.

The protecting your baby against hepatitis B immunisation leaflet explains the course of vaccinations for babies born to women with hepatitis B to help protect babies from developing hepatitis B infection. This leaflet can be ordered using product code 410230B from HealthPublications.

The guide to your care in pregnancy and after your baby is born screening leaflet is for use from April 2021. It explains the hepatitis B screening and care offered to women with hepatitis B in pregnancy. This leaflet can be ordered using the product code 2019256HB from HealthPublications.

Pregnancy: how to help protect you and your baby

This leaflet 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.

An English large print version is available to order.

A Braille version of this leaflet is available to order.

An audio version of this leaflet is available to download.

A quick links poster with QR codes to the Pregnancy: how to help protect you and your baby and the COVID-19 vaccination: a guide on pregnancy and breastfeeding leaflets is available to download.

Immunisations at one year of age

A leaflet to remind parents to get their child immunised at one year are available free to order using product code 2022QG1EN from HealthPublications.

It’s also available free to order or download in the languages below. Orders of the translated leaflets will be dispatched as soon as stock is available.

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

Accessible versions of this leaflet are also available free to order or download:

• audio
• Braille
• British Sign Language (BSL) video
• large print

TB BCG and your baby

This leaflet contains the current information on tuberculosis (TB) and the BCG vaccine including the benefits and contraindications for BCG immunisation in infants.

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

English, Bengali, Farsi, Gujarati,  Hindi, Kurdish, Nepali, Panjabi,  Pashto, Romanian, Romany, Somali, Tamil, Turkish, Ukrainian, and Urdu.

A quick links poster with QR codes to the English and translated versions of the TB, BCG and your baby leaflet is available to download.

TB, BCG and your baby poster

A poster aimed at parents and carers of babies who may be at risk of tuberculosis and need a BCG vaccine to protect them are available to order for free as paper copies from HealthPublications.

Updated routine immunisation schedule and translations

The schedule was revised 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.

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.

Video resources

A range of new videos on immunisation and related topics are available on the UKHSA YouTube channel:

TB BCG and your baby animation

TB BCG and your baby animation

How contagious is measles? with Dr Colin Campbell

How contagious is measles?

Flu vaccination for 2 and 3 year olds with Dr Suzanna McDonald

Flu vaccination for 2 and 3 year olds

Travels with the immunisation stand

Student Midwife Festival in London, 8 November 2023

Cherstyn and Louise Letley had the privilege of meeting so many young and up and coming health professionals at the Student Midwife festival. From freshers nursing students to research midwives it was so wonderful to speak to so many engaged and interested current and future members of the health family and discuss the vital role of vaccination in maternal care.

Our Lead Research Nurse Louise Letley gave a talk on Attitudes towards maternal vaccination based on the annual survey from UKHSA, which was well received. The full report about the Attitudinal Survey is available now.

Our pregnancy leaflets highlighted above were very popular at this event.

Nursing Live in Liverpool, 11 to 12 November 2023

Yves-Pearl, David and Kirsty were at RCNI’s Nursing Live in Liverpool. This brand new event was a real success. It was fantastic to meet such a broad range of nursing professionals from a range of disciplines and discuss the Immunisation programme and the associated resources.

We heard about some really good work engaging with asylum seekers and nurses working with the team to bring them up to date with the UK schedule. This included some award-winning work going on in the North West.

Our translated Routine Immunisation Schedules and the quick link flyer (RS1-Poster) that goes with them were very popular at this event.

World AMR Awareness Week in the East of England

We were delighted to support Sarah Cavanagh and Vicki Braithwaite and their East of England team with their World Antimicrobial Resistance Awareness Week (WAAW) event. Thank you so much to everyone involved.

WAAW is a global initiative to raise awareness about the growing threat of antimicrobial resistance.

WAAW takes place every year between the 11 and 24 November and is an opportunity to promote best practices for using antimicrobials responsibly to avoid the further emergence and spread of drug-resistant infections.

As well as raising awareness about the risks associated with antimicrobial resistance, this year there are 3 cross-cutting themes underpinning all 5 days; children, sustainability and inequalities.

There are also suggested daily themes:

• Day 1 - ‘Prevention’ theme (such as vaccination, hydration, C difficile)
• Day 2 - ‘Antimicrobials in clinical practice’ theme such as. antibiotic course lengths, broad spectrum reduction and promotion of current clinical guidelines)
• Day 3 - ‘Optimising diagnostics’ theme (such as blood culture pathway)
• Day 4 - ‘Antimicrobials and untrue or spurious allergy’ theme (such as de-labelling spurious penicillin allergy labels)
• Day 5 - ‘Antimicrobial resistance and the environment and research’ theme (such as IV to oral switch and antibiotic amnesty)

Here in the East of England, we held a launch event for this year’s WAAW, organised jointly by our NHS England (NHSE) regional infection prevention and control and antimicrobial stewardship teams, supported by our regional UKHSA colleagues.

Sarah Cavanagh, pharmacist at NHS England East of England said:

It was a great day – full of interesting presentations and discussion. There were a range of speakers and attendees from across systems – including antimicrobial stewardship specialist pharmacy teams, IPC leads, consultant microbiologists and public health commissioning colleagues. We also teamed up with our UKHSA colleagues, to promote vaccination and to encourage individuals to pledge to become antibiotic guardians.

This year for WAAW, the public health commissioning team is promoting public health initiatives such as vaccinations, to prevent individuals from contracting an illness that then requires the use of antibiotics. Vaccinations are a principal method of infection prevention, as they provide a safeguard against various bacterial infections like pneumococcal, diphtheria, tetanus, pertussis, reducing the need for antibiotics.

They also protect against viral infections such as measles, flu, and COVID-19. This not only curtails the inappropriate use of antibiotics for viral infections but also prevents secondary bacterial infections that might necessitate antibiotic treatment.

Dr Vickie Braithwaite, public health registrar in the public health commissioning team said:

Everyone can play their part in reducing the growing threat of antimicrobial resistance by keeping up to date with your vaccinations. It is never too late to receive your childhood vaccines (such as 2 doses of MMR). Make sure that you are up to date with your seasonal vaccinations too (such as COVID-19 and flu).

Event resources and Vaccine Update features

If you would like to feature literature from our immunisation collection at a local event in your area, please do get in touch at Immunisation@ukhsa.gov.uk

We can help tailor a pack of resources for your event and send them out to you for free to support awareness of the immunisation programmes.

If you would like to be featured in a future edition of Vaccine Update, please get in touch.

Vaccine supply

Routine vaccination programme

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

Christmas and New Years 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 December 2023
• Tuesday 26 December 2023
• 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 that also covers delivery schedules.

For customers with standard delivery day of Monday, note that after Monday 18 December 2023, your next available delivery day will be Monday 8 January 2024.

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 1 January 2024	Closed	No deliveries or order processing	New Year’s Day
Tuesday 2 January 2024	Thursday 28 December 2023	11.55AM	Bank Holiday in Scotland only – orders delivered on 3 January
Wednesday 3 January 2024	Friday 29 December 2023	11.55AM
Thursday 4 January 2024	Tuesday 2 January 2024	11.55AM
Friday 5 January 2024	Wednesday 3 January 2024	11.55AM
Monday 8 January 2024	Thursday 4 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 aged 4 to under 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 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 under 2 years
• children aged 2 years to under 18 years in clinical risk groups for whom LAIV is clinically contraindicated or otherwise unsuitable
• healthy children from aged 2 years 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 (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 NHSE 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 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.
• MSD: Vaxneuvance 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: MenQuadfi is available

Yellow fever

Sanofi : 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 but subject to order caps of 10 packs/per customer/per week
• Patientric: Vaxchora is available

Japanese encephalitis vaccine

Valneva: Ixiaro is available but subject to a temporary order cap of 10 doses/ per customer/per week with effect from week commencing 6 November until unconstrained supply returns (expected week beginning 20 November).

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 out of stock – expected recovery Q4

Herpes zoster vaccine

GSK: Shingrix is currently available