More than 11
million people in England will be targeted first
The priority groups who will be first in line for vaccination
against swine flu will include pregnant women, frontline health
and social care workers, and everyone in at-risk groups aged over
six months, Health Secretary Andy Burnham announced today.
This follows advice from independent experts on who should be
first in line for vaccination.
The Joint Committee on Vaccination and Immunisation reviewed the
evidence and advised the Department of Health on the crucial risk
groups to be offered vaccination in order to reduce the rate or
possibility of serious illness.
This advice was also scrutinised and endorsed by the Scientific
Advisory Group for Emergencies (SAGE).
The following groups will be prioritised in this order (numbers
given are approximate and are for England only):
People aged over six months and under 65 years in current
seasonal flu vaccine clinical at-risk groups (about 5 million
people). All pregnant women, subject to licensing conditions on
trimesters (about 0.5 million people).Household contacts of people
with compromised immune systems e.g. people in regular close
contact with patients on treatment for cancer (about 0.5 million
people).People aged 65 and over in the current seasonal flu
vaccine clinical at-risk groups (about 3.5 million people). This
does not include otherwise healthy over 65s, since they appear to
have some natural immunity to the virus.
Vaccination of frontline health and social care workers
(approximately 2 million people) will begin at the same time as
the first at-risk group, and will continue for as long as
necessary. This group is at increased risk of infection and of
transmitting that infection to susceptible patients. Protecting
these people will help the NHS workforce to remain resilient and
able to treat sick patients.
Preparations continue to be made to extend the programme beyond
these initial priority groups, and the Joint Committee on
Vaccination and Immunisation will consider this matter further and
report back in due course.
Health Secretary, Andy Burnham, said:
"The UK will be one of the first countries in the world
to receive a vaccine supply, thanks to contracts put in place by
the Government in advance of the pandemic.
"Ministers from all four nations have today accepted the
advice of the Joint Committee on Vaccination and Immunisation on
priority groups for H1N1 vaccination.
"We are now working with BMA and NHS organisations to
reach a comprehensive swine flu vaccine implementation plan for
this first stage of the programme.
"Although the virus has so far proved to be mild in most
people, for others it has been more serious. By vaccinating high
risk groups first, we aim to protect those most vulnerable to this virus.
"Our decisions at all times are based on advice from the
most eminent specialists, and this will continue to be the case as
we go forward."
Details of how the vaccination programme will be delivered are
being finalised, but listing the priority groups will enable the
NHS and social care sector to plan for the vaccination programme.
Supplies will be delivered as soon as they become available but,
due to natural limitations in vaccine production, the groups most
vulnerable to this new strain of influenza need to be prioritised.
Licensing
The vaccination programme is expected to begin in the Autumn,
subject to the vaccine being licensed by the European Medicines
Agency. The EMEA has strict processes in place for licensing
pandemic vaccines. The vaccine will not be used until it is
licensed. Manufacturers anticipate that licenses may be granted in
late September or October. Vaccination will commence as soon as
possible once licences are granted.
Risk benefit analysis
Experts have advised on the most vulnerable groups and completed
thorough risk benefit analyses. The virus has so far
disproportionately affected people in the at-risk groups outlined.
Therefore, our advice is that these groups would clearly benefit
from this vaccine at an early opportunity.
Whilst children are also disproportionately affected by swine
flu, the vast majority make a full recovery. As such, the experts
do not advise that children, other than those in at-risk groups,
should be vaccinated initially.
Next steps
Decisions on vaccinating the wider healthy population will depend
on the evolution of the pandemic as well as new and emerging
clinical data on the use of the vaccine. This will be kept under
close review.
Further operational guidance to the NHS on the roll out of the
programme will be made available in the next few weeks. The
Department of Health is working with the BMA and NHS organisations
to reach a comprehensive swine flu vaccine implementation plan.
People in the priority groups outlined do not need to take any
action yet. Further announcements will be made when the
vaccination strategy is ready, and people who need a vaccine will
be contacted.
Notes to Editors
1. Frontline health and social care workers will offered the
vaccine at the same time as the first clinical risk group as they
are at increased risk of infection and of transmitting that
infection to susceptible patients. Frontline healthcare workers
eligible for this vaccination programme are those also eligible
for seasonal influenza vaccination, as detailed in the Green Book
here: The Green Book was last updated in full in 2006 and is
available on line at http://www.dh.gov.uk/prod_consum_dh/groups/dh_digitalassets/@dh/@en/documents/digitalasset/dh_063632.pdf
2. Eligibility guidance for vaccination for frontline social care
workers is
The definition for social care workers is: “social care staff
who are employed to provide personal care to children and
adults, both in care homes and in the community”.
The Government has agreed the following definition, that
“Personal care" means:
physical assistance given to a person in connection with:eating
or drinking (including the administration of parenteral
nutrition),toileting (including in relation to the process of
menstruation),washing or bathing,dressing,oral care, orthe care of
skin, hair and nails (with the exception of nail care provided by
a chiropodist or podiatrist); orthe prompting, together with
supervision, of a person, in relation to the performance of any of
the activities listed in paragraph (a), where that person is
unable to make a decision for themselves in relation to performing
such an activity without such prompting and supervision.
Some examples of staff who would be included in this definition are:
Care home staff in residential/nursing homes who provide
personal care to residentsDomiciliary care workers employed by
agencies who provide personal care to service users in their own
homesPersonal assistants – staff employed to provide personal care
to a single service userStudents and trainees in these disciplines
And examples of people who would not be included are:
· Social workers
· Informal carers – family members and/or
friends
· Non care staff in residential/nursing homes
·
Housing staff – those who work in managing sheltered and similar
housing
· Staff working in child or adult safeguarding
·
Foster carers
The Department of Health (DH) has placed orders for sufficient
H1N1 swine flu vaccine for the UK population. The orders are with
GSK and with Baxter. Clinical risk groups for seasonal flu,
including examples (decisions are based on clinical judgement)
Chronic respiratory disease and asthma that requires continuous
or repeated use of inhaled or systemic steroids or with previous
exacerbations requiring hospital admission:
· Chronic obstructive pulmonary disease (COPD) including chronic
bronchitis and emphysema; bronchiectasis, cystic fibrosis,
interstitial lung fibrosis, pneumoconiosis and bronchopulmonary
dysplasia (BPD)
· Children who have previously been admitted
to hospital for lower respiratory tract disease
Chronic heart disease
· Congenital heart disease
· Hypertension with cardiac
complications
· Chronic heart failure
Individuals
requiring regular medication and/or follow-up for ischaemic heart disease
Chronic renal disease
· Chronic renal failure
· Nephrotic syndrome
· Renal transplantation
Chronic liver disease
· Cirrhosis
· Biliary artesia
· Chronic hepatitis
Chronic neurological disease
· Stroke
· Transient ischaemic attack (TIA)
Diabetes
· Type 1 diabetes
· Type 2 diabetes requiring insulin or oral
hypoglycaemic drugs
· Diet controlled diabetes
Immunosuppression
· Immunosupression due to disease or treatment
Patients
undergoing chemotherapy leading to immunosuppression
·
Asplenia or splenic dysfunction
· HIV infection
·
Individuals treated with or likely to be treated with systemic
steroids for more than a month at a dose equivalent to
prednisolone at 20mg or more per day (any age) or for children
under 20kg a dose of 1mg or more per kg per day.
· Some
immunocompromised patients may have a suboptimal immunological
response to the vaccine
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Contacts:
Department of Health
Phone: 020 7210 5221
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