Flu jab cost to NHS

Archergirl wrote: »

Just wondering about this, not moneysaving to us but maybe to the NHS ... Which is more cost effective for the NHS, getting your flu jab at the doctors by a nurse or getting it done at the chemist?

In pure NHS cost just for the shot service, probably the chemist. In overall service delivery probably the GP. Vaccine only costs are on page 3 of the vaccine program update.

For an adult under 65 whichever place offers the cell-based quadrivalent vaccine instead of the quadrivalent egg-based is likely to be the best choice. Quadrivalent means it protects against four types of flu virus. The new this year choice is grown in mammal cells (QIVc) instead of eggs and because of this difference it adds about 20 percentage points to the effectiveness against flu type A(H3N2). Egg-based (QICe) is less effective for this particular type because it's changed to do better in eggs than against the type in humans, a process called egg adaptation. The various A(H3..) types are currently the most common ones being found in the UK by the national flu monitoring program but this may well change to an A(H1...) type when the main flu season comes along. Cell-based will be used for everyone in this group with an egg allergy. As an individual patient you might as well go for the most effective vaccine. Egg QIVe costs £8.00 or £9.94 depending on brand, cell QIVc £9.94.

For 65 and over the egg types QIVe for under-65s aren't offered because they aren't effective enough. It's age that makes the under 65 types unsuitable (but better than nothing) because we respond less to vaccines as we get older. The risk is higher in this group overall so getting any of the types is what matters. You're quite likely to be given a trivalent (three types of flu) vaccine that's had adjustments made to get better protection for older people (adjuvanted trivalent, aTIV) but might get a quadrivalent cell-grown one instead. It's currently unclear which is best. As of 17 October around 40% of GP patients in this group had already been vaccinated. Adjuvanted trivalent costs £9.79, QIVc £9.94.

GPs can get extra payments for advanced services mainly related to getting more people immunised, including letters and texts.

A GP might divert you from a nurse to a doctor if that seems useful due to some other health factor.

You can read the Joint Committee on Vaccination and Immunisation's Advice on influenza vaccines for 2019/20 or learn more from their minutes.

For more on flu vaccination in the UK see chapter 19 of the green book.

Lots of coverage of specific groups but free NHS immunisation is also available to those in regular contact with them can also get it free at their GPs discretion, including:

• those who are in receipt of a carer’s allowance, or those who are the main carer of an elderly or disabled person whose welfare may be at risk if the carer falls ill. Vaccination should be given on an individual basis at the GP’s discretion in the context of other clinical risk groups in their practice
• others involved directly in delivering health and social care such that they and vulnerable patients/clients are at increased risk of exposure to influenza
• health and social care staff directly involved in the care of their patients or clients
• those living in long-stay residential care homes or other long-stay care facilities where rapid spread is likely to follow introduction of infection and cause high morbidity and mortality (this does not include prisons, young offender institutions, university halls of residence etc.)

Fascinating James! How easy is it to find out which vaccine is offered at eg Superdrug vs Boots? I just ask?

Very interesting posts, James.