Influenza/UK guidance

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In 2006-7 there may be delays in influenza vaccine supply.

Consequently, the CMO letter for England recommends that vaccine should be offered to people in the categories shown in [[Table: England Categories and priority for influenza vaccination 2006-7|the table below]] in priority order, with only those in category 1 being offered vaccine in the first instance, then those in category 2, and so on, to ensure that if supplies fail, those who need it most will have been vaccinated.[1]

Table: England Categories and priority for influenza vaccination 2006-7
Table: England Categories and priority for influenza vaccination 2006-7
Category (vaccine should first be given to those in category 1, then category 2, and so on) Description
1
2

Those living in long-stay residential care homes or other longstay care facilities where rapid spread is likely to follow introduction of infection and cause high morbidity and mortality (this does not include prisons, young offenders institutions, or university halls of residence)

3

Carers: Those who are the main carer of disabled or elderly whose welfare may be compromised if the carer falls ill.

4

Healthcare Workers

5

Any other groups

The JCVI has recommended that in the 2007-8 season (not the forthcoming 2006-7 season):

""The Subgroup recommended that pregnant women in the second and third trimesters, i.e. those who have an estimated date of delivery (EDD) between 1 November and 31 March be added to the list of 'at risk' groups who should be offered influenza vaccine.
"The advice will be taken to the next main JCVI committee meeting for consideration for the 2007/08 immunisation programme. The Subgroup emphasised that this recommendation referred to inactivated vaccine only."[2]
Table: Clinical Risks Groups 2006/7
Clinical Risks Groups 2006/7
Clinical Risk Group Examples
Chronic respiratory disease & 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 Atresia
  • Chronic hepatitis
Diabetes requiring insulin or oral hypoglycaemic drugs
  • Type 1 diabetes
  • Type 2 diabetes requiring oral hypoglycaemic drugs
Immunosuppression
  • Immunusuppression 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 20mgs or more per day (any age) or for children under 20 kgs a dose of 1mg/kg/day

Some immunocompromised patients may have a suboptimal immunological response to the vaccine

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