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Limited Stock of Hepatitis B Vaccine

Background

There are only two global manufacturers of hepatitis B vaccine, and both have had manufacturing problems. The only current supplies are from GSK, who will have no new vaccine produced at all this month, and the problem will not be alleviated until we are well into 2018.

GSK have been discussing with PHE how to prioritise supplies.

PHE have produced guidance on this which can be found here

https://www.gov.uk/government/publications/hepatitis-b-vaccine-recommendations-during-supply-constraints

Vaccines for children are not affected, neither the neonatal vaccine nor the new hexavalent one that will be used for all children from now on.

Initial proposal

PHE are, quite rightly, prioritising supplies to where they can produce most benefit. They cannot enforce these plans but GSK are in agreement that they will no longer supply private travel clinics or private occupational health services. Supplies to NHS occupational health and hospital trusts will continue.

They intended to supply all GP customers with one vaccine a month, to be used as the practice felt best according to the recommendations in the PHE guidance.

Problems

1. The proposed supply arrangements did not reflect the differing sizes of populations served by each ‘GP Customer’

2. The guidance is complex and most GPs have other pressures on their time.

3. GPs would face the prospect of criticism either if using their single vaccine for a patient and then not having one available for a more deserving patient, or declining to immunize a lower-priority patient who nevertheless was in a recommended group.

Agreement.

Rather than agree to an inadequate supply of vaccine, we have agreed with PHE that CSK will not supply GPs with any vaccine at all until the supply problems are resolved, on the basis that it is easier to have none and ‘just say no’ than to be a rationer of an inadequate supply. This will improve the supply to hospital trusts who can prioritise according to the guidance.

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