Month: January 2023

Uptake of influenza vaccination in pregnancy

Our study published today in the British Journal of General Practice shows how the uptake of flu vaccination in pregnancy varies with age, ethnicity and socio-economic deprivation.

Pregnant women are at an increased risk from influenza (flu), yet uptake of  Seasonal influenza vaccination (SIV) during pregnancy remains low, despite increases since 2010.

Getting the flu vaccine when pregnant is important, because it reduces the risk of severe disease, complications and adverse outcomes for both mother and child such as pre-term birth. However, uptake was lower among women living in more deprived areas, women who were younger or older than average, Black women and those with undocumented ethnicity.

Although the flu vaccine is safe and recommended for pregnant women, misconceptions about safety play a role in pregnant women not being vaccinated and flu vaccination levels among pregnant women are suboptimal worldwide.

In the UK, since 2010, the Joint Committee on Vaccination and Immunisation (JCVI) has recommended that pregnant women get the flu vaccine to provide protection during the winter flu season. Despite these recommendations, data from Public Health England (now the YK Health Security Agency) showed that in 2020-21, fewer than half of pregnant women were vaccinated.

Previous studies of influenza vaccine uptake during pregnancy have either used data from a single care provider, or from surveys. Our retrospective cohort study looked at 450,000 pregnancies among 260,000 women in North West London, over a ten year period. By applying statistical models to data on women’s age, ethnicity, health conditions and socio-economic deprivation, we were able to identify groups with lower uptake of the flu vaccine.

Misconceptions about the safety and efficacy of antenatal vaccinations play a role in pregnant women being unvaccinated, while recommendation by health professionals improves uptake. To ensure access to vaccines, for high uptake among pregnant women, strong primary care systems are needed and targeted approaches are recommended to reducing inequalities in access to vaccination and should focus on women of Black ethnicity, younger and older women, and women living in deprived areas.

Update for Primary Care Clinical Team 19 January 2023

1. Covid-19 statistics update

After a peak in December, Covid-19 cases, hospital admissions and deaths have begun to decline in January 2023. We are though likely to see further waves of infection later in the year.

2. Covid-19 vaccine boosters

Uptake of Covid-19 boosters has plateaued at a lower level than we hoped for. In England, around 64.4% of people aged 50 and over have received a booster in the current campaign. In Lambeth, only 40% of people aged 50 and over have received a Covid-19 booster, well below the national average. Pleas encourage patients to attend for a booster if they are eligible.

3. Covid-19 treatments

Some people at highest risk of becoming seriously ill from COVID-19 are eligible for antiviral treatments on the NHS. These include some patients with cancer, blood conditions, kidney disease, liver disease and autoimmune conditions, among others.  GP reception staff must arrange an appointment with the clinical team if a patient calls and says they are eligible for these treatments, have tested positive for COVID-19 and have not been contacted about treatment.

My view is that the NHS England treatment pathway is flawed. Asking patients to contact their general practice delays the start of treatment and adds to GP workload. Patients should have been asked to contact their local CMDU directly if they have not been contacted about treatment after a positive Covid-19 test. Any failure by the local CMDU to contact a patient should be seen as an SEA.

 4. Influenza

The latest UKHSA report shows that influenza admissions in London have started to fall from their peak in February. See recent Evening Standard article. https://www.standard.co.uk/news/london/london-past-peak-flu-wave-nhs-azeem-majeed-b1053535.html

We were expecting a larger flu wave in the Winter of 2022-23 because of the greater social missing this winter and the low levels of flu over the previous 2 years.

5.  NHS pressures

The NHS in England has experienced exceptionally high pressures in recent weeks, leading to the Prime Minister holding an emergency NHS summit on Saturday 7 January. We await the outcome of the summit. Strike action is adding to NHS pressures. We need to consider a team how we can support our patients and manage workload.