Vaccination Programme:
October 29, 2009

The national swine flu vaccination programme started recently when the first batch of vaccines was delivered to NHS acute trusts across the country. This batch of vaccines is being used for protecting frontline staff and patients in at-risk groups in hospitals. Around two million frontline health and social care workers are being offered the vaccine. 

Chief medical officer, Sir Liam Donaldson, said, “Vaccination will ensure protection of the clinical risk groups, and frontline health and social care workers. Not only will vaccination help staff protect themselves, their patients, colleagues and families, it will reduce demand on critical care which is likely to come under heavy pressure during the months ahead.”

Who will be vaccinated?
The clinical high risk groups were identified by the Joint Committee for Vaccination and Immunisation (JCVI). These groups have been prioritised as they are at a greater risk of complications from swine flu, and hence the initial focus is on protecting individuals in these groups. GP practices will initiate swine flu vaccination sessions as soon as they receive the vaccine.  

In order of priority, the high risk groups are:
1. People aged six months to 65 years, who normally get the seasonal flu jab;
2. Pregnant women;
3. Household contacts of people having weak immune systems;
4. People aged 65 and over, who normally get the seasonal flu jab. This does notinclude otherwise healthy over-65s; 

Frontline health and social care staff will be the first to be offered the vaccine.  

Dr Tony Hill, director of public health, North East Lincolnshire Care Trust Plus said: “It is likely that some people will fall in two or more of the above groups. Front line health and social care workers will be vaccinated alongside the above high risk groups.  

“The swine flu vaccine is voluntary. However, we strongly encourage everyone in a high risk group, including all frontline NHS staff, to have it. Ultimately, it is down to an individual to decide whether they, or any children in their care, have the vaccine or not. This is the same for all vaccines, not just swine flu.” 

Frontline health and social care staff
Staff who will be invited to have the vaccine include everyone who has regular clinical contact with patients and those who are directly involved in patient care. This includes doctors, dentists, midwives, nurses, paramedics, ambulance drivers, occupational therapists and radiographers, for example. Students and trainees in these disciplines, and volunteers working with patients will also be included. 

Eligibility is not about a person’s job title, but the work they are doing, i.e., if a person is providing frontline healthcare, they should have the vaccine. 

In North East Lincolnshire, the following practices will be providing staff vaccinations:
Fieldhouse, Freshney Green Primary Care Centre
Ashwood, Weelsby View Primary Care Centre
Dr Sharma practice, North Sea Lane
Roxton Practice, Immingham  

It is safe for people to carry on with normal duties after they’ve had the vaccine. The vaccines contain inactivated forms of the virus, so they do not make the person infectious. 

It is expected that this swine flu vaccine will provide protection against swine flu for several years after vaccination. However, it is important to stress, the swine flu vaccine will ONLY protect against this particular flu strain. Those who normally get the seasonal flu vaccine must continue to have their annual seasonal flu jab in order to be protected from the ‘normal’ seasonal flu. 

When will the vaccine be available?
Phyllis Cole, swine flu vaccination lead for North East Lincolnshire Care Trust Plus, said: “The delivery of vaccines to GP surgeries has started. It will take around 3-4 weeks to complete the distribution of first supplies to all practices.  

“The UK has purchased two different swine flu vaccines, Pandemrix (from GSK) and Celvapan (from Baxter). Both have been licensed for use by the European Commission. Information on the vaccines and their licenses are on the EMEA website (see www.emea.europa.eu)  

“Baxter and GSK have different methods of producing the vaccine. The main difference is in the way the virus used in the vaccine is produced.  

“The virus for the Pandemrix is prepared in hens’ eggs, the same way as the seasonal flu vaccine. Celvapan is made from virus that is grown in cultured cells. 

“These vaccines have undergone clinical trials involving many thousands of people, including the elderly and young children, which showed these vaccines are generally safe and effective.” 

Previous studies have also shown that changing the strain of virus in a vaccine does not substantially affect its safety profile. These extensive trials therefore strongly suggest that the new swine flu vaccines carry a very low risk.  The Department of Health will continue with clinical trials involving the swine flu vaccine to monitor for any sign of rare side effects.

But the evidence that is currently available suggests that the risk of a serious reaction is extremely small, and outweighed by the risk of falling seriously ill from the virus itself. 

Exceptions:
There are very few people who cannot receive swine flu vaccines. The vaccine should not be given to people who have had an anaphylactic reaction to the vaccine or a component of the vaccine.  

Phyllis Cole explained: “Pandemrix is not suitable for individuals, including children, with a history of severe anaphylactic reaction (shock or acute difficulty in breathing) after egg containing products; they should receive Celvapan. It should, however, be given to individuals, including children, with less severe allergic reactions to egg.  

“Pandemrix and Celvapan can be co-administered with all other vaccines, including seasonal flu and childhood vaccines.” 

Some porcine products are used in the manufacturing process of the Baxter vaccine. However, there are no detectable traces of these products in the vaccine itself. Pandemrix does not contain porcine products. For more advice on vaccines and faith groups, please see:www.immunisation.nhs.uk/Library/Search?stags=&terms=porcine  

Children and young people
JCVI confirmed its earlier advice that Pandemrix should be the vaccine of choice for children and young people up to 18 years of age. This is because currently there is no paediatric data available for Celvapan.  People who have had laboratory confirmed swine flu infection do not need to be vaccinated although, the vaccine can be given to these individuals with no ill effects.  

Pregnant women
Pandemrix can be given to pregnant women. It is recommended that pregnant women receive the vaccination as we know they are particularly vulnerable to the swine flu virus.  Indeed, figures from the US have shown that pregnant women are four times more likely to develop serious complications from swine flu and four to five times more likely to be hospitalised. 

Expert scientific advice is clear that thiomersal-containing vaccines do not present a risk to pregnant women or their baby.

Seasonal flu Vs swine flu:
The seasonal flu campaign will continue as normal. Some surgeries have already started conducting sessions for their seasonal flu vaccination. The swine flu vaccine can be given at the same time as other vaccines, including the seasonal flu vaccine. 

Swine flu is a new virus which means most people don’t have any inbuilt resistance to it. People who never normally get ill from seasonal flu may therefore get sick from swine flu. It has been seen that swine flu can lead to serious complications. The most severe cases tend to involve people with underlying health conditions, but even among healthy people, swine flu has the potential to be a dangerous disease.


Important advice about antivirals and forms of ID
July 24, 2009

The National Pandemic Flu Service (NPFS) website (www.direct.gov.uk/pandemicflu) and phone line (0800 1513 100 or 0800 1513 200 (textphone)) will give people who have swine flu symptoms a unique access number and information of their nearest antiviral collection point.  

People should only contact their doctor directly rather than using the NPFS if:

• they have a serious underlying illness;
• they are pregnant;
• they have a sick child under one year old;
• their condition suddenly gets much worse; or
• their condition is still getting worse after 7 days (5 for a child).

 Due to the limited amount of stock available Oseltamivir Solution/Suspension will be reserved for the treatment of infants aged between 2 months and 1 year. When contacting the GP it would be useful to know the weight of children under the age of one year as their dosage will be based on weight. Further detailed information is available on the NHS Choices website www.nhs.uk by entering a search on Tamiflu or Relenza. Normal prescription charges do not apply to antiviral medicines.  

Dr Tony Hill, Director of Public Health said:

“If patients are unable to swallow capsules they can open them and mix the contents with a suitable, small amount (1 teaspoon maximum) of sweetened food product such as yogurt, apple sauce, sugar dissolved in water, regular or sugar-free chocolate syrup or dessert toppings, condensed milk, or honey (only for children two years or older) to mask the bitter taste.”  

A flu friend – a friend or relative who can collect the antiviral – will require identification documents for themselves as well as the patient in order to pick up the antiviral from a recommended collection point. The unique access number and ID information will be checked at the collection point to make sure it matches the information provided during the assessment of symptoms. 

The following documents will be accepted as forms of ID: 

• Passport
• Driving licence
• Paid utility bill (not less than 6 months)
• Building society/national savings book
• Cheque guarantee/credit card/debit card
• Cheque book
• Credit card statement (not older than 6 months)
• Council tax payment book
• Birth/marriage certificate
• Military ID
• Trade Union card
• Standard Acknowledgement letter (SLA) issued by Home Office for Asylum seekers
• Child benefit letter
• Parent held record (red book)
• NHS card
• Healthcare professional registration number and ID
• Pension/benefit book

For general advice and information about swine flu, call the National Flu line on 0800 1 513 513.

*****

Active Antiviral Collection Points
24/07/09

TESCO (GRIMSBY), MARKET STREET, GRIMSBY, DN31 1QS 01472 623447	Mon 08.00-22.30 Tue-Fri 06.30-22.30 Sat 06.30-22.00 Sun 10.00-16.00 then via security guard 16.00-18.00
LLOYDS PHARMACY, 18A DUDLEY STREET, GRIMSBY, DN312AB 01472 241769	Mon – Fri 09.00-13.00 & 14.00-18.00 Sat & Sun Closed
LLOYDS PHARMACY, 168C SUTCLIFFE AVENUE, NUNSTHORPE, GRIMSBY, DN33 1HA 01472 879568	Mon–Fri 09.00-18.00 Sat 09.00-13.00 Sun Closed
E A BROADBURN, 34-36 LOUTH ROAD, SCARTHO, GRIMSBY, DN33 2EP 01472 879181	Mon–Wed 09.00-17.30 Thur 09.00-13.00 Fri 09.00-17.30 Sat 09.00-12.00 Sun Closed
LLOYDS PHARMACY, 208 LITTLECOATES ROAD, BRADLEY CROSSROADS, GRIMSBY, DN34 5SU 01472 871112	Mon–Fri 08.30-18.00 Sat 09.00-17.30 Sun Closed
LINCOLN CO-OP, 121 GRIMSBY ROAD, CLEETHORPES DN35 7DG 01472 343155	Mon – Fri 09.00--12.00 & 13.00-18.00 Sat 09.00-12.30 Sun Closed
LLOYDS PHARMACY, 55 FIELDHOUSE ROAD, HUMBERSTON, GRIMSBY, DN36 4UJ 01472 812323	Mon–Fri 08.30-17.30 Sat 08.30-17.00 Sun Closed
COTTINGHAM CHEMIST, 41 HIGH STREET, WALTHAM, GRIMSBY, DN37 0LJ 01472 230042	Mon–Fri 08.45-17.30 Sat 08.45-17.00 Sun Closed
LLOYDS PHARMACY, 8 CAISTOR ROAD, LACEBY, DN37 7HX 01472 753375	Mon–Tue 08.30-13.00 & 14.00- 18.30 Wed 08.30-13.00 Thur-Fri 08.30- 13.00 & 14.00- 18.30 Sat & Sun Closed
LLOYDS PHARMACY, 33 - 35 KENNEDY WAYIMMINGHAM, DN40 2AB 01469 572699	Mon - Fri 9.00-18.00 Sat 9.00-17.00 Sun Closed

*****

Antiviral Advice
22/07/09  

You may be aware that people diagnosed with swine flu by the GP and especially those that have a chronic health condition, are being offered antiviral medication.

The time between infection and appearance of symptoms for swine flu can be up to seven days, but is most likely to be between two and five days. People are most infectious to others soon after they develop symptoms, although they continue to spread the virus (in coughs and sneezes) for up to seven days. 

People should NOT go to their GP practice, A&E, Walk-in Centres or their chemist if they suspect they have swine flu in order to reduce the risk of others catching it and to help the NHS treat people who may need other urgent medical care. 

If you think you have swine flu, 
1. In the first instance, check the internet based online symptom checker at www.nhs.uk, or telephone the National Flu Information Line on 0800 1 513 513 for advice.
2. If necessary, you will be advised to telephone your own GP for a local diagnosis and treatment which will be normally carried out over the phone. Your GP will confirm whether you need an antiviral. 
3. If you are prescribed an antiviral by your GP, a healthy friend or relative (flu friend *) can pick up the prescription from the GP practice and collect the antiviral drugs from an antiviral collection point. It is important to complete the prescribed course. 
4.  If you feel you have symptoms of swine flu and you feel you may require urgent medical attention because of it, telephone your GP. If the surgery is closed follow their instructions for contacting the emergency doctor. Do not turn up at A&E unannounced as you could expose other people to the infection.  

If you are diagnosed with swine flu, your GP will confirm whether an antiviral is required and if so, what you need to do in order to collect it. If prescribed an antiviral, you will need to identify a flu friend to go and pick up the prescription from your GP practice and they will be told where to collect the antiviral drugs from.  

The antiviral is not a cure, but it can help you recover by:

• Relieving some of the symptoms;
• Reducing the length of time you are ill by around one day; and
• Reducing the potential for serious complications, such as pneumonia.

 It is worth remembering though that antivirals, such as Tamiflu, can have side effects including:

• Nausea;
• Vomiting;
• Abdominal pains; and
• Headaches.

 It is important to remember that many people will be able to recover from swine flu without the need for antivirals. If you are not in a higher risk group and have no underlying medical conditions you probably do not need any medication and can treat yourself at home with over-the-counter Paracetamol-based cold remedies. Remember to keep hydrated and drink plenty of fluids.

*See Swineflu FAQ for more information on flu friends.

*****

Swine Flu - Diagnosis & Treatment
21/07/09

It appears that concern over the gravity of the current swine flu situation has led to a rapidly escalating number of calls to GPs nationally.  The clinical evidence shows that, in the majority of cases, swine flu is a mild, self limiting condition and its symptoms are similar to those of seasonal flu. 

If you have swine flu, you will have a high temperature which is 38C (around 100F) or above. You may also have two or more of the following symptoms:
cough
sore throat
runny nose
severe tiredness
loss of appetite
pain in muscles and joints
headaches.

Some people may also have diarrhoea or vomiting. 

If you think you have swine flu, you should:
1. In the first instance, check the internet based online symptom checker at www.nhs.uk, or telephone the National Flu Information Line on 0800 1 513 513 for advice.  
2. If necessary, you will be advised to telephone your own GP for a local diagnosis and treatment which will be normally carried out over the phone. Your GP will confirm whether you need an antiviral. 

Most people will begin to feel better after a few days without taking an antiviral. For those who are prescribed an antiviral, ten pharmacies in North East Lincolnshire are currently available for the distribution of antiviral medication. One course of the medicine is then available per person. The antiviral is not a cure but it can relieve some of the symptoms, shorten the duration of the illness by a day and reduce the likelihood of complications.

It is worth remembering though that antivirals, such as Tamiflu®, can have side effects including:
• Nausea;
• Vomiting;
• Stomach aches 

Deputy Director of Public Health, Geoffrey Barnes said:

“It is important to remember that alongside dealing with current enquiries over swine flu, GPs have the ongoing task of treating their normal patients as well. Ringing your GP with questions which can be answered by NHS direct on 0845 4647 (www.nhsdirect.nhs.uk) or the NHS swine flu information line on 0800 1 513 513 may cause unnecessary delays for those requiring other urgent medical help."