The House of Commons Science and Technology Committee was shocked by survey results which showed that the flu vaccination uptake in social care settings was at best around 25%.
The Committee was prompted to undertake this inquiry as a result of the high disease burden of flu in 2017/18, high hospitalisation rates and discussions on the variable uptake of the flu vaccination.
In March 2018 the Committee held a one-off oral evidence session on the flu vaccination programme and heard from Public Health England, NHS England, the Deputy Chief Medical Officer for England and others.
Uptake of the vaccine in social care settings
The Committee was shocked to find such a low uptake of the flu vaccination in social care settings, given that 2017/18 saw the worst flu outbreak for seven years. The Committee heard that an ad hoc Public Health England (PHE) survey of care homes had revealed ‘huge variability, with the best [uptake] at 25%’, with a low response rate to PHE’s questions.
There should be an expectation of full coverage amongst social care staff.
The Committee was also concerned that data on vaccination rates of staff in care homes was not routinely collected due to the “complexity of care homes”, making scrutiny of uptake rates difficult.
Rt Hon Norman Lamb MP, Chair of the Science and Technology Committee, said:
“The flu season is upon us again and it’s outrageous that so few social care staff appear to be vaccinated. Data is not routinely collected on uptake rates and any data that is collected is not published—this is a significant flaw in the system. Publishing data could be a key tool in further encouraging uptake of the vaccine.
“Some of our most vulnerable people are living in care homes and more must be done to protect them. Everyone caring for the elderly and infirm should see it as a professional duty to minimise the risk of passing on flu. The Government should aim for 100% vaccination of social care workers to ensure the protection of those most vulnerable to the effects of flu”
Mandatory vaccinations for healthcare workers?
Vaccination uptake among healthcare workers is significantly higher than among social care workers and has increased in recent years. However, the Committee found that there was still huge variation in the level of vaccination among frontline staff. In 2017/18 the lowest level of vaccination at trust level was 38.9% and the highest level was 92.3%.
The Committee welcomes recent steps by NHS England and NHS Improvement to increase uptake rates. The Committee calls for a review into whether vaccination should be mandatory for healthcare workers by February 2019.
Norman Lamb MP said:
“The huge variation in uptake rates of the flu vaccination among healthcare workers is unacceptable. The fact that some trusts manage to get such high uptake rates demonstrates that what is being asked is not unachievable. It is time for many trusts to up their game and encourage their staff to get vaccinated.
“Welcome steps have been taken by NHS England and NHS Improvement to encourage frontline hospital staff to be vaccinated but the time has now come for the Government to consider whether the flu vaccine should be mandatory for healthcare workers”
The Committee also recommends that:
- the Government ensures that research into better understanding of the causes of unacceptable variation in vaccine uptake takes place;
- the Government continues to look at what actions work to increase flu uptake and invests in campaigns that are proven to be successful;
- the Care Quality Commission should continue to assess how well trusts have performed their role in encouraging flu vaccination uptake and take action where fundamental standards relating to infection prevention and control have not been met;
- the Government should review information collection and determine how vaccination uptake data can be collected from care homes;
- an effective system of data collection on uptake rates in social care should be established by the 2019/20 flu season;
- the Care Quality Commission should take action where poor immunisation rates (or poor recording of uptake) in social care could impact on standards of infection prevention and control;
- the Government should look at ways in which uptake among social care staff could be improved and establish the same principle as now exists in the NHS—the aim of 100% coverage;
- co-operation between GPs, Public Health England, NHS England and flu vaccination manufacturers should continue so that GP practices can change their orders following a change in advice;
- the Government should take account of the future relationship with the European Medicines Agency and the impact this could have on flu vaccination in the UK as part of preparations for the UK leaving the European Union; and
- the Government should ensure that it continues to support and invest in the development of important new medical products, including new and more effective vaccines.