The relationship we have with the flu is a funny one – the fact that we usually use a nickname instead of the full title (Influenza) for a constantly mutating, potentially lethal infection is in itself an oddity. Although there are massive national campaigns warning of the dangers of flu each year, it is often unclear in the public’s eyes what the differences are between a bad case of the common cold and a true case of influenza. There are those who will soldier on into work with a blocked nose and sore throat, proclaiming to all that they are the victims of this malicious virus, whereas if this was the case, they most likely wouldn’t be standing, and certainly shouldn’t be coming in to the office to share their misfortune. I am by no means belittling the misery that the cold can cause – like most people, I have experienced this first hand! What I am trying to get across is how unusual it is that this virus doesn’t seem to be on our collective consciousness as a serious health issue, which can be reflected in the relatively poor uptake of the flu vaccine by some sectors of Scotland’s population, an inexpensive but effective way of lowering your chances of a week or two laid up in bed – or worse.
The flu can knock healthy adults for six, but a full recovery is usually made within a couple of weeks. On the other hand, there are certain groups of people who are at an increased risk of complications, and are provided the vaccine for free on the NHS.
Those over 65 are more susceptible to chest infections and pneumonia as a result of the flu, and as such they are targeted to receive the vaccine every year. Generally, the uptake is good in this age range, usually just exceeding the NHS target of over 75 per cent of the target group being immunised. This not only protects each individual, but limits the spread of the virus through the older population by providing what is known as “herd immunity”.
Those who have certain pre-existing health conditions are also targeted by the NHS to reduce the risks of ill health and hospitalisation. Diseases such as diabetes, heart disease and lung diseases mean that patients are at risk of not just direct complications, but also of their disease state worsening – an example would be the increased risk of an asthma attack.
Pregnant women also fall into this category, as the flu can result in premature labour, low birth weight and in rare cases miscarriage. In contrast to the over-65s, these groups have never come close to meeting the 75 peer cent target for vaccine uptake. This may be partially explained by the current arrangements for provision. If a patient has an appointment with their GP or nurse in the run-up to winter, they will often be offered the vaccine there and then. However most patients won’t have an appointment and the most common option is to attend on one of a few set days where the surgery will try to vaccinate as many people as possible – a flu clinic. These may be run on weekends to accommodate patients who work, but they are often still unsuitable for those wishing to get the vaccination through no fault of the surgeries – they only have capacity to run a limited number of clinics.
A proportion of working patients with pre-existing conditions or who are pregnant and wish to receive the vaccine are left with the choice of paying for a private service such as in community pharmacy, where most people over the age of 16 can (and should!) access the service for a small fee.
With more pharmacies offering flu vaccinations in local communities at convenient times, one of the easiest ways to help the NHS achieve their targets would be to allow community pharmacies to vaccinate these patients on behalf of the NHS at no cost to the patient.
Unfortunately, although our counterparts in England have been able to do this for the past two years (to great success), legislation does not allow for this to happen in Scotland . . . yet. Community Pharmacy Scotland is dedicated to realising this ambition and being able to complement the existing arrangements in doctor’s surgeries, giving patients greater choice and dealing a major blow to this often-underestimated virus. Until then, pharmacists will continue to use their private flu services to defend against winter illness for those who choose to access them.
Harry McQuillan, chief executive of Community Pharmacy Scotland