GPs Urged to be Cautious with Child Flu Vaccines

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The Medical Defence Union (MDU) is advising GPs and practice nurses to take extra care when immunising children with seasonal flu vaccines after becoming aware of a handful of cases where the incorrect vaccine has been given.

Although this number of adverse incidents is low considering the numbers of immunisations given, vaccine errors do represent a sizeable proportion of the medication incidents notified to the MDU.

The Medical Defence Union (MDU) is advising GPs and practice nurses to take extra care when immunising children with seasonal flu vaccines after becoming aware of a handful of cases where the incorrect vaccine has been given.

The MDU has received a number of calls from members on its advice line recently where there has been a mix-up over the type of vaccine administered to children. In addition, a survey of cases reported to the MDU has revealed that 108 immunisation errors were reported over the last five years. Of these, 98 (90%) involved children and three concerned doctors administering the incorrect seasonal influenza vaccine to children.

Dr Jacqui Phillips, MDU medico-legal adviser said:
“Although this number of adverse incidents is low considering the numbers of immunisations given, vaccine errors do represent a sizeable proportion of the medication incidents notified to the MDU.

“Not all seasonal flu vaccines are suitable for children and GPs need to ensure that neither they nor practice staff administer the incorrect ones. According to Department of Health guidance1 certain specific and generic influenza vaccines should not be used in children under five after epidemiological evidence in Australia suggested that there was an increased risk of febrile convulsions following immunisation. In addition certain vaccines are only licensed for use in children over 48 months of age.”

The MDU issued the following advice to help GPs and practice nurses avoid immunisation errors:

  •     Make sure you check the records before giving an immunisation.
  •     Take a full history from the patient including details of previous vaccinations and current medication.
  •     When seeking consent or parental authority for immunisation, this should include details of the proposed procedure, warnings of the risks involved, any side effects and alternatives.
  •     Check the status of the adult accompanying the child to be immunised. If the person does not have parental responsibility he or she will not be able to authorise the vaccination.
  •     Ensure you are familiar with the relevant guidance on which vaccine to use.
  •     GPs who delegate the patient’s immunisation to a nurse will still be responsible for the patient’s overall care and should ensure the person to whom they delegate is suitably qualified and experienced.2
  •     The healthcare professional administering the drug should check the product licence and document details of the drug, mode and site of injection as well as the batch number and expiry date.
  •     Ensure the practice has an agreed, up-to-date protocol, signed by the GP and practice nurse.
  •     Complete, legible and contemporaneous clinical records should be kept.
  •     If things do go wrong, apologise and provide a clear explanation. Ensure that you take steps to deal with the consequences and arrange appropriate treatment and follow-up.

Further information
1.    Department of Health, Gateway reference number 146123. Professor D M
Salisbury 28 July 2010
http://www.dh.gov.uk/prod_consum_dh/groups/dh_digitalassets/documents/digitalasset/dh_118017.pdf
2.    Paragraph 54, Good Medical Practice; GMC 2006

The MDU is a mutual, not for profit, organisation owned by our members who include over 50 per cent of the UK’s hospital doctors and GPs. Established in 1885, 2010 marks the 125th anniversary of the MDU leading the way in supporting and defending our medical members, we were the world's first medical defence organisation. We defend the professional reputations of our members when their clinical performance is called into question. Our benefits of membership include insurance* for claims of clinical negligence and a wide range of medico-legal advisory services.

Contact Susan Field or Dawn Boyall in the MDU’s press office on T: 020 7202 1535/1504, M: 07773 772816, E: fields(at)the-mdu(dot)com, boyalld(at)the-mdu(dot)com - the-mdu.com

Follow us on Twitter @The_MDU

*Insurance co-underwritten by SCOR UK Company Limited and by International Insurance Company of Hannover

MDU Services Limited (MDUSL) is authorised and regulated by the Financial Services Authority in respect of insurance mediation activities only. MDUSL is an agent for The Medical Defence Union Limited (the MDU). The MDU is not an insurance company. The benefits of membership of the MDU are all discretionary and are subject to the Memorandum and Articles of Association.

MDU Services Limited is registered in England 3957086. Registered Office: 230 Blackfriars Road London SE1 8PJ.

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