Clinical

PHE Notice - Re: Shortage of hepatitis B vaccines - recommendations for national clinical directors

Dr. Mary Ramsay and Dr Sema Mandal
Immunisation, Hepatitis, Blood Safety and Countermeasures Response

There is a global shortage of hepatitis B vaccine which is currently impacting severely on the UK supply. The situation is particularly critical during August but limitations on supply are likely to continue until early 2018. To ensure that stock is available for those individuals at highest and most immediate risk of exposure to hepatitis B, Public Health England (PHE) has developed temporary recommendations to support clinicians undertaking an individual risk assessment.

PHE and Department of Health (DH) have been working with both vaccine manufacturers to institute ordering restrictions according to customer type. The allocation is based on an agreed assessment of the proportion of vaccines used by that provider type for individuals in the highest priority groups. As a consequence, some providers may not be able to order any stock and others will have limits applied to their orders. A mechanism will be in place, however, to allow for exceptional orders if there is an urgent and immediate need for an individual following an individual risk assessment.

NHS Hospital Trusts will get the highest allocation, but it has been agreed with the BMA's General Practitioners Committee that general practice will not be able to order any adult hepatitis B vaccine stock until further notice. Because of this, patients requiring post-exposure hepatitis B vaccination will be referred to urgent care or Accident and Emergency based in NHS trusts for an assessment. In addition, specialist services such as liver services, who may normally request that GPs offer hepatitis B vaccination to their patients should note that the GP may not be able to meet this request.

To sustain supply for those at greatest need, all services are being asked to:

  • ensure that clinicians are aware of the temporary recommendations on prioritising vaccines
  • only order essential vaccine stock (small amounts more frequently) and avoid stockpiling
  • coordinate and monitor stock usage across the service to ensure that scarce stock is being used responsibly
  • accept and use alternative products including combined hepatitis A and B vaccines, and other presentations (e.g. multi-dose packs)

The full list of recommendations may be downloaded below: