The global shortage of hepatitis B vaccine is currently impacting severely on the UK supply. The situation has become particularly critical during August, but limitations on supply are likely to continue until early 2018. To ensure that stock is available for those at highest and most immediate risk of exposure to hepatitis B, temporary recommendations have been developed by Public Health England (PHE) to support practitioners undertaking individual risk assessment.
To further ease the situation, PHE and the Department of Health, in liaison with partners in the devolved administrations have been working with both manufacturers of UK licensed vaccine to put in place ordering restrictions according to customer type. The allocation is based on an assessment of the proportion of vaccines used by those customers for individuals in the highest priority groups. As a result:
- Travel Clinics, GP practices, retail pharmacies, private Occupational Health and Universities – will not be receiving any adult vaccine until further notice.
- NHS Boards and Trusts, hospitals (including GUM/HIV services, A/E), specialist community services (eg. drug services) and prisons – will have further limits applied to their orders.
A mechanism is in place to allow for exceptional orders if there is an urgent and immediate need for an individual following a thorough risk assessment:
- In Scotland this is through the local NHS Board Vaccine Holding Centre
- In other parts of the UK the mechanism for override is to contact customer services to discuss (GlaxoSmithKline - Tel: 0208 047 5000) .
- Individuals requiring vaccine post exposure can be referred to urgent care centres for prompt management.
- GP’s/hospitals/clinics can continue to order paediatric vaccine as part of the programme for vaccinating infants born to hepatitis B infected mothers through their usual supplier, although restrictions are in place.
- Hexavalent vaccine (DTaP/IPV/Hib/HepB) due to be introduced to the infant programme across the UK from September is not affected.
Advice for Travellers
Most travellers will not fall into one of the priority groups for vaccination groups (detailed in Table 1 of the temporary recommendations). If, following individual risk assessment, a traveller is deemed to be at unavoidable, high and imminent risk then vaccine can be requested through the mechanism for ordering detailed above.
Travellers should be given advice on how to minimise exposure and be reminded that non-vaccine precautions are important to prevent other blood-borne viruses such as HIV and Hepatitis C. Having appropriate travel insurance is important since this may reduce the risk of healthcare associated exposure. Detailed prevention advice can be found on the hepatitis B page.
A specific patient information leaflet for individuals in whom vaccine is deferred has also been produced by PHE, found here
The situation is under constant review and updates will be posted on TRAVAX as they become available.