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Dr Curran and Partners – Clinical Update 7 September 2023

 1. Advice on school attendance for children with URTIs or anxiety

School absence has increased since the start of the Covid-19 pandemic. The Chief Medical Office has recently written to schools about the importance to children’s health and wellbeing of regular attendance at school. GPs and other primary care staff should advise families that pupils should not stay off school with mild upper respiratory tract infection symptoms or anxiety.

Full letter: https://www.gov.uk/government/publications/letter-to-school-leaders-on-mild-illness-and-school-attendance/letter-to-school-leaders-on-mild-illness-and-school-attendance

Our view is that NHS professionals should encourage school attendance among their patients. But their role is limited in comparison to the role for schools, parents and carers.

2. Flu vaccine Autumn-Winter 2023-24

The flu vaccine programme for this Autumn and Winter is starting. The groups eligible for flu vaccination in the 2023 to 2024 flu season include:

  • all children aged 2 or 3 years on 31 August 2023
  • all primary school aged children (from reception to year 6)
  • secondary school-aged children (years 7, 8 ,9, 10 and 11)
  • those aged 6 months to under 65 years in clinical risk groups (as defined in the Green Book, Chapter 19 (Influenza))
  • pregnant women
  • those aged 65 years and over (including those who are 64 but will be 65 on or before 31 March 2024
  • those in long-stay residential care homes and other long-stay care facilities where rapid spread is likely to follow introduction of infection and cause high morbidity and mortality (this does not include, for example, prisons, young offender institutions, university halls of residence)
  • carers in receipt of carer’s allowance, or those who are the main carer of an elderly or disabled person
  • close contacts of immunocompromised individuals
  • frontline workers in a social care setting without employer led occupational health schemes including those working for:
    • a registered residential care or nursing home
    • registered domiciliary care providers
    • voluntary managed hospice providers
  • those that are employed by those who receive direct payments (personal budgets) or Personal Health Budgets, such as Personal Assistants

Clinicians should exercise professional judgement when assessing a patient and can recommend vaccination for individuals, even if they are not in a listed risk group, if influenza is likely to exacerbate their underlying medical condition.

3. Covid-19 vaccine Autumn-Winter 2023-24

The Covid-19 vaccine booster programme has been brought forwards to start in September (instead of October). The JCVI advises that for the 2023 autumn booster programme, the following groups should be offered a COVID-19 vaccine:

  • residents in a care home for older adults
  • all adults aged 65 years and over
  • persons aged 6 months to 64 years in a clinical risk group, as defined in tables 3 and 4 of the COVID-19 chapter of the Green book
  • frontline health and social care workers
  • persons aged 12 to 64 years who are household contacts, as defined in the Green book, of people with immunosuppression
  • persons aged 16 to 64 years who are carers, as defined in the Green book, and staff working in care homes for older adults

To optimise protection over the winter months, the autumn programme should aim to complete vaccinations by early December 2023. In attaining this objective, deployment teams should also be mindful that protection from vaccination is highest in the first 3 months following vaccination, and therefore delivery of the programme over an appropriate period of time ahead of winter will maximise the potential benefits of the programme.

From autumn 2023, the JCVI additionally advises that primary course COVID-19 vaccination should consist of a single dose of COVID-19 vaccine. Eligibility for the offer of primary vaccination will be the same as for autumn 2023 booster vaccination.

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