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The Pharmacy Vaccinations Development Group (PVDG) has called on the Government to make it easier for patients to book vaccinations in community pharmacies and provide commissioners with a more accurate forecast of the availability of vaccines by integrating proprietary booking systems with the national booking system.

In a report assessing current models of vaccine supply, the PVDG said integrating proprietary booking systems with public booking portals will “simplify processes and provide better information”.

“This would simplify patients’ ability to book vaccination appointments and provide a better overview of total demand,” said the PVDG, whose members include pharmacy wholesalers, trade bodies and chains. The national booking system is an online portal which allows patients in England to book vaccines from a provider of their choice.

Consider impact on private vaccine activity when planning NHS supply chains

The PVDG also urged the Government to ensure the impact on private vaccination activity is considered when planning NHS vaccination supply chains.

“Any NHS supply models must consider the possible impact of changes to supply chains on well-established private vaccination services, such as the flu service, to avoid unintended consequences,” the group said.

Its report looked at the advantages and disadvantages of three current models of vaccine supply – push or allocation, pull or draw down and inventory control or hybrid models.

Under the ‘push or allocation’ model, commissioners are responsible for ordering vaccines. The ‘pull or drawn down’ model gives providers responsibility for procuring vaccines which are delivered by wholesalers while ‘inventory control or hybrid’ models involve the allocation of stock and ability of providers to order additional vaccines based on demand.

In relation to the first model, the PVDG said there have been concerns that “in a financially challenging environment, providers are attempting to limit their risk by only ordering the vaccine they ‘will definitely use’”.

“This has led to fears that people late to vaccination, often those more hesitant, will find providers have run out of vaccination,” it said, insisting an allocation model “can move much of the financial risk away from providers and ensure there is vaccine available for the entire eligible population”.

Supported by better forecasting 

“Commissioners are required to predict where vaccine stock will be needed and allocate sufficient quantities to those locations,” the PVDG said. “This requires strong data to allow for accurate modelling, but also an understanding of subsequent local demand signals.”

The report said the ‘pull or drawn down’ model, mainly used by pharmacies to order NHS flu vaccines, can be supported by better forecasting and gives providers “greater flexibility” since they are “ideally placed to be aware of factors that may impact patient demand, including additional clinics, local advertising, or a similar local change in awareness”.

“If vaccine is procured at the providers cost, providers are more likely to take additional steps to minimise wastage,” it said. However, the report said this is impacted by competing factors including discount rates and “other commercial return agreements”.

“If centrally procured, then providers may be more confident in ordering vaccine for potential rather than just known demand. The flexibility of a pull model allows providers and commissioners to respond to peaks and troughs in demand,” it said.

The PVDG, though, warned quotas, used by some wholesalers to ensure there is enough supply across providers by preventing some from ordering high amounts of stock and potentially leaving others without vaccines, can also create “artificial bottlenecks”.

The report said the ‘inventory control or hybrid’ model, in which stock is allocated to providers at the start of a season based on expected demand, allows them to order additional vaccine if they need to.

“This could be monitored via inventory control, where vaccine stock is monitored and ‘topped up’ as it is used,” it said.

However, the report cautioned the model places “a high administrative burden on commissioners to determine initial allocations” and “an equally high demand on providers to monitor ongoing inventory”.

The PVDG includes representatives from AAH Pharmaceuticals, Asda, Alliance Healthcare, Boots UK, the National Pharmacy Association, Numark, Pharmacy2U, Phoenix Medical, Rowlands Pharmacy, the Royal Pharmaceutical Society, Superdrug, Tesco and Well. It is sponsored by GSK, Pfizer UK, MSD and Viatris.