To think that DP should be able to get a hepatitis B vaccine somewhere?

[caddywally]

DP works somewhere that often has a fair few homeless people hanging around, and as some of these people have drug problems, it's not uncommon to see needles etc. left lying around. Last night he stepped on a bloody needle and it went through his shoe and into his foot. In case there was a chance he could've contracted a disease (though hopefully this is unlikely) he went straight to A&E.

He spent about 5 hours in A&E and eventually the doctor took some blood and advised him to get a hepatitis B vaccine, though advised him that he'd have to get it done at the GP surgery as soon as possible as A&E didn't have any hep b vaccines available. He called the GP this morning and they told him to go back to A&E. He called A&E and explained the situation and they said that they were unable to order any in, but the GP would be able to. He went to the GP this afternoon and showed the note from the doctor advising that the GP vaccinates him, but they said they can't order in the vaccine and told him to go back to A&E.

Can anyone who works in healthcare (or anyone else!) shed some light on this? Is this normal? I know it's unlikely that he was infected, but if a few months down the line it turns out he is infected because nobody could decide who should give him the vaccine, I'll be very upset.

so I'm afraid under those circumstances, he'd be sent back to the GP.

If that is what sexual health clinics are doing, they shouldn't be. The GP isn't funded or employed to provide hep b vaccines for occupational risk. That is his employers responsibility.

There seems a national shortage on most trusts risk registers. It's being prioritised but sexual health clinics are best bet.

Yes agreed Nestofvipers, however, if there isn't an occupational health department, it's in the GPs interest to provide at least the first (most important) vaccine, as ultimately, if the poor guy did go on to develop Hep B, it will be the GP who has to pay for the care and treatment of it... So although I don't agree with passing the buck, the bottom line is the GP is responsible if no-one else can or will provide the care in this kind of scenario.

the bottom line is the GP is responsible if no-one else can or will provide the care in this kind of scenario.
The GP is not responsible. His employer is responsible. If his employer doesn't want to provide the care, that doesn't make it the GPs responsibility.

If his employer doesn't have an OH department, they need to pay for him to see a private OH physician. This has nothing to do with the GP and if he did go on to develop hep b (which he hopefully won't), it would be his employer's fault.

There is a manufacturing issue with Hep b vaccines at the moment. Unable to order it in from anywhere.

And what nestofvipers says - not GO responsibility, it is employers responsibility. Much like GPs aren't dentists, they also don't double up as occupational health.

What the hell are we going to do with the presumably epidemic numbers of people who are going to end up infected during this shortage? Bloody terrifies me but then I've worked in homelessness most of my life.

Gardengeek there is no point in the OP going back to A&E and refusing to leave as they do not have any there - they are not refusing to give it, just saying that they can't because there's a shortage.

OP, might be worth giving your local sexual health service a ring just to see if they have any in stock and would be willing to give the first dose as A&E can't.

Everyone suggesting a&e or GP is contributing to the situation that the DH employer has not provided adequate cover for its worker, and failed to provide sufficient support for an injury sustained in the course of doing his job!

Would you expect nurses, police officers, etc to be running around for days / pay privately / etc?

If no, then stop contributing to the confusion (refuse to leave a&e - really?! [Hmm]) - the OP DH needs to talk to his manager/escalate to HR today.

GardenGeek
What's the point of that? If they haven't got it there, they can't give it to him can they?

This is his employers responsibility to sort out so why are you advising he tries to put the responsibility on someone else? Why aren't you advising he does this to his employer who does actually have the responsibility to sort this out?

It isn't right or fair to try and dump the issue on someone who should have nothing to do with it and no wonder the NHS is on its knees with attitudes like this,

Kailoer
Thank you for adding some sense to this!

I'm on the brink of exiting the thread to go and bang my head against a wall.

OP how did today go

Just to clarify: as this is related to an acute needlestick injury rather than a need for theoretical occupational protection then A&E WOULD normally give the first dose following a potential exposure. I have worked in a number of A&E depts and this has always been the protocol that we follow. The employer/occupational health provider would then be expected to make arrangements for follow up and course completion (for staff it's done by our own occupational health dept).

The issue here is a vaccine shortage rather than an unwillingness by A&E to vaccinate. A&E would have given the vaccination if they had had it in stock.

Thanks for your help yesterday, everyone. DP spoke to his boss today and he's contacted occupational health and see what they can do about it.

Private travel clinics don't have any either btw, for all the people saying to pay to go there.

Does anyone have any links to good info on why this has happened ? It seems to me as though it's a serious public health failure. Would like to understand more.

There has been a worldwide shortage of Hep B, Hep A and typhoid vaccines for several months. ( Late last year it was Rabies that you couldn't get for love or money). The official reason is manufacturing difficulties. There are 2 companies who make in the UK but 3 brands of Hep B plus the combined Hep A /Hep B. Some of the reason is there has been a push to vaccinate against Hep B in the sexual health clinics and also the introduction of Hep B into the infant schedule may have put a strain on the system. I think the Hep A and Typhoid may have been more planned to make other vaccines.
as far as a major public health issue - I don't think it is in the general populations as it is not highly common in the UK. HCP should have it before they start their training/degrees as they are most at risk from contacting it or passing it on, some other groups are recommended to have it for their work , there is prevelance is the needle sharing drug users - hence the concern with a needlestick injury, and some other groups.