Does the GP decide who does and doesn't get the swine flu jab - amongst priority patients?

[bellissima]

I'm writing this as a result of an extremely worrying conversation with my GP's practice receptionist this morning.

DD1 (10) has asthma. She had her latest attack two weeks' ago. She has a free annual seasonal flu jab as a 'priority' case. This morning I took her to get her (seasonal) jab and, in view of the news about the imminent roll out of the swine flu vaccination, asked the receptionist when she might be called up and how (letter/do I have to keep calling in/whatever). "Oh no", came the reply. "I can't guarantee that she will get one. it depends how many doses we get and what we decide."

Now I understand that some reading this might be opposed to vaccinations in general or the swine flu one in particular. Believe me, I respect your views, and yes I know about the historic US case where one person died of swine flu and several of the vaccination etc. I happen to believe in vaccinations - i don't seek to impose my views on anyone at all - but I desperately want my vulnerable child to have this vaccination and thought, from everything I had read, that she would be a priority case. We keep being told that a significant proportion of those who die from the virus have 'underlying health issues'. As if that's alright then, phew. But one of those 'issues' is asthma - something that affects thousands. I understand that 25% of those hospitalised with swine flu in Scotland are asthmatics. I read that children with respiratory problems would be in the first phase of the programme and was somewhat reassured by this - but now my GP's surgery is telling me something different - it is up to them to decide apparently. But do we know on what criteria? Are they monitored by the Department of Health? Is there any right of appeal?

I am made even more uneasy by the fact that my daughter tells me that a classmate with, as far as I am honestly aware, absolutely no underlying health issues but one of whose parents is a GP, has told her that 'shes going to get the vaccine'. So, er, when GP's get to prioritise who gets it, on just what criteria are they supposed to go? mates? relatives? whoever shouts loudest in the surgery?

Grateful for anyone with information on this.

No idea, but I've been wondering about this too. (I would guess that the GP's daughter just means 'get the vaccine rather than not get it', though, and not anything more sinister.)

Just out of interest - if you found out in a week or two, perhaps, that your daughter would be vaccinated within a couple more weeks, would you then consider keeping her out of school (assuming she goes) for those last weeks before the vaccination? If cases were rising fast and you knew that it was going round the school?

This is something I've been wondering about - whether it would make sense to do that, and how a school might look on anyone doing this. I suppose at the moment the number of cases is still not high enough to be seen as exceptional and justify exceptional measures though.

Yes reluctantrobin - I have considered precisely that if cases rise!

(Back here because I couldn't sleep worrying about this - yes I know tell me to calm down dear and have a nice cup of tea. But I honestly assumed that she was a priority case and was gobsmacked by what they said. I didn't argue or say anything, I was just rather devastated.)

Is there a nice gp at practice you could speak to about this, as it's obviously really worrying you?

Doctors receptionists not always known for their people skills (sorry to any reading - there are many lovely helpful ones too). Stupid woman should have been more sensitive.

I don't have any inside info, but I'm not sure if they know exactly what's happening yet (and that's what it sounds like from what she said) which is probably why you got this response. Try to focus on the fact that she didn't say she wasn't getting one, and this is probably her standard response to everyone at the moment.

You need to get info from the horse's mouth, not receptionists/children in playground.

I think she's maybe referring to the fact that GPs can use their discretion a bit when it comes to deciding whether some people come into the "underlying health problem" category - some patients won't have clear cut diagnosis like asthma but the GP in their opinion may think that individual should be offered the jab. I can't see them not prioritising your daughter TBH.

Thanks for messages. And yes a good idea to talk to GP - in fact we have a follow up appointment (after last attack inhaler doses altered) this week so I'll have a word.

I would emphasise that I have another child with no underlying health condition and, whilst I would love to have her vaccinated (whilst respecting other views on the matter), I fully appreciate that she is not a priority case and must wait her turn, ie I'm not trying to queue-jump, just very concerned that what I read are the guidelines for priorities don't seem to matter when you talk to the surgery - but you are right - maybe just the receptionist.

Probably when the receptionist said that she couldnt guarentee that your daughter would get one, it probably wasnt from any position of being able to know if your daughter would get one or not, but maybe more from not wanting to get herself in trouble to promising something that she wasnt in any position to give, IYSWIM.

Also your daughters classmate is probably just saying that she will have the vaccine when offered it, rather than that she is going to try and jump the queue.

If they're only getting 500 doses then I imagine they'll be looking at however many people they've got in those priority groups and deciding which amongst those are the most vulnerable - e.g. asthma with regular hospitalisation vs well controlled asthma, more than one vulnerability vs only a single one in an otherwise healthy person.

Maybe the surgery will receive their vaccines in batches because of lack of storage space (they usually struggle with only the regular flu) and they don't know how they're going to prioritise within the priority list.

Would very much doubt they would go against Department of Health guidelines. If they do, you can complain to the PCT via PALS.

I have a feeling you will be able to get them privately anyway. Can't see all those big corporations risking going out of business because all their staff are sick!

I would echo the 'talk to the GP' advice, good that you have an appointment already booked - from experience, would not be surprised if this was just cagey receptionist talk!

As far as I've understood it, time and time again, your dd should be a priority case and in the first batch that get offered the vaccine. After health care workers.