Future Proofing Policy for Adult Influenza Vaccines in the UK: The Case for Centralized Procurement

OBJECTIVES: A critical part of NHS winter planning is the deployment of the annual adult influenza vaccination program alongside the COVID-19 immunization program. These programs are essential for alleviating NHS pressures and protecting public health against respiratory illnesses. Ensuring procurement frameworks are adaptable to future needs and technological advancements is vital for forward planning, optimizing public health, and pandemic preparedness.

METHODS: A targeted literature review was conducted of the current and past policy frameworks informing adult influenza procurement. The focus was on England, Scotland, Wales, and Northern Ireland, with an emphasis on procurement, purchasing, and policy instruments used for buying adult influenza vaccines. The assessment considered the mechanisms used, applicability to current health policy imperatives, and the need for future reform given the advent of new technologies and preventative interventions. Official policy, government documents, and grey literature from the last 20 years, focusing on UK-based publications, were searched to ensure comprehensive coverage.

RESULTS: There is disparity in procurement approaches across the UK devolved nations. Scotland and Northern Ireland have centralized procurement systems, whereas England and Wales use a direct purchasing payment mechanism where GPs and pharmacists order directly from manufacturers and are reimbursed. Both systems include a complex array of incentives for vaccinators. A UK-wide shift to a centralized system would allow better management and coordination of vaccine distribution, reducing the risk of local shortages and ensuring consistent supply, thereby mitigating access-related health inequalities. For future technologies combining adult influenza vaccination with other respiratory pathogens, a centralized system would be beneficial for procurement and patient access.

CONCLUSIONS: Harmonizing procurement approaches across the devolved nations to a system of centralized procurement could improve vaccine distribution, reduce the risk of seasonal shortages, lower costs and better leverage new technologies for improved efficiency and access.