Britain is suffering a nationwide shortage of one of the two main vaccines — PPV23 — that helps prevent pneumonia, BuzzFeed News can reveal.
Some GP surgeries, which provide the pneumococcal jab, have run out completely and have not been informed when suppliers will replenish their stock, prompting patients to attempt to buy it from pharmacies.
But pharmacists at multiple branches of Boots told BuzzFeed News that they too have been out of stock for months, and had no idea when supplies will return.
One pharmacist at a central London branch said they hadn’t had PPV23 since November and have had to cancel appointments booked by members of the public at risk of pneumonia. A pharmacist at another branch said the problem was “everywhere”.
The PPV23 vaccine — which protects against the 23 most common strains of pneumococcal bacterium — is recommended for everyone over the age of 65, as well as people who live with a range of chronic conditions. For the elderly without health problems, a single dose can be given, but all patients with long-term conditions may need the jab every five years.
The vaccine is between 50% and 70% effective in preventing pneumonia, and therefore would help ensure patients in high-risk groups — such as people with HIV who are not virally suppressed — are not made more vulnerable to other infections, such as coronavirus.
Pneumonia has so far been found to affect 10% to 15% of patients hospitalised with coronavirus, although neither of the two vaccines available could have prevented these patients developing the life-threatening inflammation of the lung.
Dr Michael Brady, medical director of the Terrence Higgins Trust, Britain’s largest HIV charity, explained: “It’s slightly separate but interlinked — not having the pneumococcus vaccine doesn’t make you at any greater risk of getting coronavirus. It’s more about accessing any vaccination you can to reduce your risk of getting another chest condition, which if you got it, might make things worse for coronavirus.
"Everyone who’s got HIV who’s at risk of any chest infection should be able to access vaccinations that can protect them. It's bad that it's not available.”
Those most at risk of dying from coronavirus are the elderly and those with underlying health conditions.
In a statement to BuzzFeed News, a Department of Health spokesperson said the government was “aware of intermittent supply issues affecting the adult vaccine PPV23”, which it said were a result of "manufacturing and global market issues", but insisted that supplies were available for patients in the UK.
The statement added: "Public Health England has issued comprehensive guidance to the NHS which provides information for clinicians on the management of potentially affected patients during this time.”
This guidance, which has been seen by BuzzFeed News, was issued after the department informed doctors in October 2019 that there would be a shortage over the winter that “would make it unlikely that practices will be able to offer the vaccine … to all eligible patients in lower priority groups (eg healthy people aged 65 years and over)”.
Instead, GPs were advised to give the vaccine to patients “newly diagnosed with conditions” most at risk of pneumonia first, followed by those with moderate risk conditions.
The conditions deemed at highest risk included people with spleen problems and those who are immunosuppressed, including patients with cancer receiving chemotherapy and people with HIV. The British HIV Association, however, advises doctors that only those who are not virally suppressed through treatment need the PPV23.
Moderate-risk conditions included chronic respiratory disease, heart, kidney and liver disease, and diabetes.
The guidance predates the outbreak of coronavirus, which has now prompted doctors concerned about the impact on their vulnerable patients to raise the alarm about the shortages.
A leading HIV consultant concerned about the shortage told BuzzFeed News that the national vaccine service had declined a request to shepherd supplies to ensure HIV patients had the vaccine, prompting the doctor to urge colleagues involved in the coronavirus response to repeat the request.
The guidance assured clinicians that new deliveries of the vaccine were expected in January 2020. Shortages, however, remain. When asked how many, or what proportion of GP surgeries were out of stock, the Department of Health spokesperson did not respond.
A spokesperson for Boots said: "We can confirm we still have some limited stock available in our warehouse and are sending this to stores daily for appointments that have already been booked."
The other pneumococcal vaccine is the PCV13, which is given to children and recommended for everyone with HIV, even those who are virally suppressed and have no other conditions. The Department of Health spokesperson denied there was a shortage of PCV13.
However, a GP surgery in London said they were out of stock of both types with no indication when new deliveries would arrive — and many pharmacists said they too have been out of stock for weeks.
On Thursday, a woman in her seventies was confirmed as the first person to die of coronavirus on British soil.