Influenza Vaccination

To make full use of the CDRC influenza vaccination system:  

1. Ensure that the “Imms – Influenza Vaccination” Patient Status Alert is enabled.

Go to Setup > Data Output > Patient Status Alerts. Search for “Imms” and the following PSAs will be shown below, you can see if they are CDRC PSAs as in the Availability (AvailabilityShortDesc) column, it will show DCS. The Tick in the Enabled column will indicate that the PSA is enabled.

2. Create Vaccination Templates for Centrally Supplied Vaccines

These templates are required to ensure the vaccines are not claimed via the FP34D report
NB. the names of the vaccine templates are important – Spelling, spacing and capitals.
Ensure you do not duplicate vaccine templates from previous years or the vaccine will be recorded twice

Setup > Vaccinations > Vaccination Templates > Add Vaccination

1. Fluenz (likely to be on your system already if you have used the system before)
   Template name: Influenza nasal
   Vaccine: Fluenz Tetra (AstraZeneca UK Ltd) 1
   Method: Nasal
   GMS Status: Not under GMS
2. QIVc Seqirus
   Template name: Influenza QIVc Seqirus central supply
   Vaccine: Cell-based quadrivalent Flu/Vac/SA inj 0.5ml pfs (Seqirus UK Ltd) 1
   Method: Nasal
   GMS Status: Not under GMS

3. Opt into Patient Status Alerts for Vaccinations

The Imms – Influenza Vaccination Patient Status Alert (PSA) will provide an opportunistic alert to signify if the patient is eligible for an Influenza Vaccine.

CDRC’s Patient Status Alerts (PSAs) are inactive at your unit by default.

To enable Patient Status Alerts you will need to email contact-cdrc@healthinnovationennc.org.uk to let us know that you would like the Influenza Vaccination Patient Status Alert enabled at your unit and a member of the team will enable this for you.

To check this alert is activated at your unit, run this search to see if it returns a similar number to your list size.

The Influenza Vaccination Management Visualisation is a complete system that allows you to effectively conduct and review your Influenza vaccinations. It allows you to view all patients eligible for the vaccine by indication, patients who need coding assessments, patients who have not had an invite in this season or received 3 invites, and how to send electronic invites and appointment booking information.

To launch the Influenza Vaccination Management – CDRC Visualisation either:

1. Click on the Imms – Influenza Vaccination Patient Stats Alert (see node above)

2. In the search bar located in the bottom left-hand corner of the screen, type in “launch visualistion” and select the returned result, as shown below.

This will open the Select Visualisation menu, type in ” Influenza Vaccination Management – CDRC ” into the search bar and select the returned result to open the aforementioned visualisation.

Expand Using The CDRC Influenza Vaccination System for more information on how to use CDRC Influenza Vaccination System effectively.

Each of the nodes below provides you with specific information and patient cohorts, you can expand the nodes by clicking on the downward arrow located next to each node heading.

For example, expanding the Casefinding, Coding and Patient Selection node highlights patients likely to be eligible for a Influenza vaccination but have not been picked up by the business rules.

Clicking on the Red Jigsaw piece returns a patient list of specific patient cohorts.

The Influenza Vaccination – CDRC Visualisation is used when giving the vaccine to the patient. This visualisation can be accessed in two way, either by clicking on the PSA shown in the drop down below or by a direct search.

Using the search bar in the bottom left-hand corner of the screen, type in “launch patient visualisation” and select the returned feature. This will open the Select Visualisation menu.

Type “Influenza Vaccination – CDRC” into the search bar and select the returned feature:

This visualisation shows key information from the record and displays the estimated vaccine type to be used.  Appropriate warnings are displayed e.g. previous ADR to vaccine, egg allergy (if applicable), in the case below recent steroids for asthma.  Warnings about eligibility are displayed.

Verbal invitation can be recorded or electronic invitations can be sent, including self-booking links.  There are also preset comms links to send information about the vaccine.

CDRC’s Influenza Reports are located within the CDRC Vaccination Folder and have been separated into 5 sub-folders to provide an ease of use.

Influenza 1 Cohorts:

• All patients eligible for the vaccine by indication, subdivided in to those with and without business rules coding

Influenza 2 Eligible Patients:

• Patients currently eligible for a vaccine There are subdivisions by vaccine type, housebound status, at risk conditions etc.

Influenza 3 Invitation:

• Patients who require an vaccine invitation

Influenza 4 Performance:

• Provides an overview of vaccination performance

Influenza 5 QC and Admin:

• Reports in this folder identify patients who are likely to be eligible but who do not have a code that satisfies the business rules. If you do not wish for these patients to be identified for vaccination, please add the code Seasonal Influenza Vaccination not indicated.
• You can add the code Needs influenza immunisation to the record (on or after 1st September) to add the patient ton the ‘business rules’ list. You can do this systematically at the beginning of the flu season or the influenza vaccination protocol will prompt you to do this as you vaccinate patients.

Risk Factor	ES	Business rules	Green Book	DCS
Asthmatics with admission in the last year or on ICS	✓	✓	✓	✓
Asthmatics with oral steroids in the last year	✓	X	✓	✓
Children previously admitted to hospital with LRTI	✓	X	✓	X
Other respiratory disease	✓	✓	✓	✓
Heart disease (and PAD, AF, PE)	✓	✓ (partial)2	✓	✓
CKD 3-5 and other diseases suggesting chronic kidney disease.	✓	✓	✓	✓
Chronic liver disease	✓	✓ (partial)3	✓	✓
Chronic neurological disease	✓	✓(partial)4	✓	✓
Learning disability	✓	✓	✓	✓
Diabetes	✓	✓	✓	✓
Addisons	✓	✓	✓	✓
Immunosuppression1	✓	✓ (partial)5	✓	✓
Household contacts of the immunosuppressed or shielded patients	✓	✓ (if coded)	✓	✓ (if coded)
Pregnant women	✓	✓ (partial)6	✓	✓
Carers8	✓	✓	✓	✓
Locum GPs	✓	X	✓	X
Frontline health and social care staff	✓	✓ (if coded)	✓	✓ (if coded)
BMI >40	✓	✓ (partial)7	✓	✓

¹Patients immunosuppressed due to long term corticosteroids will not be identified automatically by DCS as it is not possible to search for steroid doses.  The enhanced service recommends that only patients on 20mg prednisolone or equivalent for more than 1 month should receive influenza vaccination.

² The 2024/25 specification seems to miss some heart disease/vascular codes e.g. PE, AF, PAD.  It also picks up many young patients with insignificant congenital heart issues e.g. minor, resolve PFO

³ The 2024/25 specification seems to miss many liver disease codes such as PSC, Hep B/C, NAFLD, NASH

⁴ The 2024/25 specification seems to miss many neurological disease codes such as MS, cerebral palsy and dementia

⁵ The 2024/25 specification misses patients who have repeats of relevant drugs that are being issued in secondary care such as transplant immunosuppression.  It also discounts any ‘patient immunosuppressed’ codes (and some others) that are older than 1 year old.

⁶ The 2024/25 specification seems to miss many pregnancy codes such as antenatal examination

⁷ The 2024/25 specification only looks for BMI results in the last 3 years

⁸ The 2024/25 specification includes the code for a professional carer in this section so might lead to inappropriate people being invited.