1.0 Introduction
1.1 The seasonal flu vaccination programme has become a well established part of the health care provided to the people of Scotland. Normally around 75% of the population of older people in Scotland receive the flu jag each year; and other groups are targeted although with varying degrees of success. By the end of December 2006, just under 70% of older people in Scotland had been vaccinated. The lower level than usual may be due to the late delivery of vaccine because of difficulties on the part of the manufacturers in developing the vaccine. Although cause and effect are difficult to prove absolutely, the absence of serious outbreaks of flu, particularly among older people, in recent years suggests that the vaccination programme is succeeding in its aims.
1.2 Although the programme has been carried out more or less successfully, each year for the past three there have been concerns about the delivery of the vaccine and its timely availability, leading to difficulties for the practitioners involved in the programme and to (often unjustified) stories in the media alleging that eligible patients will not be able to be vaccinated. The Scottish Executive Health Department (SEHD) has therefore commissioned a review of all aspects of the seasonal flu vaccination programme, with a view to determining whether any changes should be made to the programme, and if so what they should be.
1.3 The annual cycle relating to the vaccine is quite protracted, requiring the manufacturers to order the eggs in which the vaccine is cultivated early in the New Year. Accordingly, in order to have any impact on the programme for 2007-08 the review has had to be conducted to a tight timescale. As a result, inevitably, it has had to concentrate on those elements of the remit (full details of which are at Annex 1) where it seems most likely that change is desirable and deliverable.
1.4 I wish to thank the wide range of professionals involved in the programme, many of whom have given up time to help me to understand the issues involved and to formulate recommendations. I hope that the conclusions of the review will be regarded as fair and balanced, but responsibility for the conclusions is mine alone.