Family doctors running low on influenza vaccine in Estonia

Patient receiving a flu vaccine (photo is illustrative).
Patient receiving a flu vaccine (photo is illustrative). Source: Siim Lõvi/ERR

Family doctors are having difficulties finding the influenza vaccine in Estonia this year. Drug wholesalers believe the reason is due to increased interest this winter but family doctors think wholesalers are prioritizing giving the vaccine to pharmacies.

Estonia has received all of its flu vaccines for this year and no more will be available, ETV's evening new show "Aktuaalne kaamera" (AK) reported on Sunday. 

Family doctor Alina Terep in Jüri, Harju County told AK she had purchased 269 vaccines at the end of August by ordering from three different pharmacies. But she would need at least this amount again to meet demand. She told AK that she had submitted four additional requests to pharmacies for more vaccines but has not been able to get hold of any.

"Not many people are vaccinated against the flu in Estonia, but at the moment the situation is so absurd that I have to say no even to the few who turn to me," said Terep. She said one of the tasks of a family doctor is disease prevention and she cannot do it at the moment.

Terep said the current procedure for distributing influenza vaccines is not transparent. She's not the only one who thinks so. Several of Terep's colleagues, as well as the Ministry of Social Affairs, suspect that wholesale companies prefer pharmacies where people are vaccinated on site when selling vaccines.

CEO of pharmaceutical wholesale company Tamro Estonia Tanel Kuusmann told AK this is not the case. He said only 3 percent of vaccines from his company are sent to pharmacies.

"This is certainly not the reason why family doctors do not have enough," Kuusmann said.

He said the reason for the shortage of vaccines is a much higher demand than normal this winter due to the coronavirus. Additionally, vaccine producers have allocated a smaller amount to Estonia than last year. Kuusmann said the vaccine was distributed equally to all those who pre-ordered.

This year Estonia received 153,000 doses of the vaccine. Last year, 202,000 were available but 40,000 were not used by the end of flu season and were either destroyed or sent elsewhere.

Deputy Director General of the State Agency of Medicines (Ravimiamet) Katrin Kiisk said the agency does not see a clear distinction between the pharmacies that carry out vaccinations in terms of the quantities of vaccines purchased.

"There are some pharmacies that have bought 1,000 doses, but there are also those that have bought 20 doses. The same can be said about those pharmacies where vaccination does not take place," she said.

Significant amounts of the vaccine have already been received by big hospitals, ambulance centers, the health service for vaccinating residents of nursing homes, as well as the Defense Forces and occupational health physicians. 

The state is trying to find more doses of the vaccine.

"We have talked to manufacturers and said that if the vaccine runs out in Estonia, they should try to find other ways to bring the vaccine here from other European Union markets," said Kiisk.

Kuusmann said this is unlikely to happen because there is a high demand for influenza vaccine throughout Europe this year. 

Family doctor Alina Terep said she is not satisfied with these explanations. If there are so few vaccine doses in pharmacies, then where are the rest and why can't she order them?

Terep does not believe that vaccination in pharmacies should be stopped. This would be an inconvenience, as it may be difficult for people working in the city to go to a family doctor, but family doctors should not miss out on vaccines.

"The family doctor has a better overview of risk cases of who needs the flu vaccine, who has asthma or high blood pressure. I can offer them this vaccine to help, but everyone who passes by the pharmacy and notices will receive the injection," said Terep. 

"The point here is that those who need the vaccine should not be deprived of it," she stressed.

If the health center in Jüri cannot find additional vaccines, risks group such as elderly will suffer. "Vaccination in a pharmacy is not available in Jüri, we have four lists of a thousand elderly people and they are not all visitors to the city," Terep explained.

Drug wholesaler Tamro Estonia has a small stock of vaccine left which is intended for West Tallinn Central Hospital to cover the needs of public procurement. The amount for family doctors has already been sent to pharmacies and they no longer have anything to give to doctors.

"In a situation where the vaccine is not distributed, you should announce your wish as soon as the initial planning begins, but I don't think our clients, family doctors in early spring, can predict the need for autumn in February," said Kuusmann. 

He said in the future, the inclusion of an influenza vaccine in the national vaccination plan could be considered to cover the needs of risk groups.


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Editor: Helen Wright

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