A LEADING public health expert has warned that a flu vaccination system which will inoculate the oldest last “really needs to be rethought”.

Linda Bauld, professor of public health at Edinburgh University, said it was vital that those most at risk from influenza and Covid are vaccinated first.

This is the first winter that health boards have taken over responsibility from GPs for delivering the winter flu vaccine.

The Herald revealed that NHS Greater Glasgow and Clyde is rolling out appointments based on the Scottish Immunisation Recall System (SIRS) originally designed for childhood vaccinations, which prioritises the youngest first.

As a result, 65-year-olds are invited first while those in their 80s and 90s face waiting weeks longer than normal, with Age Scotland saying it has heard from elderly people told they would not be seen until the end of November or even December.

NHS Lanarkshire has now confirmed that it is also using the SIRS system, while a spokeswoman for NHS Lothian said it was being used in a “limited way” in West Lothian.

NHS Forth Valley is also using SIRS but a spokeswoman said GPs in the region would continue to vaccinate patients with underlying health conditions in both the over- and under-65 age groups.

NHS Western Isles said it is using SIRS for over- and under-65s, but was “not aware” of residents in their 60s being invited earlier than older islanders.

READ MORE: The real reason winter flu vaccines are being delivered differently - and it isn't Covid 

NHS Tayside, Grampian, Ayrshire and Arran, Highland and Fife confirmed that they are not using SIRS, while NHS Borders said patients were being invited to book appointments at a date and time convenient to them, with over-65s contacted first followed by under-65s with high-risk health conditions.

A spokeswoman said this meant "that those people who want to be vaccinated can be seen in a more timely manner”.

NHS Dumfries and Galloway has not yet responded. 

Research has shown that patients who catch flu and Covid together are twice as likely to die, compared to those with Covid alone, and rates of coronavirus are currently highest in the Greater Glasgow and Lanarkshire regions.

Prof Bauld said adopting a model that vaccinated 65-year-olds up to two months earlier than those in their 90s was “highly unfortunate and short-sighted”.

She said: “The reason why we’re placing such a great emphasis on the influenza vaccination this year is because of Covid.

“It’s always important for at-risk groups to get inoculated, but it’s really important this year.

“It’s obvious that we want to protect the most at risk groups, so I think this really needs to be rethought.”

Huge demand for the flu vaccine this year means that most high street pharmacies, which order stocks a year in advance, have run out of supplies for customers looking to purchase the jag privately.

There are two flu vaccines: a quadrivalent vaccine for under-65s that protects against four different influenza viruses, and a trivalent vaccine for over-65s containing adjuvant to stimulate greater antibody production and longer-lasting immunity.

It is up to health boards whether to involve pharmacists in the NHS rollout, but a spokeswoman for the Royal Pharmaceutical Society said in “most cases” where pharmacists had been asked to help it was only in providing the vaccine for under-65s.

READ MORE: 'Absolute shambles' as it's revealed oldest will get flu jags last 

Vaccination is being carried out this year at community hubs, such as football grounds and town halls.

Appointment letters are sent out by a contractor working on behalf of NHS National Services Scotland (NSS).

However, the Herald has heard of numerous cases of patients receiving letters after or on the same day as their appointment.

Patricia Donoghue, a 66-year-old retired practice nurse from Cumbernauld in North Lanarkshire, said her letter arrived in the mail at 11am on Wednesday for an appointment at 9.05am that day at Cumbernauld New Town Hall.

After spending five hours failing to get through on the helpline number on the letter, Mrs Donoghue called the town hall directly on Thursday and spoke to a nurse who she said was “not surprised” to hear what had happened and invited her to come for the jag as a ‘walk-in’ instead that day.

Mrs Donoghue said she met several other patients there who had also missed or had just a few hours notice of their appointment when letters arrived.

She said it is "shocking" that she has been vaccinated before her housebound 90-year-old mother and her 40-year-old son, who has lung damage due to chronic asthma.

Mrs Donoghue, who organised winter flu vaccination for 15 years during her career in general practice, said this year’s rollout is “irresponsible and very ageist”.

She said: “Somebody has organised this and it worries me that it wasn’t a clinical person. It’s been some manager without a clue.

“I find it mind-bogglingly awful that this is happening this year.

“The population who need it the most - the oldest, the most vulnerable - are not going to get the vaccine for quite some time and that is a massive worry, considering we’re in the middle of a growing pandemic.

“We’ve had months to plan and it’s just an absolute mess.”

READ MORE: GPs warn over centralisation of vaccinations 

Responsibility for routine immunisations has been transferred from GPs to health boards following an agreement struck between the BMA trade union and Scottish Government in the 2018 GP contract.

The process was supposed to begin in 2021, but has been accelerated due to the pandemic.

Dr Carey Lunan, chair of the Royal College of GPs (RCGP) Scotland, said: “We are unable to comment on the specific approaches being taken by different health boards in terms of age groupings, but in general we would always advocate prioritising vaccinations for those patients who fall into the highest risk groups.

“The older someone is, the higher their risk of developing more serious illness if they develop flu, or Covid-19.”

Jamie Hepburn, SNP MSP for Cumbernauld and Kilsyth, said: “Unfortunately I have been contacted by a number of people who have experienced either short notice of their appointment, or indeed in one instance it arriving after the appointment had been scheduled for. This is obviously unacceptable.”

Craig Cunningham, head of commissioning and performance, for the Lanarkshire health and social care partnership (HSCP), said: “All appointments for priority patients will be issued before the end of November, however, the nature of the Scottish Immunisation Recall System (SIRS) being used for this means that we are unfortunately unable to tell people when they will be vaccinated until the system generates their appointment.

"More than 300,000 patients are eligible for vaccination this year and, as such, the programme will run over a number of weeks.

"The scheduling means that patients may receive their invite at a different time than normal."

Priority patients are the housebound, anyone with an underlying health condition which increases their risk from the virus, and everyone aged 65 and older. 

Mr Cunningham added that they were "using the details from GP practice lists to identify who is eligible".

People aged 55 to 64, who do not have underlying health conditions, will be vaccinated in the second phase which is expected to begin in December.

A spokeswoman for NSS said: "This is the largest flu vaccination programme ever offered in Scotland and it is happening in the middle of a pandemic. 

"We accept there have been some challenges.

"We are working closely with the health boards to resolve any issues as quickly as possible. 

"Health boards have given the Scottish Government their reassurance that this issue has been resolved and anyone who received their vaccination letters after the date of their appointment will have been given an alternative appointment date."