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**Y RHAGLEN BRECHU PLANT RHAG Y FFLIW**


Rwy’n ysgrifennu i hysbysu Aelodau, oherwydd ffactorau y tu hwnt i'n rheolaeth, y caiff y rhaglen imiwneiddio rhag y ffliw mewn ysgolion cynradd ar gyfer plant 4\-10 oed ei had\-drefnu oherwydd oedi o ran cyflenwi’r brechlyn.


Mae Iechyd Cyhoeddus Lloegr, sy'n gyfrifol am gaffael y brechlynnau ar ran y DU, wedi ein hysbysu y bydd oedi o ran rhai cyflenwadau o'r brechlyn chwistrell trwyn (Fluenz Tetra®) a ddefnyddir yn y rhaglen brechu plant rhag y ffliw. Bydd yr oedi yn effeithio ar gyflenwadau a oedd i fod i gyrraedd yn ystod mis Tachwedd. Mae'r oedi wedi ei achosi gan faterion sy'n ymwneud â chynnal profion rheolaidd gan y gweithgynhyrchwr, ac nid yw'n ymwneud â diogelwch y brechlyn na'i effeithiolrwydd. Nid yw'r brechlyn ar gael o gyflenwr arall.


Er mwyn sicrhau nad yw'r oedi o ran cyflenwi'r brechlyn yn effeithio ar y rheini sydd fwyaf agored i niwed, mae'r Prif Swyddog Meddygol wedi ysgrifennu at fyrddau iechyd a Phwyllgor Ymarferwyr Cyffredinol Cymru i ofyn iddynt ail\-flaenoriaethu brechu ym maes gofal sylfaenol plant: 


* 2 a 3 oed
* 2 i 17 oed mewn grŵp risg clinigol (gan gynnwys y rheini a fyddai fel arfer yn cael brechlyn yn yr ysgol).


Dechreuodd y broses o archebu brechlynnau ffliw plant ar gyfer gofal sylfaenol ar 18 Hydref, ac mae digon o stoc a threfniadau nas effeithiwyd arnynt i ddanfon cyflenwadau i sicrhau y caiff yr elfen hon o'r rhaglen ei chwblhau. Er mwyn diogelu pob plentyn mewn grwpiau risg clinigol yn y ffordd orau bosibl, mae'r Prif Swyddog Meddygol wedi gofyn i feddygon teulu frechu'r grwpiau hyn â blaenoriaeth cyn gynted â phosibl.


Mae byrddau iechyd eisoes wedi cael dros 80,000 o ddosau o'r brechlyn ar gyfer y rhaglen brechu mewn ysgolion erbyn y gwyliau hanner tymor \- mae hynny'n ddigon ar gyfer 46% o gyfanswm nifer y plant a frechwyd mewn ysgolion y llynedd. Mae'n bosibl y gall Lloegr barhau â'u rhaglen brechu mewn ysgolion am gyfnod hwy, ond mae hynny oherwydd yn gyfrannol y byddant wedi defnyddio llai o'r stoc a ddyrannwyd yn gyfrannol iddynt ym mis Hydref.


Rwy'n rhagweld y bydd y dyraniad llawn o frechlynnau ar gyfer Cymru yn cyrraedd yn ystod y tymor, ac y bydd y rhaglen brechu mewn ysgolion yn ailddechrau cyn gynted â bod cyflenwadau digonol ar gael. Gall fyrddau iechyd y mae brechlynnau ar gael eisoes ganddynt mewn fferyllfeydd barhau â'r rhaglen brechu mewn ysgolion am gyhyd â phosibl, neu ddefnyddio'r stoc i gynorthwyo practisau cyffredinol.


Mae'r Prif Swyddog Meddygol wedi gofyn i fyrddau iechyd aildrefnu'r sesiynau brechu mewn ysgolion hynny a gaiff eu gohirio, a sicrhau bod anghenion rhieni o ran gwybodaeth leol yn cael eu diwallu. Mae Iechyd Cyhoeddus Cymru wedi datblygu deunyddiau i fod o gymorth i fyrddau iechyd a phractisau yn ystod y cyfnod hwn, gan gynnwys templedi llythyrau ac atebion i Gwestiynau Cyffredin.


Er bod y sefyllfa hon yn anffodus ac yn heriol, ein blaenoriaeth yw diogelu cynifer o blant â phosibl rhag effeithiau'r ffliw, a helpu i atal y ffliw rhag lledaenu yn y gymuned i unigolion eraill sy'n agored i niwed. 


 


**BRECHLYNNAU OEDOLION**


Mae'n bosibl bod aelodau hefyd yn ymwybodol y bu oedi o ran argaeledd brechlyn pedwarfalent a gynhyrchir gan Sanofi, sef brechlyn a argymhellir ar gyfer oedolion o dan 65 oed sy'n wynebu risg. Mae'r oedi o ran cyhoeddi cyfansoddion y brechlyn ar gyfer y gaeaf hwn wedi rhoi pwysau ychwanegol ar weithgynhyrchwyr i gynhyrchu'r miliynau o frechlynnau sydd eu hangen ar gyfer hemisffer y gogledd erbyn yr adeg arferol. Mae hyn wedi cael mwy o effaith ar y brechlynnau hynny sy'n cymryd mwy o amser i'w cynhyrchu, ac mae hyn wedi arwain at anfon cyflenwadau fesul cam i bractisau.


Mae brechlynnau ffliw i'w chwistrellu yn cael eu harchebu gan bractisau cyffredinol a fferyllfeydd yng Nghymru yn uniongyrchol o'r gweithgynhyrchwyr neu'r cyflenwyr; nid ydynt yn cael eu cyflenwi drwy'r GIG.  Roedd brechlynnau eraill ar gyfer pobl o dan 65 oed sy'n wynebu risg ar gael i'w harchebu, ac nid oes oedi o ran y cyflenwadau hynny. Nid yw hyn wedi effeithio ar frechlynnau i bobl dros 65 oed ychwaith.  


Nid yw'r ffliw yn dueddol o ddechrau mynd ar led tan tua chanol mis Rhagfyr, ond rwy'n gwerthfawrogi bod unrhyw oedi o ran cael y brechlyn yn peri pryder. Os nad oes brechlyn addas ar gael mewn meddygfeydd meddygon teulu, dylai unigolion sydd mewn grwpiau sy'n wynebu risg ystyried cael y brechlyn mewn fferyllfa leol sy'n cynnig gwasanaeth brechu rhag y ffliw y GIG. 


Rwy'n cydnabod yr effaith y mae oedi o ran cyflenwadau brechlynnau yn ei chael ar gyflawni'r ymgyrch brechu rhag y ffliw.  Rwy'n ddiolchgar am gymorth staff practisau cyffredinol, y gwasanaeth nyrsio mewn ysgolion a staff y GIG yn ystod y cyfnod heriol hwn. 







Translation:


 
**CHILDREN’S FLU VACCINES**


I am writing to inform Members that due to factors beyond our control, the primary school flu immunisation programme for children aged 4\-10 years will be re\-scheduled due to a delay in vaccine supply.


Public Health England, which is responsible for procuring the vaccines on behalf of the UK, has informed us that there will be a delay to some deliveries of the nasal spray vaccine (Fluenz Tetra®) used in the children’s flu vaccination programme. The delay will affect deliveries due to be received during November and relates to issues around routine testing by the manufacturer and is not related to the safety of efficacy of the vaccine. An alternative supplier of vaccine is not available.


To ensure that the delay in vaccine supply does not impact on those who are most vulnerable, the Chief Medical Officer (CMO) has written to health boards and GPC Wales asking them to re\-prioritise vaccination in primary care of children: 


* aged 2 and 3 years
* aged 2 to 17 years in a clinical risk group (including those who would normally receive a vaccine in school).


Ordering of children’s flu vaccines for primary care commenced on 18th October and there is sufficient stock and unaffected planned deliveries to see this element of the programme through to completion. To maximise protection for all children in clinical risk groups, the CMO has requested general practice colleagues vaccinate these priority groups as early as possible. 


Over 80,000 doses of vaccine had already been received by health boards for the school programme by the half term break – this is sufficient for 46% of the total number of children vaccinated last year in schools. England may be able to carry on with their schools programme for longer, but that is only because they will have used proportionately less of their allocated stock in October.


I anticipate that the full allocation of vaccines for Wales will be received over the course of the season, and that the school programme will recommence as soon as sufficient supplies are available. Health boards which have vaccines already available in pharmacies can continue an ongoing school programme for as long as is possible, or use the stock to support general practices.


The CMO has asked health boards to reschedule those school vaccination sessions which are being postponed, and to ensure that parents’ local information needs are met. Public Health Wales has developed materials to support health boards and practices during this period including template letters and Frequently Asked Questions.


Whilst this situation is unfortunate and challenging, our priority is to protect as many children as possible from the effects of flu and help reduce its spread in the community to other vulnerable individuals.   


**ADULT VACCINES**


Members may also be aware that there have been delays in the availability of a quadrivalent vaccine manufactured by Sanofi, recommended for at risk adults under 65 years of age. The delay in announcing the vaccine composition for this winter has put additional pressure on manufacturers to produce the millions of vaccines required for the northern hemisphere by the usual time. The vaccines that take longer to produce have been affected more, and in this case have resulted in staggered deliveries to practices.


General practices and pharmacies in Wales order injectable flu vaccines directly from manufacturers or suppliers; they are not supplied through the NHS.  Other vaccines for at risk people under 65 years of age were available to order and these have not been delayed. Vaccines for over 65s have also not been affected.  


Flu doesn’t tend to start to circulate until mid\-December but I appreciate that any delays in receiving the vaccine are worrying. If a suitable vaccine is not available at GP surgeries, individuals in at\-risk groups should consider having the vaccine at a local pharmacy that offers the NHS flu vaccination service. 


I acknowledge the impact that disruption to vaccine supplies has on delivering the flu vaccination campaign.  I am grateful  for the support of general practice staff, the school nursing service and other NHS staff during this challenging period.