Swine Flu Q & A

Tue, Nov 17, 2009

health

What are the current seasonal flu vaccine clinical at-risk groups?

The following are in the seasonal flu risk groups:

People with,

-          chronic respiratory disease;

-          chronic heart disease;

-          chronic kidney disease;

-          chronic liver disease;

-          chronic neurological disease

-          diabetes; and

-          immunosuppression.

 

This list is available in the seasonal flu CMO letter that was sent out on 3rd April 2009 http://www.immunisation.nhs.uk/Professional_information/CMO_letters

 

and in  Immunisation against infectious disease – ‘The Green Book’

 

Why aren’t children included in the priority groups?

JCVI has advised that the use of the vaccine in the wider healthy population should depend on the evolution of the pandemic as well as new and emerging clinical data on the use of the vaccine. This will be kept under review.

 

We will ensure we have further advice from JCVI on this issue before announcing further groups.

 

What timeframe will people be vaccinated over?

We hope that most of the clinical at risk groups will be offered the vaccine by December this year.

 

This is not the Department of Health’s schedule – it is led by the manufacturers. It is therefore subject to change.

 

It is expected that the at-risk purchase cialis in china groups will be vaccinated in the order of priority listed.

 

What do you say to frontline health professionals who are reluctant to have the vaccine?

Frontline health professionals will be absolutely crucial in the height of a pandemic – without them, patient care will suffer, and the NHS will be stretched. Getting the swine flu vaccine will protect health professionals and their patients. That’s why we’re offering frontline staff the vaccine as a top priority. As well as protecting them, it will reduce the chance of them passing the virus to vulnerable patients. Of course, vaccination will be optional.

 

If the virus is mild, why are we purchasing enough vaccine for the whole population?

As this virus is a new strain of virus, most people are susceptible to infection. The virus currently produces mild disease in most people. However we have learnt from previous pandemics that the virus can change and can lead to more serious disease. This is why JCVI is keeping the issue under review.

 

There have been concerns about the use of adjuvanted vaccines in pregnant women, what is the Department of Health’s recommendation?

The previous WHO position was given long before the vaccine was licensed for use in pregnant women by the European regulator and recommended by the independent UK committee on vaccination – the Joint Committee on Vaccine Immunisation. The JCVI strongly recommends the use of the GSK vaccine in pregnant women because it would protect them more quickly from the risk of flu with just one dose of vaccine.

 

 It would be extremely irresponsible to suggest the UK would use a vaccine without careful consideration of safety issues.

 

Why should pregnant women be vaccinated at all?

Pregnant women are four times more likely to develop serious complications from swine flu and they are four to five times more likely to be hospitalised with swine flu than non-pregnant women.

 

On 17 September it was announced that the UK will provide up to £23 million to help the developing world tackle the H1N1 pandemic. 

It is also implied that ‘up to 10%’  of the UK vaccine stockpile will be made available. How much is the UK committing?

The UK is making approximately 10% of its vaccine capacity available to the WHO and at the same time donating £23m to the UN to use for buying that vaccine, or for other priorities depending on needs.

 

How can the UK donate 10% of its vaccines and still honour the commitment to acquire sufficient stocks to vaccinate the entire UK population? 

Our first duty is to protect our domestic citizens and so the Government has contracted to buy sufficient vaccine to provide for two doses to the entire UK population. Emerging evidence suggests that one dose of vaccine rather than two might be sufficient to generate a sufficient immune response in some people. The Joint Committee on Vaccination and Immunisation has also advised that use of the vaccine in the wider healthy population should depend on the evolution of the pandemic as well as new and emerging clinical data on the use of the vaccine.

 

Why is the UK giving this away before we have a final decision about whether one dose or two is required?

Emerging evidence is suggesting that one dose of vaccine rather than two might be sufficient to generate a sufficient immune response in some people. Our response continues to be informed by the latest scientific advice and epidemiological data and we are confident that we can donate this proportion of our stockpile without disadvantaging the UK population.

 

How will this donation be funded?

The donation will be funded from within existing Departmental budgets.

 

What will you do with the excess vaccine if one dose is enough?

Companies are starting to produce preliminary data from their H1N1 vaccine trials in a limited number of subjects. Initial results appear to indicate adequate immune responses from a single dose of swine flu vaccine in adults and, whilst these results are encouraging, they need to be fully evaluated before definitive conclusions can be reached.

 

If the vaccine is safe, why are clinical trials continuing before administering more widely?

The safety of all licensed vaccines and other medicines are kept under review. A specific condition of the regulatory process for pandemic vaccines is that clinical trials continue to be conducted to further evaluate the immune response and safety of the vaccine. As with any new vaccine or medicine, safety will continue to be assessed during use in the general population to identify any possible rare side effects.

 

JCVI has advised that subsequent use of the vaccine in the wider healthy population should depend on the evolution of the pandemic as well as new and emerging clinical data on the use of the vaccine. This will be kept under review.

 

Will those who have already had swine flu still need to be vaccinated? If not, is it right to assume only those who have had diagnosis of H1N1 lab confirmed will not be vaccinated and clinically & self-assessed cases will still be eligible for vaccine?

Theoretically, those who have had swine flu will not need to be vaccinated, but as we are currently relying on clinical diagnosis for the majority of cases, it will not be possible to easily differentiate those that have definitely had swine flu, so we will be offering vaccine to everyone.  It is quite safe to be vaccinated even if you have already had swine flu.

 

Will the rise in swine flu cases mean higher levels of MRSA?

There is no [DQ: should this say no “known” link?]link between MRSA rates and high rates of bed occupancy. Over the past few years, trusts with high bed occupancy have reduced their MRSA levels to a similar extent to the low occupancy trusts. We have been clear that during the pandemic the NHS must continue to follow the same high standards of infection prevention practice that have significantly reduced MRSA.

 

The NHS is well-prepared to deal with a second wave of swine flu, and has robust plans in place to deal with an increase in the number of swine flu patients alongside Winter pressures. 

 

 

 

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