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Is there a flu vaccine shortage?

Fergus Walsh | 16:12 UK time, Wednesday, 5 January 2011

Whether or not there is a flu vaccine shortage seems to depend on who you ask. Dr Rosemary Leonard, a regular on BBC Breakfast, believes there is.

Dr Leonard, who has a practice in Dulwich, south London said: "There's been a rush on the vaccine and my surgery ran out yesterday. We have 40 people waiting to be immunised who are eligible for the vaccine. They didn't come forward when we invited them a few months ago but they want it now."

Dr Leonard said several other GPs in London have reported similar problems.

But according to a spokesperson for the English Department of Health: "There is no national shortage of seasonal flu vaccine. PCTs are working with their GPs to ensure that local supply issues are resolved locally where possible. "

And a spokesman for NHS London said: "Most GPs in London have a good supply of the flu vaccine. However, some are experiencing increased demand with more people than expected wanting the jab. Where stocks run low, GPs are able to share supplies with neighbouring practices.

It would seem that, overall, GPs still have doses, but there are localised problems with individual surgeries which have run out. The Royal College of GPs told me they were not aware of any major national shortage.

To understand how local problems could occur, it is worth setting out how the system works. GPs order their vaccine direct from the five manufacturers who supply the UK or from wholesalers. It is not the responsibility of the various devolved Departments of Health around the UK.

Doctors are encouraged to place orders by the end of March, because it takes several months to create the flu jab. The only way GPs can anticipate demand is to base their order on previous years, taking into account any changes in the recommendations for who should receive the jab. They don't want to run out, but they also don't want to be left with hundreds of unused jabs. There is an element of guesswork involved.

Vaccine uptake this season has been down on previous years, but there has been a sudden surge in demand since the week before Christmas, when the flu story began to grab the headlines.

Usually GPs get their flu vaccine clinics over and done in October and November, so this is very late in the season to be organising them.

So whose fault is it if a surgery runs out? You could simply blame the GPs for lack of foresight if they ordered fewer doses than previous years. But one can hardly expect them to anticipate a late surge.

What about the vaccine manufacturers? Surely they should have made more - just in case they were needed? Nice idea, but they are, after all, running a business, and it does not make economic sense to throw millions of doses away.

Figures from the UK Vaccine Industry Group (UVIG) show that their companies will have delivered 14.7 million flu doses in the UK this season - similar to the two previous years. Most of these were delivered in October, with 98% delivered by the end of November. So they have fulfilled all their orders.

Richard Stubbins, managing director of Sanofi Pasteur MSD, one of biggest vaccine suppliers, said his company had had more calls yesterday from GPs asking for doses, than they would expect in a week.

Mr Stubbins, also the chairman of UVIG, said: "Most companies keep a bit of extra stock for top-ups when GPs run short, but the demand at this time of the year is very unusual. We have perhaps just 8,000 doses left in the UK - and they are going fast."

The five companies that supply flu vaccine to the UK are: Pfizer, GSK, Novartis, Abbott (formerly Solvay) and Sanofi Pasteur MSD.

UVIG said it would be surprised if other manufacturers had stock remaining.

What about blaming the Department of Health? Last year, the DH took over purchasing and distribution of the pandemic swine flu vaccine. They also do this with most childhood vaccines. But flu, adult, pneumococcal and travel vaccines are left to GPs to order direct.

Some might argue that central purchasing would work better. At present, there seem to be enough flu doses around, but some are lying unused in GP fridges - while other surgeries are crying out for them.

The Department of Health has asked vaccine manufacturers how many UK licensed doses are available that are not yet in the UK. This effectively means vaccine with the packaging and leaflet written in English and another language - dual-labelled.

Richard Stubbins said: "My company is looking for dual-labelled doses from Spain and Italy. But altogether there could be less than 100,000 doses spread among all the companies."

That will be a help, but it represents less than 1% of the 14.7 million doses produced this year.

Another option would be to bring in doses which are not labelled in English. But this raises regulatory issues because the vaccines may be packaged differently and the doses will not be licensed for UK use. It would need the Medicines and Healthcare products Regulatory Agency (MHRA) to approve this, which would take some time. By then the flu outbreak may have peaked.

Regarding blame, we could also try pointing the finger at the private sector for buying doses which will largely go to the worried well. About 700,000 doses - 5% of the total - are sold by the manufacturers to the commercial sector - chemists, supermarkets and private companies - who offer the jab to staff.

But this happens every year. And since the manufacturers have supplied all the doses the NHS has asked for, it is hard to see how one can blame the private sector for using doses that it ordered.

I would prefer not to blame anyone, but rather hope that people who need the vaccine get it. Then perhaps some thought could be given to improving the system for supplying flu jabs in the future.

Tomorrow we will get the latest flu figures which might indicate whether the outbreak is getting bigger or easing off. I hope for the latter but suspect the former.

update 18:15

There seems to be some confusion about what the Department of Health has asked the vaccine manufacturers to do.

A DH spokesperson gave my colleague Nick Triggle this quote earlier today: "We have urged the vaccine suppliers in the UK to be in contact with their factories in Europe to see if more UK licensed vaccine can be brought into the UK as soon as possible."

That seems crystal clear. But Richard Stubbins, of UVIG expressed surprise:

"It is not UVIG nor my understanding that we have been asked by the DoH to bring in any available UK licensed flu vaccines.

They have asked 'what doses there are', that is:
The number of available doses in the UK
The number of UK licensed doses which could be brought into the UK
The number of other (non-UK labelled) doses we have around Europe, which could be brought in (regulatory issues notwithstanding).

They had this information on Monday/Tuesday."

So there you have it. Do the DH want extra doses brought in or not? I will let you know when the situation has been clarified.

update 19:30

I am grateful to Kate Pike the Chief Press Officer at the Department of Health who has clarified the situation. She emailed me this: "It appears that what has happened is that the press officer who was speaking to Nick, gave him a statement before we'd checked it with the experts. The "urgently" and "as soon as possible" bits were taken out, as they weren't true.

So my apologies for that. Completely our fault."

I think it is rather nice when people hold their hands up when there is a mistake. The correct line from the DH is this:

"Vaccine suppliers in the UK are in contact with their factories in Europe to see if more UK licensed vaccine can be brought into the UK. "

So they have not asked them to bring in more stocks yet, but I guess they might do in the near future.

update 21:35

If there are local difficulties regarding vaccine supply, they do not, it appears, apply to Scotland. The Scottish govenrment said in a statement: "There are no supply issues with the seasonal flu vaccine here in Scotland.

Over a million doses of seasonal flu vaccine have already been distributed to GP surgeries and pharmacies, with an additional stockpile available should it be required."

Comments

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  • 1. At 4:29pm on 05 Jan 2011, SkylineOnFire wrote:

    Tomorrows figures will be deceptive in a way, as they will only record the tail end of the winter holidays, and wont take into account the return to work and schools of millions of people this week.

    Although I'm actually quite skeptical about that, as I feel the vast majority of flu spreading is done within groups of family and friends, i.e the people who were all together all through the Christmas period. The vast majority of infectious people with influenza will be at home, if your infectious and shedding the virus in large quantities, its odds on your symptomatic too, and the majority of people with proper flu don't leave the house, let alone go to work and school. I guess we will just have to wait and see.

    The mortality figures are lower than last year, significantly so. Despite the fact there are millions of cases this winter so far, there are very few deaths compared to an average flu season, also compared to last winter's swine flu period too. Which indicates that either there isn't as much going around as last year (I don't believe this to be true at all) or that people are seeking treatment earlier (hence the incredibly busy intensive care units etc) and less people are dying due to that.

    I think this season will peak soon, if not already. Purely due to the fact it's such a rapidly spreading virus, it burns itself out quickly, and goes through the community much faster than regular seasonal influenza strains due to the lack of herd immunity, since its a strain not seen for decades.

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  • 2. At 4:34pm on 05 Jan 2011, angelscomeinthrees wrote:

    This is exactly the issue that my GP talked about yesterday. Despite being sent two letters, staging a flu jab clinic and a massive poster campaign in-surgery there was a low up-take so the surgery started using the vaccine for those who were less at risk, on the basis that it is better to vaccinate someone and reduce the spread of the virus in the community than have a vaccine sitting there unused. Now they are being inundated with people who didn't take up the initial two offers of the vaccine and now they've changed their minds and want it as of yesterday.

    Skyline, in your previous post you talked about how horrid this virus is. During the last outbreak there were many asympomatic/mild sniffly cases. Do you think that is still the case or are people experiencing more severe symptoms this time around? I'm only hearing about very nasty experiences - are there many people with it who don't know as before? Does anyone know if there always has to be a chest problem with it for it to be swine flu?

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  • 3. At 4:48pm on 05 Jan 2011, SkylineOnFire wrote:

    The virus hasn't changed, its the exact same virus. The percentage of asymptomatic, mild, severe, etc... It's all the same. The only difference is the more severe seem to be getting treated much better and more efficiently, lowering the number of deaths significantly from last year.

    You only hear about what the media puts out, i.e the worst. There is no money in putting out good news, or even regular news, why bother when you can print the worst case and sell 100,000 more papers or generate 50,000 more clicks on your article online?

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  • 4. At 5:08pm on 05 Jan 2011, amazingHampshireHog wrote:

    One thing that confuses me is that we are told that around 3,000 people die annually from seasonal flu, mainly the elderly. Less than 500 died from swine flu last year, and the number may be similar or less this year. Yet we are told that the NHS is struggling to cope with a surge in flu cases. If this is the case why don't we hear anything about the NHS struggling in previous flu seasons, when apparently more people died? Presumably most of the 3,000 who die in a typical flu season are admitted to hospital at some stage, along with many others who survive from complications such as pneumonia.

    It strikes me as odd - can someone on this blog provide a logical explanation?

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  • 5. At 5:14pm on 05 Jan 2011, Questionsaplenty2 wrote:

    Well I am apprehensive about the results coming out tomorrow. Hopefully they will show a further decrease in acceleration of cases even if the number continues to increase.

    Both my son's came home from school saying nobody much off sick in their classes which is reassuring. I know of a couple of cases locally over Christmas but that is all. Hopefully the kids were the superspreaders the last time SF was here and hence have all had it!

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  • 6. At 5:30pm on 05 Jan 2011, SkylineOnFire wrote:

    AmazingHampshireHog,

    Swine flu is a media buzz word, it generates revenue and attention. Every year there is a little coverage on "seasonal" flu, nowhere near the levels with swine flu though. And every year the NHS is stretched due to flu cases, not like it is now no, although it has been worse than this many times before, i.e 1999/2000.

    The fact we have so many cases in hospitals, is due to the fact so many people are catching it, far more than in a regular flu season, we are talking hundreds of thousands of people per week. You also have to remember that usually a flu season is spread over a few months, not like pandemic flu, which is usually shorter and more severe. So the cases are spread out, rather than the huge numbers we are seeing currently, in a smaller time frame.

    And every winter the hospitals are very very busy from influenza related illness, we just don't hear about it as it doesn't sell like swine flu.

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  • 7. At 5:37pm on 05 Jan 2011, Questionsaplenty2 wrote:

    Good point skyline, in that tomorrow's figures will not be reflecting the back to work/ back to school situation at all, but rather that of the tail end of the Christmas break. It will be next week's figures that will show up what happens as a result of schools starting back.

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  • 8. At 6:05pm on 05 Jan 2011, angelscomeinthrees wrote:

    amazingHampshire, the lasat big flu story I remember in the news (apart from the Child Killing Australian Flu from 2008 which never materialised) was the epidemic of 2000. There were so many deaths that the morgues couldn't cope and were using refridgeration lorries. The reason that story didn't generate the panic that swine flu has is that it was seasonal flu, and therefore its victims were mostly the elderly. Maybe it seems more natural for older people to die or maybe this reflects the lack of respect that our society has for our senior people; take your pick. It's certainly not unusual for hospitals to work at maximum capacity; I think that we are all becoming so alarmed because the way swine flu hits the previously healthy sometimes makes us aware that there might not be a bed should we or someone we love need it for any reason. And of course the press jump on that.

    Skyline, thanks for your comments; I guess 'I had a sniffle and took some paracetamol and then I felt a lot better' isn't much of a blog post. I'm not entirely sure that the explanation that there are so many more cases in critical care this time because they've been treating people quicker quite answers everything but I also expect that the atrocious weather coupled with the way we shop and mix at Christmas might account for the rise in numbers, too.

    I think it is logical to expect that tomorrow's news might be alarming, but it's probably worth remembering that when swine flu first came along death estimates of 65-100,000 were being talked about. Every death is an individual tragedy and I feel so desperately for eveyone involved.

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  • 9. At 6:49pm on 05 Jan 2011, Questionsaplenty2 wrote:

    Was just speaking on the phone to a friend who works at a doctor's surgery...she said they are getting inundated with calls from parents who want their healthy kids vaccinated and won't take no for an answer.I think there are a lot of concerned parents out there, I didn't ask but I wonder if many of them are the 5 year olds that previously qualified for vaccine?

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  • 10. At 10:06pm on 05 Jan 2011, KRUSADER wrote:

    Please read:
    'UK H1N1 ICU Cases Spike To 738' http://www.recombinomics.com/News/12301001/H1N1_UK_ICU_738.html
    'Who is more at risk of severe illness? What about other risks?' http://www.who.int/csr/disease/swineflu/frequently_asked_questions/risk/en/index.html
    'What is post-pandemic?' http://www.who.int/csr/disease/swineflu/frequently_asked_questions/post_pandemic/en/index.html
    'H1N1 in post-pandemic period' http://www.who.int/mediacentre/news/statements/2010/h1n1_vpc_20100810/en/index.html
    'Comparing deaths from pandemic and seasonal influenza' (Pandemic (H1N1) 2009 briefing note 20) http://www.who.int/csr/disease/swineflu/notes/briefing_20091222/en/index.htm

    If you read what Margaret Chan of the WHO said in the above,as compared to Fergus, who is I believe slightly misinformed there were over 16,000 deaths from A/H1N1 influenza - but she also tells us the true figure would be much higher as this figure only covered those cases where individuals died of A/H1N1 influenza and this was given as the cause. In many more cases those who had died of complications e.g. bronchitis or pneumonia would have this listed as bronchitis or pneumonia. In many patients no tests were done to see if they died of A/H1N1 influenza because the tests are so expensive - e.g. in African countries.

    I have my own pages on the internet - I will also be putting this information on that.

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  • 11. At 11:50am on 06 Jan 2011, angelscomeinthrees wrote:

    Something I meant to mention earlier - Fergus, you said that most private flu doses go to the 'worried well'. I think this is a little unfair as it implies that these vaccinations are unnecessary and even smacking of hypochondria. Leaving aside the issues of personal choice and also the fact that any amount off vaccination reduces the amount of flu circulating and therefore benefits the population as a whole, many people who seek out the flu jab privately do so because they are self-employed and cannot afford to lose any working hours to illness - or entire clients if the customer decides to hire someone else. Also when I worked in London many big firms brought in private nurses to vaccinate their workers should they wish to have it, again to reduce working hours lost and maintain productivity - something this country needs right now.

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  • 12. At 12:18pm on 06 Jan 2011, andylambs wrote:

    There shouldn't need to be a rush on flu jabs. My daughter is immunosuppressed. My parents are elderly. They were all given the jab back in the autumn when the vaccine was first available from the GP.

    I don't think the GPs will have been remiss in scheduling their usual flu jab clinics. So why did people not turn up in the autumn? Is it somehow easier to find the time for an injection when you know the virus is circulating?

    I would not contemplate missing the flu jab for my daughter. People need to take responsibility for their own health, not blame others for their laziness.

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  • 13. At 1:21pm on 06 Jan 2011, Sutara wrote:

    andylambs

    My theory on this - as yet unsubstantiated - is that some people when called to get the seasonal flu jab had been influenced by the idea that the jab was 'mainly' H1N1. They probably took the view that they had already had a jab for that and so they didn't need to double-protect themselves from that strain.

    What the NHS may have failed to do was to adequately get over to people - over and above the volume level of media hype - that the seasonal flu jab also vaccinated against other flu types too.

    Add to that the voices of the 'anti-vaccination' brigade.

    Add to that the economic difficulties and the pressures to not take time off of work to go to a flu-jab clinic.

    Add to that a sense of 'all this swine flu stuff is just a pile of media hype anyhow'.

    Add to that probably a range of other factors.

    The real concern here is that if there has been a significant lowering of take-up of the seasonal flu jab, how come all those well-paid-from-the-public-purse senior officers in the NHS / DOH didn't come up with any sort of a Plan B in the interests of their public health responsibilities?

    Maybe it was just easier to ignore the low take-up than to do anything about it?

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  • 14. At 1:42pm on 06 Jan 2011, gez wrote:

    I think that responsible journalism should include the following information when scare mongering.
    1. How many of the people that have died from swine flu had other health issues such as cancer etc.
    2. Are other countries in the EU having the same problem?
    3. Has swine flu been established as the absolute cause of the deaths being reported?
    4. What are if there are any side effects of the swine flu jab and how toxic to humans is the jab and what does it contain?
    5. How many of the group of alleged related deaths to swine flu were pregnant women, etc and what is the average for this time of year?
    6. What is the average year’s death toll from ordinary flu currently and for the last 10 years and how does it compare with swine flu? Is there an increase?

    icould go on and on with these questions!

    I think it is a worrying time for everybody and if journalists are to report on such things as swine flu it should be done responsibly and contain all the facts for people to make an informed decision that could be possibly life threatening.

    Please report well or don’t bother the public are used to being lied to for economic reasons and are a little unsure who to beleive.

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  • 15. At 1:44pm on 06 Jan 2011, angelscomeinthrees wrote:

    Sutara, I definietly agree with you - in particular there was a big anti-vaccination story in the Mail with some 'patient group going on about how adding swine flu to this years' flu vaccine reduced 'patient choice', and that a separate jab without sf in should have been made available. Not a million miles from the separate MMR jab thing really.

    Maybe the fact that last year seasonal flu wasn't about also lulled people into a false sense of security.

    But I wonder how many of the front line medical professionals have been taken by surprise? As I've said before, when I had my flu jab I mentioned to the nurse something about swine flu and she said that it was all over with. When I expressed surprise, not least because I'd been talking to people who were getting it in NZ over the summer (their flu season), she said, 'Really? I hadn't heard that. Maybe we will see it again this winter but certainly it's not something that we've been told to prepare for.' ???????

    Sometyhing that's worrying me: what's all this from NI about people with sf being 'sicker' this year? :(

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  • 16. At 1:49pm on 06 Jan 2011, DisgustedOfMitcham2 wrote:

    I suspect my GP's surgery was running short before Christmas. My partner has asthma, has had life-threatening complications of flu in the past, and not unreasonably thought she was in a risk factor group.

    She didn't get an invitation from the GP, and when she got in touch with the surgery in December, she was told she couldn't have the jab because they were no longer considering asthma to be a risk factor. They claimed that his was based on new government guidance, which I suspect is incorrect.

    I find that a bit worrying. Presumably this was their way of making stock last a bit longer, although I'm not sure what the point of that is if they're going to deny it to people who have risk factors anyway.

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  • 17. At 2:01pm on 06 Jan 2011, redrobb wrote:

    Did you not hear that us JOCKS north of the border have so much stockpiled that oor Health Minister has considered approving the transfer of £12m that was earmarked for Flu Vaccines but will possibly be transfered over to 2014 commonwealth games, as I hear the've gone and got themselves into a wee bitty financial trouble, does anyone recall when a Mr Maxwell underwrote the last commenwealth games, in reality it was perhaps not Mirror pensioners that did all the underwriting, but hey-ho he got all the back-slapping.......

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  • 18. At 2:06pm on 06 Jan 2011, angelscomeinthrees wrote:

    Gez, in answer to your question about flu deaths, usually there are several thousand a year, mostly the elderly and those who have underlying health issues. In 1999/2000 there were more like 20,000 deaths.

    It looks like we will be looking at deaths in the hundreds from swine flu. Difference being, it'll mostly be younger people. So far the statistics I've seen seem to be suggesting it is mainly yound adults rather than children but that may change now the schools are open again. In terms of cases though, we're definitely heading for an epidemic like in 1999/2000. Yet...the Gp I spoke to this week said that they are seeing nothing out of the ordinary and last year was far worse. Maybe we haven't been hit in my area yet or maybe it isn't going to happen.

    I believe the deaths recorded are people who have died 'with swine flu'; I have spoken to people involved in treating people and in many cases, but not all, death was likely from any strain of flu or other illness that the person caught because they were already so poorly. However, it is also possible that deaths don't get recorded where a person died from complications arising after the virus has passed, I suspect. And some people who died have been otherwise healthy.

    I don't think we're being lied to - if anything we are being panicked over something that doesn't require such extreme reaction. I believe any government to be capable of pretty much anything but in this case I think there can't be any definitive answers until the peak has passed and the lessons learned.

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  • 19. At 2:37pm on 06 Jan 2011, Questionsaplenty2 wrote:

    HPA report is out

    http://www.hpa.org.uk/web/HPAweb&HPAwebStandard/HPAweb_C/1287147913271

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  • 20. At 2:40pm on 06 Jan 2011, Questionsaplenty2 wrote:

    So promising results: 11 further daeths shows stability and a decrease in reported cases overall in England

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  • 21. At 2:45pm on 06 Jan 2011, Questionsaplenty2 wrote:

    plus a decrease in Scotland too, and stability in Wales

    Depending on how much herd immunity is in existence for the schoolkids will depend if we have an upwards blip next week, but it does look promising. No noticeable numbers of kids off at my childrens schools yesterday.

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  • 22. At 2:52pm on 06 Jan 2011, Questionsaplenty2 wrote:

    Extremely sad for the families of those 11 who died thought, I didn't mean to dismiss that fact

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  • 23. At 2:54pm on 06 Jan 2011, SkylineOnFire wrote:

    My predictions on the numbers of infected hovering around the same area, or decreasing, were quite accurate, but I'm quite surprised by how little deaths have been reported, espeically since there were so many in intensive care, and so many cases over christmas and the holidays. Good news all round though.

    You must expect a slight increase next week, and the week following that, due to the return of schools and workplaces. It's not a guarantee but there's a good chance there will be a slight increase. But these figures are very positive.

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  • 24. At 3:01pm on 06 Jan 2011, Getaperspective wrote:

    Consultation rates are probably lower because many GP practices were closed
    over the Christmas period. Travel clinics also offer the flu jab.

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  • 25. At 3:07pm on 06 Jan 2011, Questionsaplenty2 wrote:

    I think what is promising too is the figures for 1-4 year olds dropping off - they are not affected by schools or workplaces.

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  • 26. At 3:11pm on 06 Jan 2011, Questionsaplenty2 wrote:

    skyline - if the schoolkids and those mixing readily in busy offices were last years superspreaders might it not be equally possible that we don't see an increase next week. Looking at graphs of previous flus there tends to be a small upwards blip when the schools return., but those other seasonal flus had not been round the schools as recently as this one. The average number of cases for schoolkids per year of age is very low compared to other age groups even in the last few weeks. I don't know if that was the same story during the originaL h1n1 wave.

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  • 27. At 3:13pm on 06 Jan 2011, scaredycat1 wrote:

    skylineonfire

    I agree there could be an increase due to the return to work and schools however if that was likely wouldn't it be a common trend with the historical data?

    When looking back over previous flu season data there has never been a fall as large as the one over the last week followed by subsequent significant rises in rates of illness or consultation.
    Of course there is a first time for everything but it does looks good.

    I am shocked at the media's lack of positive coverage as usual, none of the mainstream outlets are reporting the drop in rates to GP's, NHS calls etc simply reporting on the increased deaths.

    I am also confused as to where the IC numbers are up to, after the 750 or so reported patients last week there has been new figures out, apart from the scare stories circulating about beds running out.

    So in conclusion is this a case of peaked cases, peaking as we speak, or yet to peak and a long way to go?

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  • 28. At 3:17pm on 06 Jan 2011, Questionsaplenty2 wrote:

    getaperspective
    True (unless they are worked out on a percentage of patients seen), but this would have been the case in the preceding week also

    But importantly, the NHS helpline numbers have also dropped as have the hospital numbers - neither of these would have been affected by the holidays.

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  • 29. At 3:27pm on 06 Jan 2011, scaredycat1 wrote:

    I now also see from the BBC article that the number of people in IC has dropped from a peak also , hopefully this is further good news and wouldnt be subject to seasonal or school holiday timings etc.

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  • 30. At 3:41pm on 06 Jan 2011, Michael wrote:

    It is fascinating to live in a country where half the population seems to be against vaccination in any circumstances, while the other half is stuffing themselves full of supplements and non-scientific remedies of various kinds (or are we talking about the same half in each case?).

    As Margaret Thatcher once said, it is a funny old world...

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  • 31. At 3:48pm on 06 Jan 2011, angelscomeinthrees wrote:

    I think the analysis on this website that the more people are worrying, the more we are causing something to worry about. In the same way that panic caused anyone with a sniffle to bag some tamiflu back in the first outbreak, we've got the run on vaccines, and possibly people who don't need to seeing their GP and hospital (our local one has a message on its website saying not to go to A&E if you have flu)
    and clogging up the system.

    Something I've heard recently is that some surgeries have found that vaccinating pregnant women has taken up a large proportion of their vaccines. Although guidance was issued in May to say that pg women should get the jab, could it be that those responsible for ordering the vaccines (which I believe is the individual surgeries) hadn't factored this in?



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  • 32. At 3:55pm on 06 Jan 2011, Whitsa1 wrote:

    These figures are very positive. Looks like the "crisis" is past the peak. From the trends in previous years it looks unlikely the numbers would increase again even with kids going back to school. Hopefully the worst is over and perhaps when we look back rationally in the weeks ahead we will wonder why there was ever such a fuss (albeit I do understand the individual tragedies, which will unfortunately always happen)

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  • 33. At 3:59pm on 06 Jan 2011, Andrew Kerr wrote:

    Most years, somewhere between 3,000 and 4,000 deaths are attributed to influenza - a simple fact that seems to have passed most reporters by. But of course it's not in their interests to report that the current situation is pretty well normal. That's hardly news, is it? So the media prefer to scare us half to death by suggesting that something very unusual is happening, which it isn't.

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  • 34. At 4:18pm on 06 Jan 2011, Peter_Sym wrote:

    This is a case of wanting it both ways: after last year Fergus's blog posts were full of criticism for the govt for spending tens of millions of pounds on un-needed stocks of Tamiflu and Swine flu vaccine. Now people complain that there AREN'T huge stockpiles lying around! The idea that the drug companies (who contrary to popular myth aren't making money hand over fist- check out the share prices- the pharm industry has been hammered over the past decade after one big product after enough failed to work) would just make millions of doses spare on the off chance they were needed is ridiculous. Tesco don't keep a million bottles of water in their back room in case there's a Northern Ireland style water shortage and no-one expects them to do so.

    Incidentally as with Spanish Flu in 1918, or the 1968-69 Hong Kong Flu epidemic (my father was a junior doctor during that one and remembers medical students being drafted in to ventilate patients in the corridors with hand operated bag & masks because ITU was so overwhelmed) there's a reason the young are affected and the old aren't: the same 'bad strains' crop up every 40 years or so and the 60 years old of today are from the 20 years olds who survived the last pandemic. Its not rocket science.

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  • 35. At 4:24pm on 06 Jan 2011, Peter_Sym wrote:

    4. At 5:08pm on 05 Jan 2011, amazingHampshireHog wrote:
    One thing that confuses me is that we are told that around 3,000 people die annually from seasonal flu, mainly the elderly. Less than 500 died from swine flu last year, and the number may be similar or less this year. Yet we are told that the NHS is struggling to cope with a surge in flu cases. If this is the case why don't we hear anything about the NHS struggling in previous flu seasons, when apparently more people died? Presumably most of the 3,000 who die in a typical flu season are admitted to hospital at some stage, along with many others who survive from complications such as pneumonia.

    It strikes me as odd - can someone on this blog provide a logical explanation?
    _______________________________________________________________

    Sadly I can. First as you say its usually bacterial secondary infections that are the problem with seasonal flu and these are easily treated with antibiotics if caught early enough. With H1N1 strains of flu its often the virus, not the secondary thats the problem and viruses are very hard to treat.

    The brutal truth is that an 80-year old with pneumonia and flu will not get the same efforts to save them as a pregnant woman or a 5 year old will. We all die eventually and one of the hardest decisions a doctor has to make is when to stop attempting to save life. 24 hours in intensive care can cost £10,000 which is why we have relatively few ITU beds and why someone with potentially 100 years of life ahead of them will get priority over someone at the end of their life.

    This was one of the reasons I became a scientist rather than a doctor. I'm paid less but I don't have to make this sort of decision.

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  • 36. At 4:32pm on 06 Jan 2011, shilkman wrote:

    It's just scaremongering by the media again as they are short of news stories!

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  • 37. At 4:33pm on 06 Jan 2011, teamw wrote:

    I've just rung my doctor's surgery to request a flu jab and been told that there are none available and won't be until next October!! I was asked if I was in an 'at risk' group (which I am) and had I not received a letter (which I hadn't).
    It has never been made clear to me that I needed to be quick off the mark to obtain a flu jab!!! Now it seems that I have missed the boat. Why is more money being wasted on advertising this service when clearly it is not available!

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  • 38. At 4:37pm on 06 Jan 2011, WanderingWill wrote:

    Rosemary Leonard makes a good point about the folk who did not come forward for re-vaccination when asked earlier - however it also seems that a great deal of surgeries simply do not ask at all. Mine still does not.

    With people dying unnecessarily, where is the equality in our health care system?

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  • 39. At 4:59pm on 06 Jan 2011, Questionsaplenty2 wrote:

    teamw

    I think in these economic struggles most people should be responsible enough to go and get their flu jab in the Autumn without a reminder, a bit like taking your car in for its MOT.

    To say why should you rush to get a vaccine when it is January and the flu season is well under way is a bit rich. It does not sound like you were particularly bothered about having it until H1N1 returned. I know my GP sets up flu vaccine clinics in Autumn to deal with everybody efficiently. My husband is asthmatic and qualifies but did not receive a letter this year. He booked an appointment off his own back, alongside his asthma checkup. Perhaps had he not done so, he would have received a letter, I don't know. My elderly mother was also vaccinated by the community nurse where she lives in the Autumn.

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  • 40. At 5:00pm on 06 Jan 2011, Questionsaplenty2 wrote:

    Also any adult who is desperate for the vaccine at this late stage can get one at pharmacies and supermarkets.

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  • 41. At 5:00pm on 06 Jan 2011, Mike wrote:

    I laugh at the 'sensational' news headlines "man dies of swine flu". All in the hope of selling a few more papers and pointless vacines that don't work (ssome people who tyake them are expected to live!). I saw another one - "400% increase in swine flu deaths". I think the original number was 1. Meanwhile 100s people die everday in road carnage, obesity and wait for it.... adverse reaction to perscription drugs (one of the biggest killers in the Western World). If the Government really cared about your health they'd ban all the fast food crack houses and poison sugar sections in supermarkets.

    Just goes to show that anything can be proved from percentages and statistics. Let's see ratios instead - then you'll see what a load of nonsense swine flu is.







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  • 42. At 5:34pm on 06 Jan 2011, Questionsaplenty2 wrote:

    Just a few factual reminders folks (it helps my anxiety to remind myself of these):

    Only 45 out of the 50 deaths reported since October were from H1N1 SF
    In the age groups under 5, there have been 5 deaths, thats 1.2 cases per year of age nationally
    In the age groups 5-14, there have been 8 deaths, thats 0.8 cases averaged per year of age
    In the age groups 15-64, there have been 33 deaths, thats 0.6 cases averaged per year of age

    That is effectively on average less than 1 person per each age year out of the whole of the UK that has actually died. Incredibly sad for those families but these figures really are small. And then ...

    Going on last weeks figures, only 2/36, approx 6% were from people who have had the vaccines, the remainder 94% were unvaccinated.
    And 27/36 had underlying conditions - that's 3 quarters!

    So sadly, if those at risk people had been vaccinated, we would probably be looking at deaths closer to 11 or 12 by now since October.

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  • 43. At 5:34pm on 06 Jan 2011, Megan wrote:

    Mike, you say, "Just goes to show that anything can be proved from percentages and statistics" - er, haven't you noticed that this is what passes for 'science' as far as the medical profession is concerned?

    You never get stories about actual causes and cures, you just get "increased risk of getting X disease due to Y factor" peddled as being a causal relationship.

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  • 44. At 5:49pm on 06 Jan 2011, markuspetz wrote:

    Hmnn I notice a blame is given and then exonerated for every party EXCEPT the patients. Yes the people that did not take up the offer when it was there in the Fall. It is their own fault - every year we are told about the flu. It is the same with brushing your teeth or using a condom to prevent STIs. People ignore what they are told by the professionals that know and then try and blame the private sector, government or medics for health failings. Surely the at risk groups can be identified in March and then vaccine ordered for all of those that will be around next flu season? If everyone had to pay ANYWAY and then did not come there would be no cause for complaint nor finger pointing.
    Although it is true the government could make inprovements:
    1. All European vaccines to be transferable between all EU countries - so where ever there is a demand we can help other places and they us. I think a Dr. can give me medicine properly even if the leaflet in the box happens to be in Hungarian or whatever. A change in EU rules could require English in all packs could be good as a common community language.
    2.Proper reporting of the figures on time - http://www.who.int/csr/disease/influenza/influenzanetwork/flunet/en/
    Is an international standard reporting, but if you look the UK has not given its figures in time this week (its not the only place) why not?
    3. Self reporting - a way to do this might be good - then we can know who has it and is at home. Via the internet can be good - why not using net banking codes? It works for accessing almost every service in Finland. It stops infected people spreading this and other diseases and allows local health monitoring.

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  • 45. At 5:59pm on 06 Jan 2011, Shamo75 wrote:

    We live in a nanny state where we are spoon fed in order to make us a more manageable and predictable population/source of revenue. If you feel strongly enough about the potential threat the flu virus may represent then it should be down to the individual to source and pay the nominal sum of £10 for that protection. Granted we pay our taxes but at some point there has to be a level of personal responsibility.
    The Government have created this monster and are now struggling to manage the resulting hype. They are desperately encouraging people to get vaccinated in order to look like they are being proactive when actually it simply highlights the lack of joined up thinking that has taken place. With Viroligists predicting an end to the Flu season in a matter of weeks it seems an empty gesture by health ministers to advocate vaccinations that will offer no significant protection for at least 10 days.
    It's worth remembering that these same ministers that seem to be muddling their way through their temporary stay in office are no different and in some cases less qualified to be in their positions than you or I. The sad truth is they should be and it's largely down to our x-factor politics and voter apathy that we are landed with a bunch of inadequate temps with their sole motivation being to avoid a proper job (Too harsh???)
    Our New Year's resolution should be to take back control of our lives/health, and socio-economic future. If you are happy to sit back and let nanny take you for a drive don't complain when the journey and destination is not what you had planned!

    Sorry for my rant.

    Out of interest why are they not reporting more on the ICU,Surgery and NHS direct statistics? Skyline mentioned a significant drop in cases and I know how good he is good with a calculator so some number crunching would be interesting to see.

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  • 46. At 6:05pm on 06 Jan 2011, Harry Hayfield wrote:

    I am very interested to know where I can get a copy of the figures that you quoted in your report in this evening's Six O'Clock News (as I have been trying to find those figures since last year!)

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  • 47. At 6:23pm on 06 Jan 2011, angelscomeinthrees wrote:

    If I were pg I would get vaccinated any time between now and March. It does appear that the shortage is largely due to the number of pregnant women requesting the jab being underestimated. Otherwise, I think this is a case of stable doors etc.

    I won't comment on individual cases but I'm afraid I agree with the premise that if you are at risk and you qualify for the flu jab, book yourself in for one, and if your GP (or more likely the receptionist) doesn't get on the ball then pay a tenner and get it done on the High Street, unless you are at risk from vaccine reactions.


    The exceptions are those who aren't capable of doing this - to some extent it's up to the relations of the old and vulnerable to ensure these things are taken care of. Our GP also runs a flu coffee morning for the older folk in our community with stall and tombolas, coffee and home-made cake, oh, and a flu jab whilst you are at it.

    Shamo, the previous govt, used fear to infantilise us and make us ever more dependent upon them (and therefore more compliant and also likely to vote for them). This lot will pinch every penny and I don't get the feeling too many of them know what they are doing. Either way, it's up to us to grow a pair and sort our own lives out rather than expect the State to do it for us.

    Just seen an interesting point re the mass media and scaremongering - it'd be interesting to know what holdings some of the big media owners have in pharmaceuticals.

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  • 48. At 6:32pm on 06 Jan 2011, Glosrules wrote:

    5 years ago my husband had a heart attack.
    Both of my in laws(in their 80's) have had Pneumonia and have still got underlying breathing health problems.
    YET, in 2009 when my husband was due for his flu jab, he was admitted to hospital yet again with more heart problems.
    I asked at the surgery if I could have his injection after looking after both in laws AND my husband, yet they refused stating that I was "not in the high risk" band.
    now they are saying they have loads left over - what was their problem. Why would they not allow me to have one when I am in FULL CONTACT with 3 vunerable people - who all gets theirs.

    The surgery really should be ashamed of themselves when they are supposed to be in the "care" profession and pull this stunt.

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  • 49. At 6:33pm on 06 Jan 2011, corum-populo-2010 wrote:

    Well, this is all very disturbing and unsettling too?

    Understandably, there is a suspicion that the Department of Health in England, under the Conservative Andrew Lansley regime, are not 'up to speed' on this issue compared to Scotland and Wales?

    Naturally, news reports can often cause 'panic' response from the public? Individuals are not being contacted by their GP surgery - or have undiagnosed respiratory problems?

    As for the reported shortages of vaccine - this is still unclear.

    Perhaps it would be more cost-effective if flu vaccines were offered automatically for everyone? Blood donor or breast screening vans could be used to take the option/opportunity to the public at their place of work? Yes, that comment is controversial - but most people are reluctant to take time off work to fit in with GP surgery times, especially right now.

    I don't know, but there must be a better way of vaccinating the population en masse?

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  • 50. At 6:33pm on 06 Jan 2011, thebleedingobvious wrote:

    perhaps nature will come up with a strain of the flue that wipe out the stupid and poor. SNEEZE INTO A TISSUE, PUT TISSUES IN A BIN, WASH YOUR HANDS. 'Old flu vaccine' WTF it is the same vaccine that would be made today to combat H1N1. There are to many hysterical parents out there that are completely incapable of taking care of their child and uninterested in teaching them basic hygiene. I suggest all parents who produce children with no realistic way of financially supporting their housing, feeding, clothing, education and health should be serialised. Its not a right to have a child it’s a privilege, one which most people think once they have achieved it is everyone but their own responsibility. We can’t afford to look after some of the self inflicted diseases that we used to so if your fat, smoke, dirty, drunk and it hurts……well done, not my problem.

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  • 51. At 6:48pm on 06 Jan 2011, Helen Taylor wrote:

    On the NHS website it states that carers of elderly or disabled people may be given the vaccine at the GP's discretion.

    I wonder if these numbers were factored into the GPs assessments of how much flu vaccine they needed to order?

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  • 52. At 6:55pm on 06 Jan 2011, Peter wrote:

    I believe there is a huge amount of scaremongering by the media about flu pandemics and shortages of vaccine. The BBC reported that 13 or was it 30 million flu jabs, which contain the swine flu vaccine, have to be used before the use by date of March 2011. So how can there be a shortage or is this really about boosting the profits of the massively powerful pharmaceutical industry.
    Perhaps the BBC should be investigating why there appears to be an increased incidence of death in younger people from winter flu. Could the problem be weakened immune response from too many jabs in childhood rather than absense of the annual flu jab!!

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  • 53. At 7:09pm on 06 Jan 2011, Mike wrote:

    Megan:

    And we live in a society where the people who do the research, make the profits on you being 'ill' - or telling us that you might get ill - absolute disgrace.

    And let's face it and no disrespect here; but doctors, nurses and medical researchers are hardy role models for health and fitness.

    And if you want a stat: 4,500 are admitted to A & E every year after putting their trousers on - perhaps that should be put on the newspaper headlines and warn of the dangers - I mean you could die.


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  • 54. At 7:13pm on 06 Jan 2011, Anne wrote:

    I don't imagine that the GPs do know about all the cases. I am currently recovering from the worst flu I have ever had in my life - but I don't get the impression that the GPs want to know, even had they been open at the time I was most ill.

    I am late 50s and not considered in a risk group, but I am self-employed and a tax payer. It irritates me to see all the media coverage about lack of take up. Many of us, whose livelihoods depend on staying at work, would like to be offered vaccination. Surely it would be a good investment for UK PLC to offer immunisation to the working population instead of treating the working population as all being "worried well" and totally expendable.

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  • 55. At 8:20pm on 06 Jan 2011, angelscomeinthrees wrote:

    Bridgwatergirl, I'm sorry to hear that you aren't well, and wish you speedy recovery.

    Put a tenner aside now - a quid a week for ten weeks' - and you will be able to bag yourself a flu jab at Tesco come October.

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  • 56. At 02:47am on 07 Jan 2011, Merrell2 wrote:

    I wonder if one of the reasons in the surge in requests for the vaccine is the initial confusion of who was entitled to it in some areas. My friend who is pregnant was told that because she had the seperate pandemic vaccine last year she didn't need this one as they weren't keen on pregnant women getting two doses.

    And as an asthmatic I usually get the flu jab every year. This autumn I wasn't well enough to get it at the asthma clinic. When I phoned up to make an appointment later at the flu clinic I was told I wasn't in one of the recognised entitled groups as that only applied to asthmatics that have had needed intervention in the last three years. So I didn't get it.

    It appears no one in our area really knows what the guidelines are. I am currently suffering from a chest infection so unable to get it from the pharmacist but will when I'm up to it. In the meantime could anyone confirm if I would have some immunity to tide me over as I had the seperate pandemic vaccination 11 months ago. Does the vaccination from last year offer any protection?

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  • 57. At 09:04am on 07 Jan 2011, Mike wrote:

    Anything the Government's or GP's or seal of approval is bound to be dubious to say the least. Doctors know little about nutrition and hand out pills and give jabs like they are sweets, rather than change your way of eating to solve health problems and make you more resistant to the flu.

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  • 58. At 08:37am on 11 Jan 2011, Andy wrote:

    We have just been informed that our 6 year old ashmatic boy, who has an egg allergy (we carry epipens everywhere)cannot have the vaccine this year (he had it last year) as egg allergy sufferers are too small a group to cater for this year - i.e. non egg based vaccine.

    Meanwhile, our daughter (4 years) is no longer in an at risk group, as she is not on constant steroid based treatment, so we now have an increased risk of the flu coming home with no vaccine potential.

    So, not so much a shortage, but more a message this year of - have allergies ? Tough luck.

    Frustrating, we even offered to pay for the vaccine, but as above - our GP said that the vaccines have simply not been made that contain no egg.
    That is a touch message as a parent, being told, tough, it is too expensive to vaccinate your children.

    Sigh..

    Andy

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