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Pandemic flu jabs to plug vaccine shortages

Fergus Walsh | 23:03 UK time, Thursday, 6 January 2011

What do you do with 12.7 million doses of pandemic flu vaccine which will pass its expiry date later this year?

The answer came today when David Cameron ordered it to be made available to any doctors who have run out of seasonal flu vaccine.

In theory, there are enough stocks of seasonal flu jabs to go round. The Department of Health said today that 14.8 million doses of trivalent vaccine were produced for the UK, protecting against H1N1 swine flu, another flu A strain, H3N2 and flu B. That is a similar amount as previous years.

But there has been a late surge in demand for the vaccine and some GPs in England are out of stock.

Swine flu has been responsible for 90% of the deaths so far this winter, with flu B claiming the rest.

So anyone getting the pandemic vaccine can be reassured that they will be protected against the dominant flu strain. The head of immunisation at the Department of Health, Professor David Salisbury said: "People will not be getting a second class vaccine. The pandemic jab is effective and safe. Indeed it is probably better at protecting people against the H1N1 virus than the seasonal flu jab".

He said this was because the pandemic vaccine contained an adjuvant (booster chemical) which gave very strong immunity. That may well be so, but I doubt very many people going to their GP will ask for last year's vaccine, if this year's is available.

There were lots of statistics released today by the Health Protection Agency. Many of you like the detail, so I will pick out some.

In England this morning there were 783 people critically ill with flu complications, the vast majority with swine flu. Of these, 640 were aged 16-64.

Fifty people have died since October with flu, up 11 from last week. Of those who died this is the age breakdown:

Under-five: five deaths

Five to 14: eight deaths

Sixteen to 64: 33 deaths

Sixty-five and over: four deaths

Most had underlying health problems and very few had been immunised. They include Sarah Applin, from Suffolk. who was just 32 when she died from swine flu earlier this week. She gave birth to a healthy baby boy just before Christmas. Her family said she simply didn't get round to having the flu jab and they urged others to get immunised.

The number of people going to their GP with flu-like illnesses in England and Wales was 98.4 per 100,00 down from 124.4 the previous week.

In Scotland it was 52 per 100,000, down from 55.8.

The only increase was in Northern Ireland where it was 179.5 per 100,00, up from 99.4.

But all these levels are far below flu rates in years gone by. In 1989-90 the consultation rate in England and Wales reached more than 600 per 100,000 and research (Curwen et al "Hidden influenza deaths: 1989-90" Population Trends 61 (1990), 31-33) suggests 25,000 people died as a result of flu complications.

The big difference is that seasonal winter flu used to mostly kill the frail elderly - but swine flu mostly hits the under-65s.

Elderly, vulnerable patients who die at home with pneumonia following a dose of flu do not grab the headlines like pregnant women or teenagers who succumb after battling the virus in intensive care.

Furthermore, 15 of the deaths so far this winter have been among people not in any at-risk group for flu. Last year I recall about one in five deaths were among healthy people, but given the comparatively small number of fatalities, that proportion will vary each year.

Every death from flu is a tragedy for the families. The hope must be that, from now on, pregnant women, and others who are most vulnerable to swine flu, will get a seasonal flu jab. A full list of those eligible is available on the NHS choices website.

Around 70% of the over-65s get the flu jab, but fewer than half of under-65s at risk get protected.

I know I keep saying this, but it is worth keeping a sense of proportion about this. One of tomorrow's headlines - the Daily Express - describes the current outbreak as a "flu plague".

Millions - probably tens of millions - of people in the UK have now been infected with H1N1 swine flu. The vast majority either had no symptoms at all or a mild but unpleasant illness from which they recovered after a few days in bed. That is hardly a plague.

I will leave you with one statistic which should shame the NHS: just 20% of front-line health care workers have been immunised against flu this winter. That really is pathetic.

Immunisation protects them, protects their patients, and ensures that vital healthcare staff can continue to work during an outbreak. How can the NHS encourage the public to get the jab when its own staff don't bother?

The NHS Chief Executive Sir David Nicholson described the uptake figure as "disappointing" but said he would not consider making flu jabs mandatory for frontline staff.


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