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Don't fear the swine flu jab: Health chiefs reassure the public at start of mass vaccination
10-22-2009, 07:33 AM,
Don't fear the swine flu jab: Health chiefs reassure the public at start of mass vaccination
Quote:Health chiefs yesterday had to issue an assurance that swine flu jabs were safe - on the day that the mass vaccination programme began.

They said the vaccines have been thoroughly tested and urged high-risk patients and frontline NHS staff to get inoculated.

The call came amid persistent fears over the safety of the programme which was launched in hospitals yesterday.

Pregnant women will be offered jabs from next week by GPs, along with other high-risk patients, including children and young people with underlying health conditions.

Two vaccines will be used, Pandemrix manufactured by GlaxoSmithKline and Celvapan, from Baxter.

Pandemrix was made using chicken eggs, to which some patients are allergic, and also contains a controversial ingredient that boosts the immunising effect.

Surveys suggest many of those eligible for vaccination will refuse because of concerns over the speed of the testing programme, or because they believe it's unnecessary because the risks posed by swine flu are low in healthy people.

They may also be discouraged by the fact that many health professionals are reluctant to be vaccinated according to a number of polls.

Chief Medical Officer Sir Liam Donaldson admitted the vaccines had been produced more quickly than usual, but denied they had been rushed. He said extensive pre-testing on a prototype had enabled manufacturers to go into rapid production once the H1N1 swine flu virus was substituted for the test virus.

Sir Liam and other Health Department advisers have consistently claimed the stimulating compound, or adjuvant, in Pandemrix poses no safety problems.

But in Germany doctors want pregnant women and children to have Celvapan because they say it's 'better-tested'.

Dr Frank Ulrich Montgomery, of the German Medical Association, said: 'We know the effects of the various ingredients in adjuvant vaccines but not the combined effect. It's under-standable that people are wary of getting jabs of drug cocktails.'

However, a spokesman for the Department of Health pointed out there was no data currently available on the use of Celvapan in children.

Pandemrix is recommended for pregnant women because they are at greater risk of complications and get quicker protection after just one dose of vaccine, she said.

'The European Medicines Agency has strict processes in place for licensing pandemic vaccines. It would be extremely irresponsible to suggest the UK would use a vaccine without careful consideration of safety issues,' the spokesman said.

Traditionally healthcare workers have been reluctant to get jabs against seasonal flu, with uptake in a typical winter being as low as 20 per cent. But Sir Liam urged them to get a swine flu jab as soon as possible.

He said: 'It will help prevent them and their families getting the virus from patients, it will stop them passing the virus on to their patients, it will potentially protect them from mutated strains and it will reduce the disruption to NHS services caused by people being absent due to illness.'

A joint statement from the British Medical Association and the Royal College of General Practitioners told staff the vaccines had been ' thoroughly tested'. Dr Peter Carter, chief executive of the Royal College of Nursing, said if the pandemic 'really takes off ' it will be vital to have nurses on the wards.

More than 11million will be offered the vaccine, including two million health and social care workers.


Last week there were 27,000 new swine flu cases - up from 18,000 the week before. And the numbers are likely now to double every fortnight, according to The Health Protection Agency.

In response to this new threat, this week a mass swine flu vaccination programme is being rolled out, with frontline health and social care workers, as well as high-risk patients, among the first to be vaccinated.

However, no one knows for sure whether this second wave of flu (renamed 'novel' swine flu or H1N1/09) will be milder - or worse - than the first.

'It's still up in the air,' says Professor John Oxford, the UK's leading virologist. 'The number of people affected so far has been fewer than anticipated, so we hope that that remains the case. But there are still worries though that it could turn nasty and cause more complications, so everyone needs to remain vigilant.'


Yesterday, Dr Liz Miller, a GP from London, went on Radio 4's Today programme to say she will not be having the swine flu vaccine. She argued that in her personal opinion, the risk from swine flu is not significant enough to have the vaccine when she doesn't know what's in it and is not sure of its safety.

Sir Liam Donaldson, the Government's Chief Medical Officer, says these fears are groundless. So who's right?

The swine flu jab certainly seems to be effective, according to early results of a trial in Australia. The question is what potential side effects it might have.

Trials in Australia suggested these were minimal - soreness, redness, or local swelling where the shot was given; fever, and aches and pains. If these problems occur, they usually begin soon after the vaccine shot, and last 1-2 days. Trials also suggested an allergic reaction to the vaccine is rare.

An earlier swine flu jab - given to 40 million Americans in an outbreak in the 1970s - was linked to the development of Guillain-BarrĂˆ syndrome, a rare neurological side-effect causing paralysis. Around 500 Americans were paralysed, and 25 people died.

This condition is a potential, although extremely rare, side effect from any vaccination.

Furthermore, experts such as virologist Professor John Oxford say this new jab is different - it's basically the seasonal flu jab with the H1N1 component inserted, so it shouldn't cause the same problems.

Some people are concerned that the vaccine has been developed so quickly, claiming safety checks have been rushed, but Professor Oxford says techniques for rapidly making vaccines are much more sophisticated now. The seasonal flu jab is considered to be very safe to use.

Hospital chiefs are concerned by indications that only around 10-20 per cent of their staff will take up the offer of a swine flu jab. Around 47 per cent of nurses won't have the jab, according to recent poll by Nursing Times (this has risen from 31 per cent in a poll in August), while the number who will definitely have the jab has fallen from 35 per cent to 23 per cent.

A poll among GPs in August found that 29 per cent would definitely opt out of having the jab, while a further 29 per cent were unsure. More than two thirds of those who will turn the jab down believe it has not been tested enough.

Most also believe the swine flu has turned out to be so mild in the vast majority of cases that the vaccine is not needed. Professor Oxford describes this outlook as 'shocking'.

Dr Martin Scurr, the Mail's GP, says he will have the vaccination 'without any doubt - and I'll encourage my patients to have it'.

He adds: 'While I don't often agree with the Department of Health, I think on vaccination they have got it entirely right. I trust both the safety studies and the policy.' Another concern that has been raised is the use of 'adjuvants' in the swine flu jab. These are chemicals such as aluminium that are used to ' turbocharge' the immune system; this reduces the amount of vaccine you require.

The European Medicines Evaluation Agency said adjuvants have been widely used before in vaccine manufacture, and have a good safety record.

However, U.S. regulators have rejected the use of adjuvants for swine flu vaccine, citing uncertainty about their effects - which means the American vaccine does not contain them.

The EMEA has requested that vaccine manufacturers implement plans to actively investigate and monitor the safety of vaccines as soon as they are used across the EU, so that action can be taken as early as possible if a safety issue emerges.

The UK has provision for up to 132 million doses - easily enough for every person in the country. Initially, it was thought people would need two doses, but this has been reduced to one jab, following Australian, Chinese and French studies which showed a single dose of the vaccine is enough to get the immune response needed. (Those aged under ten will receive two half doses, three weeks apart.)

People who are most at risk from swine flu will be vaccinated first. These groups are, in order of priority:

* Anyone between six months and 65 years who has asthma or breathing difficulties, heart conditions or with compromised immune systems (the same atrisk group who would normally receive the seasonal flu jab).
* All pregnant women.
* People who live with patients whose immune systems are compromised, such as cancer patients or those with HIV/Aids.
* Over 65s who have asthma, heart disease or compromised immune systems. Frontline health and social care workers will also be offered the vaccine at the same time as the first clinical at-risk groups.

Patients in at-risk groups will be informed by letter from their GP about appointment times. Because of the widespread disruption caused by the national postal strike, hospitals and GP surgeries will also phone people with appointment details, as well as sending text messages and emails.

Although initially there was talk of vaccinating all children between the age of three and 16, this has now changed and they are not included in the priority list. More children are affected by swine flu, but most make a full recovery, so they will not be part of the first vaccination group unless they have underlying health issues.

And while healthy over-65s are usually offered the seasonal flu jab, they're not in the first group for the swine flu jab because they're actually less likely than other groups to get the illness.

It's not yet known when the jab will be rolled out to other groups.

Six pregnant women have now died from swine flu in the UK. Overall, the risks to your health of getting swine flu while pregnant are considered to be greater than any potential risk from the vaccine, but there is no guarantee that the jab is 100 per cent safe.

Studies on the vaccine to be used in the UK have been small - involving just 340 people. Antivirals could be an alternative, but they have side effects, too.

The seasonal flu vaccine is a very safe vaccine, which 15million atrisk people have in the UK every year. There is some evidence that the jab might also protect against swine flu.

However, a recent Canadian study suggested the opposite, that it might even double the risk of developing swine flu ) but both the UK's Joint Committee on Vaccination and Immunisation, and the World Health Organisation have questioned these findings.
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