Logistical problems over swine flu vaccine

With the ubiquitous swine flu now officially declared a pandemic by the World Health Organisation (WHO), and an estimated one million Americans infected, the obvious question being asked is when will an effective vaccine to combat the H1N1 virus be made available to the public?

However, related questions of who is to receive the virus vaccine, how many shots are needed to ensure immunity, possible side effects, and its overall effectiveness, remain to be answered.

At least one of the five U.S. laboratories working on the vaccine will be ready to roll its version off the production line and others will follow shortly, said medical news Web site WebMD, which points to a massive logistic problem if all 300 million Americans are to be vaccinated.

Centre for Disease Control (CDC) flu chief Nancy J. Cox, Ph.D, told reporters at a specially convened flu meeting this week that her organisation was committed to the development of a vaccine.

"It is very clear to us that flu virus can cause serious illness and death. This pandemic virus is no exception," she said. "It is very clear a vaccine should be developed. If we see a good clear immune response and no safety problems, we will proceed."

A simultaneous statement released by CDC said: "CDC has isolated the new H1N1 virus, made a candidate vaccine virus that can be used to create vaccine, and has provided this virus to industry so they can begin scaling up for production of a vaccine, if necessary."

It said the Centre was working closely with manufacturers to achieve the goal of an efficient vaccine to combat the pandemic.

However, the number of injections a person would need to guarantee immunity from the virus is uncertain as health officials say they fear multiple shots of the vaccine may overwhelm U.S. state health agencies.

Bloomberg quoted William Schaffner, an influenza expert at Vanderbilt University School of Medicine in Nashville, Tennessee, in an interview as saying health agencies would not cope with the nationwide multiple shot treatment.

"Public health departments are under-funded and will get fatigued," he said. "One shot probably gives you very little immunity, 10 to 20 percent at most."

With U.S. health officials looking at a possible 600 million shots of the vaccine, the massive logistical problem of finding enough health workers to administer the injections and how side effects can be monitored has been questioned.

While committed to the development of a vaccine, health authorities are considering whether or not to discontinue making seasonal flu vaccine in favour of concentrating resources on H1N1.

Canada's The Gazette quotes Keiji Fukuda, assistant director-general of the World Health Organization, as saying: "Should we make the H1N1 vaccine, should we stop seasonal vaccine, should we be making both of them, what kind of combination might be reasonable?"

WHO is also monitoring the virus as it cuts through the southern hemisphere's flu season for signs that it may mutate -- much as the lethal Spanish flu did following World War One -- resulting in a more potent and deadly virus.

Though describing the virus as "unpredictable," Margaret Chan, director general of the World Health Organization, said in Moscow during the week that: "The virus is not mutating for the moment, it is stable."

U.S. health officials consider that over one million Americans have been infected by the virus and CDC Influenza Division epidemiologist Dr. Daniel Jernigan told reporters the virus continues to spread rapidly around the country, particularly in the Northeast.

He added that he expected "...(swine) flu activity [to] continue throughout the summer."

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