August 19, 2009

Swine Flu Vaccine Orders Surge

It's a tall order for the makers of the swine flu vaccine, and demand continues to rise.

So far, northern hemisphere countries have ordered more than one billion doses of swine flu vaccine, the World Health Organization said Tuesday.

The demand meets massive production delays which could create shortages.

Experts said this phenomenon could force a second, possibly more deadly, wave of flu in the fall.

Governments would then have to make hard choices about who to vaccinate first.

"Pandemic vaccine orders put in by northern hemisphere countries stand at over one billion," WHO spokeswoman Melinda Henry told AFP.

"In the early days, there will be a very limited supply of vaccine. There won't be sufficient supply to vaccinate whole populations, or even huge proportions of populations," Henry said.

Countries like Greece, The Netherlands, Canada and Israel have ordered enough double doses to inoculate their entire populations.

However, Germany, the United States, Britain and France, have put in orders that would cover between 30 and 78 percent.

The WHO said that the 25 drug companies which had announced their intention to manufacture vaccines could crank out up to 94 million doses per week starting in mid-October.

That optimistic estimate changed dramatically when the top vaccine makers found that swine flu strains did not reproduce as quickly as expected.

"The current vaccine strain would only yield 25 to 50 percent" of the original estimate, as low as 23 million doses per week, said Henry.

Many experts have said that double doses will be needed because most people have no immunity to the so-called "novel" A(H1N1) virus.

The fight over supplies could be fierce.

"Policy makers are still coming to terms with who the target groups should be," said Mark Miller, an epidemiologist at the Fogarty International Center of the US National Institutes of Health.

The majority of international and national health authorities say health professionals should be vaccinated first, because they are frequently exposed to the virus.

Beyond that, there are no universal guidelines.

"Individual countries have to look at their own conditions and adapt. They have to decide whether they want to stop transmission, protect essential infrastructure, or reduce illness and death," Henry said.

Historically, during seasonal flu epidemics, priority has gone to the elderly and those with chronic diseases, such as asthma or other lung conditions.

"But we know from our research that it is actually younger populations which are more affected during pandemics -- it is one of the signature features of pandemics," Miller said.

Meanwhile, the WHO also reported Tuesday that it was up to national regulatory authorities to decide whether to extend the shelf life of the flu drug Tamiflu by two years.

Swiss drug maker Roche said company data showed the active ingredient in Tamiflu's shelf life lasted 7 years instead of five.

Tamiflu, known generically as oseltamivir, is the frontline antiviral being used against the swine flu.

"It is WHO's view that shelf-life extensions are a matter for national regulatory authorities," WHO spokesman Gregory Hartl said in a statement sent to journalists.

The WHO says most people infected with H1N1 have mild symptoms and Tamiflu should be given only to flu sufferers at high risk including pregnant women or those with complications such as pneumonia.

The European Medicines Agency has said it is acceptable to apply the extension to current stocks of the drug during a flu pandemic, a decision followed last month by Switzerland.

"We are working with health authorities to also extend the shelf life in other markets because it makes sense," Roche spokeswoman Claudia Schmitt told Reuters.


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