CIDRAP Daily News October 2009

[Rwilmer]

Oct 28

CDC offers guidance on H1N1, seasonal flu vaccine timing

H1N1 Flu Breaking News

WHO experts tackle H1N1 vaccine questions
The World Health Organization's (WHO's) immunization experts today discussed issues related to the H1N1 vaccine, according to its agenda. The Strategic Advisory Group of Experts (SAGE) was asked if epidemiologic or vaccine-availability issues would alter SAGE's recommendations, how many doses per person are needed, if seasonal and pandemic doses can be co-administered, and if obesity is a risk factor. A WHO spokesman said results of the meeting may be available tomorrow.
[Oct 27-29 WHO SAGE agenda]

Vaccine production reaches 23.2 million doses
The cumulative total of H1N1 vaccine doses available reached 23.2 million today, up about 800,000 from yesterday's 22.4 million, Health and Human Services (HHS) Secretary Kathleen Sebelius said at a press conference today. She said about 9 million doses were added to the total in the past week. All 50 states have ordered supplies of vaccine, she reported.
[Oct 28 HHS press conference recording]

Lack of prioritization cited for LA vaccine shortage
In the early stages of Los Angeles County's free H1N1 vaccination clinics, overwhelmed staff members vaccinated many people who were not in the vaccination priority groups, the Los Angeles Times reported today. As of yesterday, the county had only enough doses to last through Nov 4 instead of the planned Nov 8, said Dr. Jonathan Fielding, public health director. He said officials didn't want to turn away people who had traveled and stood in line to get vaccinated.
[Oct 28 Los Angeles Times report]

Former FDA official says policy has slowed vaccine
Overly cautious policy decisions by the US government are partly to blame for shortages of the pandemic H1N1 vaccine, according to a former Food and Drug Administration official who wrote an editorial for the Wall Street Journal. Scott Gottlieb, MD, said the use of adjuvants could have stretched supplies. He said a focus on single-dose vials has slowed vaccine delivery, as has reliance on outdated egg-based production.
[Oct 27 Wall Street Journal article]

Oman launches H1N1 vaccine campaign
Health authorities in Oman said yesterday that they have started the country's pandemic H1N1 vaccine campaign after receiving the first 100,000 doses of its 2.6 million dose order, Agence France-Presse (AFP) reported. For now, priority groups include older people, pregnant women, health workers, and Mecca pilgrims. The vaccine is free for all citizens. To address concerns about vaccine safety, media outlets showed senior officials receiving flu shots.
[Oct 27 AFP story]

Iceland finds pandemic virus in pigs
Veterinary officials in Iceland confirmed the pandemic H1N1 virus in a pig herd after 10 of the animals started showing symptoms such as poor appetite, fever, and coughing, according to a report yesterday to the World Organization for Animal Health (OIE). Investigators are exploring the possibility that humans spread the virus to the pigs; two workers had flulike symptoms before the pigs got sick. The 4,500-pig farm is under quarantine.
[Oct 27 OIE report]

Gender-based vaccine doses suggested to boost supply
Two commentators writing in the New York Times say that using lower doses of flu vaccine in women could improve the vaccine supply without sacrificing protection. Sarah L. Klein, a Johns Hopkins immunologist, and Phyllis Greenbrier, president of the Society for Women's Health Research, point to studies in which women had a significantly stronger immune response to flu vaccines than men did. They say that besides stretching the supply, the step would reduce side effects for women.
[Oct 28 New York Times commentary]

Sen Collins asks HHS to explain vaccine delays
Sen. Susan Collins (R-Maine) wrote a letter to HHS Secretary Kathleen Sebelius yesterday asking why there are fewer pandemic H1N1 vaccine doses than officials originally projected. Her letter appeared on the Web site of the Maine Public Broadcasting Network. Collins said shortages are alarming because not all high-risk groups can be vaccinated and the vaccine could arrive too late to prevent infections in many Americans. She asked the HHS to share its latest projections.
[Oct 27 letter from Collins to Sebelius]

[Rwilmer]

Re: CIDRAP Daily News October 2009

Oct 29

Experts show benefits of IV antivirals for severe H1N1

Statins may help patients with severe seasonal flu

CDC estimates cases in H1N1 first wave at up to 5.7 million

H1N1 Flu Breaking News

Flu activity rebounds at many colleges

Flu activity at US colleges has increased significantly, showing spikes even in some areas such as the southeast that have reported decreases over the past few weeks, the American College Health Association (ACHA) said yesterday. The Midwest, mid Atlantic, and northeast regions also showed unexpected rebounds. The report for the week ending Oct 23 said the rate of flu-like illnesses on member campuses was 28 per 10,000 students, up 34% from the week before.
[Oct 28 ACHA surveillance report]

Feds address spot liquid Tamiflu shortages

In response spot shortages of the pediatric liquid suspension version of Tamiflu, an official from the US Centers for Disease Control and Prevention (CDC) said today at a media briefing that on Oct 1, 300,000 bottles from the national stockpile were shipped to states. The CDC said more pharmacy chains are compounding the medication and that parents can mix crushed pediatric capsules with a spoonful of, for example, chocolate syrup.
[CDC info on mixing Tamiflu capsules, liquid]

Novartis: US vaccine order is on track

Novartis said today it is on track to produce 90 million units of bulk pandemic vaccine antigen to the US market, enough for 60 million doses. It expects multidose and prefilled vial deliveries to reach 25 to 30 million by the end of November. The company has shipped 7.5 million doses. Novartis said early vaccine yield was low, but a new seed strain it began using in mid September is getting a 63% yield. The CDC said today that total US H1N1 vaccine received is now at 24.8 million doses.
[Oct 29 Novartis media release]

Lack of parental OK slows NYC school vaccinations

Fewer than half of New York City parents with children in elementary school have signed consent forms for their children to receive H1N1 vaccine at school, the New York Times reported. Health officials had no citywide figure but said between 5% and 50% of parents have given permission. Possible reasons for parents' reluctance may include vaccine safety concerns and the assumption that some children had the virus in the spring and are now immune.
[Oct 29 New York Times story]

US student absenteeism, school closings climb

The number of students home sick with the flu and the number of school closings have been climbing steadily, the Associated Press (AP) reported. By the end of last week, the number of closed schools reported by the US Department of Education reached 351, affecting 125,000 students. Officials suspected that many closing have not been reported. One especially hard-hit school was St. Charles East High in suburban Chicago, where 800 of 2,200 students were absent.
[Oct 28 AP story]

Some Canadian docs slow to join vaccination effort

Family physicians in parts of Canada have been slow to sign up to give H1N1 vaccinations, citing various obstacles, the Canadian Press reported. In Ontario, some doctors have been deterred by a requirement that they order vaccine in 500-dose lots, while others objected to a demand that they provide a weekly record of every dose delivered. Some provinces are not asking family doctors to help launch the vaccination drive and instead are focusing on mass immunization clinics.
[Oct 28 Canadian Press report]

Uncertain timing clouds UK vaccine campaign

General practitioners in Britain have said it could take weeks for them to receive H1N1 vaccine supplies, leaving those in priority groups uncertain about when they can be vaccinated, the Daily Express reported. Healthcare workers and hospital patients received their doses last week, and it was expected that vaccination of other priority groups would begin this week. But many doctors have not yet received their doses and don't know just when they will come.
[Oct 29 Daily Express report]

China sees tough flu fight ahead

Chinese government sources said flu activity is spiking in many parts of the country and clusters of illnesses are occurring in schools, Agence France-Presse (AFP) reported today. China's state council said the country's challenge is grim. The assessment was prompted by the death of a student at a university in Beijing where other students were ill. The fatality is China's fourth from the pandemic H1N1 virus.
[Oct 29 AFP story]

[Rwilmer]

Re: CIDRAP Daily News October 2009

Oct 30

WHO experts favor single-dose H1N1 vaccine regimen

Spreading H1N1 virus claims 19 more US children

Ukraine imposes social distancing steps amid flu surge

H1N1 Flu Breaking News

NY declaration expands vaccinator pool
New York governor David A. Paterson yesterday declared a state emergency to permit more health workers to give H1N1 flu vaccinations. Normally only physicians, nurses, and nurse practitioners can do so; the declaration will enable physician assistants, dentists, some dental hygienists, and emergency personnel to participate, the state said in a news release. The action--requested by local governments--also authorizes school-based health centers to vaccinate adults and children.
[Oct 29 New York state release]

Do seasonal flu shots open kids more to pandemic flu?
Dutch scientists suggest that vaccinating children against seasonal flu may make them more vulnerable to pandemic flu strains, according to a Canadian Press report. In a journal article, the scientists wrote that shielding children from the need to generate immunity to actual seasonal viruses might leave them more vulnerable to pandemic strains. But other experts, while not necessarily agreeing, say it's better to protect children from an annual threat than one they may face every few decades.
[Oct 29 Canadian Press report]

WHO: flu rates up in Europe, parts of Asia
Though pandemic activity continues to intensify in North America, several European countries are reporting high rates of flu-like illness and pandemic virus detections, including Iceland, Ireland, the United Kingdom, Belgium, and the Netherlands, the World Health Organization (WHO) reported today. Many other countries in Europe and western and central Asia are reporting early flu transmission. Flu activity is up sharply in Japan. At least 5,712 deaths have been reported, up 713 from last week.
[Oct 30 WHO pandemic update]

Swiss officials restrict GSK vaccine in some
Swiss regulators today restricted the use of an adjuvanted pandemic H1N1 vaccine made by GlaxoSmithKline in pregnant women, children, and people older than 60, Agence France-Presse (AFP) reported. The agency held back its authorization for the groups because it has little data on the vaccine's use in children and no data for pregnant women. It endorsed one of two pandemic vaccines made by Novartis and is still examining the company's cell-based pandemic vaccine.
[Oct 30 AFP story]