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_|EU: PRE-PANDEMIC VACCINES|_

Giuseppe

Emeritus
Brussels gives green light to Glaxo's bird flu vaccine

? Drug will let inoculations begin before a pandemic
? Product would be effective if H5N1 virus alters slightly

Nick Huber - The Guardian, Monday May 19 2008

Preparations to protect humans against a possible future bird flu pandemic will receive a boost today after GlaxoSmith-Kline became the first drug manufacturer to be granted marketing approval for its pre-pandemic influenza vaccine.
The world's second-biggest drugs group said the European commission had approved its vaccine, called Prepandrix, in all 27 EU member states.

GSK said its vaccine had the advantage of allowing governments to begin to inoculate their population before a pandemic.

The vaccine uses the current H5N1 influenza virus, which scientists believe could jump from birds to humans in a form that is highly infectious, triggering a flu pandemic that could kill tens of millions of people.

The company said its vaccine was flexible and would be effective if the virus mutated slightly.

Most other flu vaccines under development would need to be altered after a new strain of the virus emerges, which could take four to six months.

Health officials have warned that the risk of a human influenza pandemic is probably growing as the H5N1 virus becomes more entrenched in poultry in Asia, Africa and parts of Europe.

There have been 382 human cases of bird flu worldwide since 2003, 241 of them fatal, according to the World Health Organisation, an agency of the United Nations.

GSK is betting that the next pandemic flu virus will be a variant of the H5N1 virus.

If a future flu pandemic has mutated too far away from the H5N1 virus into a totally new form, then GSK's vaccine will not be effective and a new vaccine will have to be made.

Jean-Pierre Garnier, GSK's chief executive, who retires on Wednesday, said: "For the first time the authorities are approving a pre-pandemic vaccine. We have demonstrated that even if the H5N1 virus drifts to a different strain it is still effective."

He said that if governments primed the population by giving them a pandemic vaccine, it would boost their immune system. "It's like training for the Olympics - it doesn't mean you're going to win the gold medal but if you train you'll be a much better system. [Our vaccine] can make you more resistant to the pandemic."

The company hopes that governments will start vaccinating sections of their populations now with Prepandrix, combining it with seasonal flu jabs to prepare people's immune systems to fight off a possible future pandemic.

GSK has donated 50m doses of its influenza vaccine to the World Health Organisation and sold versions of it to the governments of the US, Switzerland and Finland.

The UK government has reserved the right to buy up to 122m doses of pandemic flu vaccines from a number of suppliers, including GSK, if there is an outbreak.

GSK's bird flu vaccine, which has completed clinical trials, blends small doses of existing H5N1 strains from Vietnam and Indonesia to teach the human immune system to recognise the virus and help it fight off mutations.

Garnier said other governments wanted more assurances of Prepandrix's effectiveness from regulators.

He added that its flu pandemic vaccine would be offered at a "much reduced" price to all developing nations. He declined to be drawn on the potential profits from the vaccine.

Jeremy Batstone-Carr, head of private client research at Charles Stanley, said vaccines had relatively low profit margins and therefore needed to be produced in bulk to be cost effective for the manufacturer. "The attraction for GSK lies in flogging the product to as many governments as possible," he said.

Explainer: Avian influenza
Avian influenza, known as bird flu, is a contagious viral disease in animals caused by a virus loosely related to human influenza. Domestic poultry flocks are especially vulnerable to infection, which can rapidly result in epidemics among their populations. The H5N1 form of bird flu is the most dangerous.

Most of the human deaths have been in Asia in communities in which people live close to poultry. In Britain, there have been cases of HN51 among swans on a nature reserve in Dorset and among turkeys at a Bernard Matthews farm in Suffolk.

The most severe flu pandemic occurred in 1918-19, and is estimated to have killed an estimated 50 million people across the world.

The Department of Health's national framework for pandemic flu has predicted that up to 750,000 extra deaths could be expected in Britain within 15 weeks of a flu pandemic. A quarter to half of the population could be infected and up to 2.5% of those could die.
-
http://www.guardian.co.uk/business/2008/may/19/glaxosmithklinebusiness.pharmaceuticals
-------
 
Re: _|EU: PRE-PANDEMIC VACCINES|_

Thanks Ironorehopper.

An step forward.
It will be interesting to aknowledge:

"vaccines had relatively low profit margins and therefore needed to be produced in bulk to be cost effective for the manufacturer"

How much doses to be produced for the whole EU?

"vaccinating sections of their populations now with Prepandrix, combining it with seasonal flu jabs to prepare people's immune systems to fight off a possible future pandemic"

It is an subsequeent forwarded human trial, or an ringing bell for preparedness?
 
Re: _|EU: PRE-PANDEMIC VACCINES|_

Thanks Ironorehopper.

An step forward.
It will be interesting to aknowledge:

"vaccines had relatively low profit margins and therefore needed to be produced in bulk to be cost effective for the manufacturer"

How much doses to be produced for the whole EU?

"vaccinating sections of their populations now with Prepandrix, combining it with seasonal flu jabs to prepare people's immune systems to fight off a possible future pandemic"

It is an subsequeent forwarded human trial, or an ringing bell for preparedness?

Magic words: Company hopes. A such decision by EU govts' member states may be of great benefit for GSK shares.

That's said, the possible EU regulatory office approval for this vaccine represents obviously an improvements for pandemic planning activities for every country, an additional tool to attempt a more effective citizens protection.
 
Re: _|EU: PRE-PANDEMIC VACCINES|_

European Medicines Agency - Pre-Authorisation Evaluation of Medicines for Human Use
7 Westferry Circus, Canary Wharf, London E14 4HB, UK - Tel. (44-20) 74 18 84 00 Fax (44-20) 74 18 85 45 - E-mail: mail@emea.europa.eu http://www.emea.europa.eu - ? European Medicines Agency, 2008. Reproduction is authorised provided the source is acknowledged. -

London, 21 February 2008

Doc.Ref. EMEA/CHMP/65954/2008

COMMITTEE FOR MEDICINAL PRODUCTS FOR HUMAN USE - SUMMARY OF POSITIVE OPINION*for PANDEMRIX

Common Name: Pandemic influenza vaccine (H5N1) (split, inactivated, adjuvanted)

On 21 February 2008 the Committee for Medicinal Products for Human Use (CHMP) adopted a positive opinion,** recommending to grant a marketing authorisation for the medicinal product Pandemrix, 3.75 μg HA, suspension and emulsion for emulsion for injection intended for Prophylaxis of influenza in an officially declared pandemic situation in accordance with official guidance.

The applicant for this medicinal product is GlaxoSmithKline Biologicals S.A. Belgium.

The active substance of Pandemrix is composed of purified antigen fractions of inactivated split virions of A/Vietnam/1194/2004 NIBRG-14 (H5N1), an Influenza vaccines, ATC Code J07BB02. It is an adjuvanted vaccine that induces an immune response (circulating antibodies) against the H5N1 antigen.

This vaccine will only be used in an officially declared influenza pandemic and after inclusion of the exact matching pandemic influenza vaccine strain into the vaccine.

For more information on mock-up (pandemic) vaccines, please consult the Question and Answer document.

The benefits with Pandemrix are that it can mount an appropriate immune response in individuals that are immunologically na?ve against the mock-up vaccine strain.

Data obtained with this mock-up vaccine will support a vaccination strategy that is likely to be used for the pandemic vaccine. The most common side effects are injection side reactions, headache, tiredness, fever, aching muscles and joint pain.

A pharmacovigilance plan for Pandemrix, as for all medicinal products, will be implemented as part of the marketing authorisation.

The approved indication is: ?Prophylaxis of influenza in an officially declared pandemic situation?.

Detailed recommendations for the use of this product will be described in the Summary of Product Characteristics (SPC) which will be published in the European Public Assessment Report (EPAR) and will be available in all official European Union languages after the marketing authorisation has been granted by the European Commission.

The CHMP, on the basis of quality, safety and efficacy data submitted, considers that there is a favourable benefit to risk balance for Pandemrix and therefore recommends the granting of the marketing authorisation under exceptional circumstances***.

* Summaries of positive opinion are published without prejudice to the Commission Decision, which will normally be issued within 67 days from adoption of the Opinion.

** Applicants may request a re-examination of any CHMP opinion, provided they notify the EMEA in writing of their intention to request a re-examination within 15 days of receipt of the opinion.

*** Marketing Authorisation under exceptional circumstances refers to the fact that in exceptional circumstances an authorisation may be granted subject to certain specific obligations, to be reviewed annually.
-
http://www.emea.europa.eu/pdfs/human/opinion/Pandemrix_6595408en.pdf
------
 
Re: _|EU: PRE-PANDEMIC VACCINES|_

European Medicines Agency - Press office
7 Westferry Circus, Canary Wharf, London, E14 4HB, UK
Tel. (44-20) 74 18 84 00 Fax (44-20) 74 18 84 09
E-mail: mail@emea.europa.eu http://www.emea.europa.eu

London, 21 February 2008

Doc. Ref. EMEA/CHMP/90694/2008

PRESS RELEASE
EMEA recommends authorisation of first pre-pandemic influenza vaccine

The European Medicines Agency today recommended the authorisation of the first ?pre-pandemic vaccine? for humans against influenza caused by the H5N1 virus.

This is an avian influenza (?bird flu?) virus strain that has the potential to evolve into a pandemic influenza virus affecting humans.

Prepandrix, from GlaxoSmithKline Biologicals, is a pre-pandemic vaccine that is intended to trigger an immune response against the H5N1 strain of the influenza virus before or during an officially declared influenza pandemic, in accordance with official guidance.

An influenza pandemic is a global outbreak of influenza that leads to serious illness in large numbers of people. It is caused by an influenza virus strain against which most or all humans have no natural protection, and which has mutated into a form that spreads easily from person to person.

Health authorities are concerned that the next pandemic could occur at some point within the next few years and could be caused by the H5N1 strain.

The EMEA recommendation has been sent to the European Commission for the adoption of a marketing authorisation decision.
-- ENDS --

Notes:
1. A summary of opinion for Prepandrix is available here http://www.emea.europa.eu/pdfs/human/opinion/Prepandrix_6273608en.pdf

2. Pre-pandemic vaccines are part of the commitment intended to help Member States prepare for pandemic influenza.
Other approaches include the authorisation of mock-up vaccines, two of which (Daronrix and Focetria) are authorised at the level of the European Union.
A third mock-up vaccine (Pandemrix) was recommended for marketing authorisation during the February 2008 meeting of the Committee for Medicinal Products for Human Use (CHMP).

3. A question-and-answer document explaining mock-up pandemic flu vaccines is available here http://www.emea.europa.eu/pdfs/general/direct/pr/50155706en.pdf

4. A summary of opinion for Pandemrix is available here http://www.emea.europa.eu/pdfs/human/opinion/Pandemrix_6595408en.pdf

5. More information about authorised mock-up pandemic influenza vaccines is available:
For Daronrix click here http://www.emea.europa.eu/humandocs/Humans/EPAR/daronrix/daronrix.htm
For Focetria click here http://www.emea.europa.eu/humandocs/Humans/EPAR/focetria/focetria.htm

6. The EMEA pandemic influenza crisis management plan can be found here.http://www.emea.europa.eu/pdfs/human/vwp/21430106en.pdf

7. This press release, together with other information on the work of the EMEA, can be found on the EMEA website: www.emea.europa.eu

Media enquiries only to:
Martin Harvey Allchurch or Monika Benstetter
Tel. (44-20) 74 18 84 27, E-mail press@emea.europa.eu
-
http://www.emea.europa.eu/pdfs/human/press/pr/PR_H5N1_9069408en.pdf
------
 
Re: _|EU: PRE-PANDEMIC VACCINES|_

[I guess it depends on what your definition of "current" is.]


Post #1
Brussels gives green light to Glaxo's bird flu vaccine

The world's second-biggest drugs group said the European commission had approved its vaccine, called Prepandrix, in all 27 EU member states.

The vaccine uses the current H5N1 influenza virus,...

The company said its vaccine was flexible and would be effective if the virus mutated slightly.

Post # 5

The active substance of Pandemrix is composed of purified antigen fractions of inactivated split virions of A/Vietnam/1194/2004 NIBRG-14 (H5N1), an Influenza vaccines, ATC Code J07BB02. It is an adjuvanted vaccine that induces an immune response (circulating antibodies) against the H5N1 antigen.
 
Re: _|EU: PRE-PANDEMIC VACCINES|_

mixin, we had some links earlier where the vaccine trials are listed.
e.g. WHO has a page, I can search the links...


any mention whether Prepandrix will be available for privates ?
 
Re: _|EU: PRE-PANDEMIC VACCINES|_

any mention whether Prepandrix will be available for privates ?
I hadn't dig all those plans with many, many, many generic words without usefull details about, but some clue already emerged from some cited docs (in attachment).

I think I should not err. if I said that there would be a very, very small chance to buy (legaly) in private (farmacy), an pre-pandemic vaccine, as the b.b. folks mixed it this way:

The WHO will declare a pandemic only when it would already spread everywhere!

"declared WHO pandemic = WHO Phase 6
___

flu_mock_up_EU_vaccine.pdf

London, 15 December 2006
Doc. Ref. EMEA/501557/2006
"EU/EMEA 2003 procedure allows manufacturers to gain an authorisation for a "mock-up" vaccine before a flu pandemic has occurred.
...
The objective behind a mock-up vaccine is to have a marketing authorisation (licence) in place, which can be changed quickly in the event of a pandemic to include the responsible virus strain, once it has been identified. The mock-up vaccine itself is not expected to be used or stockpiled (stored for use in the future) before the outbreak of a pandemic.
...
Once the flu strain causing a pandemic is known, it takes about 12 weeks to prepare a suitable vaccine, as the viruses need to be grown in live cells, such as hens'eggs."

(2006.-They rely on eggs!!!)

"After the final vaccine is ready, decisions on who should receive the vaccine, and when they should receive it, will be made by the government in each EU Member State."
___

flu_pandemic_response_plan_v3.pdf
Special Arrangements for Dealing with Pandemic Influenza in London
April 2008, Version 3
...

"SECTION 3

3.17 ... it is impossible to develop a vaccine until the novel influenza virus has been identified.
Whilst the Government has agreed advance supply contracts with manufacturers to produce sufficient supplies for a matching vaccine, it may take four to six months for sufficient quantities to become available.
Therefore it is improbable that a vaccine will contribute to reducing the impact of an initial wave of a pandemic.
When developed, distribution of the vaccine will be implemented following national guidance developed by the Department of Health.

3.18 Pre-pandemic wave immunisation with an influenza virus related but not specific to the pandemic strain might offer some limited protection.
Currently, there are very limited stocks of an A/H5N1 vaccine purchased specifically for the protection of healthcare workers.

Pre-pandemic vaccination of those most likely to spread the disease or suffer complications could also help reduce hospitalisations and deaths in vulnerable groups.

Decisions on use would be decided following assessments undertaken at the time of the pandemic, however, response plans should consider arrangements for limited pre-pandemic vaccination of targeted groups.
...
SECTION 4

4.3 Once efficient person-to-person transmission is established, preventing an influenza pandemic is unlikely to be possible, as most people are likely to be exposed to the virus at some stage during their normal activities.
Those with influenza like symptoms ahould minimise contact with others by remaining at home until the symtomps have resolved.
Those who are not symptomatic should continue normal activities for as long as possible."
___

Even without vaccines, and maybe infected but not symptomatic - you must continue normal activities !!!
- until you drop dead.
___

"By avoiding unnecessary close contact with others and routinely adopting high standards of personal and respiratory hygiene, the likelihood of catching or spreading influenza will be reduced."
___

From the above docs guideliness we can see that the main concept is that the show must go on no mater the (our) price.
 

Attachments

Re: _|EU: PRE-PANDEMIC VACCINES|_

the prepandemic vaccines can also serve as mock-ups,
I had read. Chances are considered good that only the
2nd vaccination has to be an exact match.

And still with a bad match there is considerable cross-protection,
better than nothing.

Vaccine for privates seems to be a political issue.
I'm not sure about the motivation, but maybe they
want to be able to put some pressure on the people :

e.g.:
no vaccine for regions who don't have enough quarantine
no vaccine for family members who refuse to suitably isolate the sick

or such.

We had this discussion some years ago with Tamiflu.
 
Re: _|EU: PRE-PANDEMIC VACCINES|_

Vaccine deal sought - Hungarians look to form joint venture
PHUSADEE ARUNMAS
BUDAPEST :

Hungarian investors are considering forming a joint venture with Thai counterparts to develop a vaccine against bird flu to prevent the possibility of human-to-human contagion, according to Deputy Commerce Minister Viroon Techapaibul.

The idea was raised in talks that Mr Viroon held with Hungary's permanent secretary for economy and transport, as part of a week-long Thai trade mission to Eastern Europe.

Hungary became the seventh European country to confirm an outbreak of the virus in domestic geese in 2006.

Thailand is also looking to step up overall bilateral trade with Hungary, said Mr Viroon.

Two-way trade between Thailand and Hungary has averaged US$337.72 million a year over the last three years. This year, bilateral trade is forecast to grow by 33.2% to $451.38 million, with Thailand having a surplus estimated at $316.75 million.

Last year, Thailand shipped $384.07 million worth of products to Hungary, a rise of 43.5% over 2006. The main exports were computers and parts, faucets and valves, television sets and parts, automobiles and parts, electrical circuits, plastic products, transformers and parts, and rubber.

Thailand imported only $67.32 million worth of goods from Hungary last year, down by 5.5% from a year earlier, with the key imports including machinery, computers, home electrical appliances, scientific and medical equipment, ore, pharmaceutical products and lenses.

According to Mr Viroon, despite being a landlocked country, Hungary has a sophisticated infrastructure network that has attracted multinational corporations to use the country as a production and distribution base to Eastern Europe and the European Union.

Hungary itself has also expertise in automotive industry, food and processed agricultural products, pharmaceuticals and solar energy, the minister said.

Pornsil Patchrintanakul, deputy secretary-general of the Thai Chamber of Commerce, who also joined the trip, said Hungarian importers also showed interest in canned pineapple and fruit from Thailand.

Mr Pornsil said that while Hungary had a population of only 10 million, it had developed a sophisticated logistics system to distribute products throughout Eastern Europe.

However, he warned Thai operators who want to do business and invest in the country to carefully study payment systems, as Hungarian operators generally favour deposits rather than letters of credit.

Benjawan Ratanaprayul, the deputy director-general of Export Promotion Department, added that rice and home furnishings also had export potential.

-
http://www.bangkokpost.com/Business/21May2008_biz47.php
-----
 
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