Good influenza coverage - but all groups were not reached

[Tonka]

http://www.dagensmedicin.se/dagenss...11/03/01/influensasatsningen-utvard/index.xml
Swedish to English translation

Good influenza coverage - but all groups were not reached
2011-03-01
Efforts against swine flu was working fine, but authorities did not reach everyone and it was not possible to monitor the burden of care. It shows in a new evaluation.

Read the full review:

Influenza A (H1N1) 2009 - Evaluation of preparation and handling of the pandemic
Last autumn pandemihot was never so serious reality that the authorities planned to, but the burden on health services was still many times greater than during a normal flu season.

It is one of the conclusions of the joint review of community preparedness and response around the flu as the Infectious Diseases Institute, Agency for Civil Contingencies and Welfare made.

In conclusion, the evaluators believe that readiness was good, but that country's authorities still have much to learn.

The vaccination campaign was scored high by the authorities. It went quickly and were efficient, thanks to dedication and loyalty among health care workers.

More difficult was communication with the work on the pandemic, which turned out to require more resources than the authorities planned for. Moreover, the failure to achieve all audiences well enough, young adults and people with mother tongue other than Swedish in particular singled out.

The implications for important public activities were insignificant, but it was probably due to flu was so mild, consider the evaluators.

A major weakness was also the possibility to monitor the spread of flu. It was only in Stockholm that there was a computer system that could monitor the spread of infection at the population level. Unable to monitor the load on hospitals and critical care at the national level.

 

[tetano]

Re: Good influenza coverage - but all groups were not reached

The final bill for the flu


The final bill for the vaccination against the flu lands in excess of 1.3 billion, according to a recent evaluation. It was not economically efficient to mass-vaccinate the population, the report states.



Swine Influenza A (H1N1), quickly spread across the world in April 2009. In May, the virus reached Sweden, and then the Swedish authorities as early as feverishly work.

On Tuesday presented the Authority for Civil and Welfare and Disease Control's evaluation of the authorities' handling of the flu.
The main conclusion is that Sweden was well prepared to face a serious epidemic. But at the same time started mass vaccination is too late.
The direct vaccination costs landed at just over 1.3 billion. This figure includes county cost for the vaccine in more than 869 million kronor, and the guarantee fee of SEK 248 million by the National Board paid to ensure delivery of the vaccine by pharmaceutical giant Glaxo Smith Cline (GSK).

When the costs of including critical care and sick leave included in the final bill lands amount to the entire 5.3 billion.
The report has evaluated whether it was economically efficient to mass-vaccinate the population, and the answer is no. In a model has been calculated on the cost of saving one life year is reasonable, and the cost of 1.3 million is more than twice that of what is deemed reasonable in similar cases.
If vaccination is, however, had begun three weeks earlier had cost-effectiveness has been high, the report states.

"The main conclusion is that very small changes in how serious influenza is, and when deliveries will, have a high impact on the effectiveness of vaccination from an economic point of view. There will always be considerable uncertainty surrounding this kind of decision, "said Anders Tegnell, Department of Health and Welfare.
Are you self-critical when it comes to vaccinations started so late? "We did the best we could. Unable to get faster delivery, "said Anders Tegnell.
Sweden ordered 18 million doses of vaccine from GSK based on the Board's recommendation that it took two doses to obtain adequate protection. This order was later reduced by 25 percent after it became clear that most teams only had one dose. But the 6.5 million doses are still unused, and now exists as a stockpile.

With hindsight, what could you have done differently regarding the purchase of the 18 million vaccine doses? "There is not much we could have done differently from what we knew then, but from what we now know, a future contract with a vaccine manufacturer be more flexible regarding the amount of doses to order ", says Anders Tegnell.

The cost of the vaccine, with 65 per dose, has previously been criticized, including by Goran Stiernstedt, director of health and care of Local Authorities and Regions. In July 2009 he called in the Swedish newspaper Svenska Dagbladet cost of "a cold shower", and contrasted it with the cost of a regular flu vaccine that is 35 per dose.
But the high cost was not estimated, according to Anders Tegnell.
"The contract we had in principle, only two bids and both were at this level. Internationally, 65 per dose is not expensive for this type of vaccine. "
You paid a guarantee fee of SEK 248 million to GSK - should not be guaranteed delivery of the vaccine be included when an order is made? "I do not understand the criticism. There was no alternative. The countries that had not guarantee contracts were offered no supplies, "said Anders Tegnell.

Pandemic-related costs in the report


Cost category
Cost M


Vaccination
1370


Work Absences for vaccination
337,5


Sickness absence due to adverse events
146


Inpatient
47


Intensive care
79,6


ECMO
28,8


Antiviral drugs
12,1


Laboratory Cost
15


Sick leave
3075


Deaths (expected average remaining working years: 14)
215


Total
5326


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