The Goverment has yet to decide how it will administer its planned swine flu vaccination programme, the largest in the State's history, writes RONAN MCGREEVY.
THE SWINE flu pandemic will lead to one of the biggest vaccination programmes in the history of the State.
In the coming months, everyone in the country will be offered two doses of a vaccine which is still being developed by the pharmaceutical giants charged with bringing it to the market.
The vaccine the world is waiting for has not been developed yet but Dr Patrick Doorley, the HSE’s national director of population health, said he is certain there will be one. “First of all you have to identify the exact nature of the virus. That is why we did not have a vaccine before this happened. The big companies have all got the seeds now. We will have a vaccine. These companies are well used to making them,” he said.
In total, 7.7 million vaccines will be bought from three foreign pharmaceutical companies – GlaxoSmith-Kline, Baxter Healthcare and Allphar Services – at a combined cost of around €80 million.
There will be enough to immunise 3.85 million people, though the plan is to immunise everybody. There have been around 150 confirmed cases, but no deaths, to date in Ireland.
As the vaccine will not be compulsory, it is expected at least 500,000 people will not take it up. That is despite the warning issued last week that a quarter of the population are at serious risk of getting the disease. “We will certainly have a vaccine for anybody who wants it,” Dr Doorley said. “Our experience of every vaccination campaign is that not everybody takes it up. You never get an uptake of 100 per cent of vaccines.”
Administration of the vaccine, when it arrives in Ireland, has not been finalised yet. The HSE expects a small supply of the vaccine to come on stream within four to six weeks.
In the following four weeks, they are expecting a further 250,000 doses. The delivery schedule will take six to 12 months and the vaccination campaign will extend for that length of time.
Both the HSE and the Department of Health have put forward a hierarchy of those who will receive the vaccine first.
It will be offered initially to frontline healthcare staff, then to other health staff. After that it will be offered to people who are at high risk, those with chronic illness, children and those over the age of 65.
It will then be offered to the public at large, though the means of how it will be done has not been decided yet. It may involve the public going to their GPs or it may be given to nurses to administer. “We are looking at those options at the moment. We have not decided yet. There are a number of ways we could do it. We could do it within the HSE, we could do it with doctors and other practitioners. Doctors, dentists and nurses could possibly administer this vaccine,” said Dr Doorley.
The vaccine will be free to everybody, though non-medical card patients will have to pay a fee to the GP to administer it.
Although Ireland has one of the most advanced pharmaceutical industries in the world, accounting last year for half of all our exports, there are no vaccine manufacturers in Ireland.
Pharmachemical Ireland director Matt Moran said: “Generally, the manufacturing in Ireland tends to be straight chemical production or biotechnology. It is something that the IDA is trying to get manufacturers to come in and do.”
Merck is currently building a €200 million strategic vaccine facility in Carlow town. It will be up and running by 2011 and will be the first such facility in the country.
The H1N1 pandemic, which has affected almost 100,000 worldwide and resulted in 450 deaths, has given an unexpected boon to pharmaceutical companies who are trying to come up with a vaccine.
Companies such as GlaxoSmithKline (GSK), Novartis and Sanofi-Aventis have seen their share price rise in anticipation of increased revenues from Governments such as the French who have put more than €1 billion aside to vaccinate the whole country. US president Barack Obama boosted the fortunes of US pharmaceutical companies by putting aside $1.8 billion (€1.3 billion) to deal with the H1N1 pandemic.
GSK is estimated to have already received orders of around €1 billion for swine flu vaccines, though they are unlikely to be shipped to customers before the end of the year.
The HSE expects the virus to spread more and become more virulent during the winter months. However, it has also reassured the public that there is enough anti-viral medication, most notably Tamiflu, to cover half the population.
Dr Alan Hay from the World Influenza Centre said the spread of the disease has taken the medical profession by surprise.
He said the extent of the disease during the summer months, which is outside the traditional flu season, indicates a significant spread of the disease during the winter.
However, he also said it was not an issue to cause undue alarm in the public. “The picture has not changed for the last two or three months. The vast majority of infections are relatively mild,” he told RTÉ last week.
“There is a small proportion of severe cases and some fatalities and that is the pattern we have observing in most countries that have been suffering from significant levels of infection.”