[back] Swine flu vaccine

Swine flu vaccine strategy 'risky'

By Dina Rosendorff

20August 2009

 http://www.abc.net.au/news/stories/2009/08/20/2662321.htm?section=justin

The country's top infectious diseases body has written to the Government to warn the swine flu vaccine is being distributed too hastily, with too many risks for the public.

The Australasian Society for Infectious Diseases says the multi-dose vials which the vaccine will be distributed in have been shown to transmit infection, spread HIV and hepatitis, and even cause death.

Federal Health Minister Nicola Roxon says the Government expects to receive 2 million doses by the end of next week, and a widespread immunisation program could start by mid-September.

But the infectious diseases doctors say the swine flu threat has now passed and there is no need for urgent mass vaccination.

"To rush to a massive vaccination using multi-dose vials that have been associated with problems in the past, seems too hasty and perhaps not measured enough for our society," said Dr Tom Gottlieb, the president of the Australasian Society for Infectious Diseases.

The doctors are worried about the method that will be used to deliver the swine flu vaccine when the national immunisation program starts in the next few weeks.

The plan is to use multi-dose vials of the vaccine, which means a health worker will use needles to take more than one dose out of each vial.

"There have been episodes of bacterial contamination of vaccines, where there has been perhaps a bacterial organism growing in the vaccine, and when the patient's been injected they may have become infected with a bacteria," Dr Gottlieb said.

"Now that's largely been addressed with preservatives that are used in vaccines, but nonetheless there are potentials for viruses from one patient to be transmitted if vaccination is not done correctly.

"And in most circumstances it would be done correctly, but when things are rolled out hastily and multi-dose vials are used that potential exists.

"And there are certainly examples of spread of infection between patients with HIV, hepatitis B, hepatitis C and so on, and that's our concern."

The group of infectious diseases doctors is so concerned that they have written to Australia's chief medical officer Jim Bishop, urging him to reconsider the vaccination strategy.

In the letter the doctors point out that many international agencies, including The World Health Organisation, prefer the use of single-dose vials.

But the drug company making the vaccine, CSL, says it would take too long to make enough single-dose vials.

"It would delay the role out of the vaccine by a long time," said Dr Rachel David, a spokeswoman for CSL.

"The other reason is that with pre-filled syringes you need to order a lot of syringes to roll out the vaccine for 21 million doses as the Government has ordered.

"So I think on balance the decision to use multi-dose vials is completely justified.

"Although it will work out being cheaper to use multi-dose vials, it's not being done this way to save money. It's been done this way to vaccinate a large number of people quickly, which is our best chance of stopping the flu epidemic."

'Urgency no longer there'

But Dr Gottlieb says there is no real need to rush.

He says there have been fewer deaths linked to swine flu than initially feared, and the epidemic has now subsided.

"In our society, all the members are strong advocates of vaccinations, so in no way do we want to undermine vaccination as a very effective strategy," he said.

"But in this particular influenza season we have to determine which are the risk groups that need vaccination, and the probable urgency is no longer there as it was perhaps a few months ago.

"And we would caution for a more measured approach and for single dose vaccines to be used preferably to multi-dose vials."

But that argument has done nothing to change the mind of Professor Bishop.

He is yet to sign off on the swine flu vaccine rollout, but he has indicated that when he does multi-dose vials will be used.

In a statement, Professor Bishop told ABC Radio's PM program that health workers will be trained to maximise infection control and minimise wastage.

The first jabs will go to pregnant women, health workers and people with underlying medical conditions.