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Who should receive vaccines and antiviral drugs in the event of a flu pandemic?
October 17, 2006Since flu vaccine and antiviral drugs are in scarce supply, the WHO recommends that all nations determine in advance which groups of people will be the first to receive these treatments in the event of a flu pandemic. But a new study in PLoS Medicine finds that 30% of nations have prioritized neither vaccine nor drugs in their pandemic influenza preparedness plans.
In the first study of its scale, Lori Uscher-Pines and colleagues from the Johns Hopkins Bloomberg School of Public Health, and the Ben-Gurion University of the Negev, Israel, analyzed 45 national plans from both developed and developing countries. Plans from all regions of the world were represented in the analysis.
Of the national plans identified, 49% prioritized which groups in society would receive antiviral drugs while 62% prioritized which groups would receive flu vaccine. This is an unexpected finding, say the authors, since antivirals may be the first-and, perhaps, the only-pharmaceutical intervention available to many countries in a pandemic.
"Because it is estimated to take six months to mass produce strain-specific vaccine," they say, "and global antiviral production and stockpiling is increasing, priority setting for antivirals may prove to be more critical to pandemic preparedness."
The researchers found that that the allocation decisions varied across different countries. While health-care workers were consistently ranked at the top of the vaccine and antiviral priority lists, there was then a wide variation between countries in their choice of who would be next in line (e.g. elderly, children, essential service workers).
One striking finding was that of the nations that prioritized who would receive vaccine in a flu pandemic, almost half prioritized children, even though the WHO states in its guidelines: "There is no evidence that use of inactivated vaccine in children will reduce the spread of a pandemic in the community, and this strategy is not recommended"-http://www.who.int/csr/resources/publications/influenza/11_29_01_A.pdf
The authors conclude that "attention to prioritization and its ethical implications may help to reduce death and disease burden, and minimize political destabilization and claims of injustice."
Public Library of Science
"Because it is estimated to take six months to mass produce strain-specific vaccine," they say, "and global antiviral production and stockpiling is increasing, priority setting for antivirals may prove to be more critical to pandemic preparedness."
The researchers found that that the allocation decisions varied across different countries. While health-care workers were consistently ranked at the top of the vaccine and antiviral priority lists, there was then a wide variation between countries in their choice of who would be next in line (e.g. elderly, children, essential service workers).
One striking finding was that of the nations that prioritized who would receive vaccine in a flu pandemic, almost half prioritized children, even though the WHO states in its guidelines: "There is no evidence that use of inactivated vaccine in children will reduce the spread of a pandemic in the community, and this strategy is not recommended"-http://www.who.int/csr/resources/publications/influenza/11_29_01_A.pdf
The authors conclude that "attention to prioritization and its ethical implications may help to reduce death and disease burden, and minimize political destabilization and claims of injustice."
Public Library of Science
Flu Pandemic Current Events and Flu Pandemic News RSSSneezing in times of a flu pandemic
The swine flu (H1N1) pandemic has received extensive media coverage this year. The World Health Organization, in addition to providing frequent updates about cases of infection and death tolls, recommends hyper vigilance in daily hygiene such as frequent hand washing or sneezing into the crook of our arms.
Lessons from flu seasons past
Pregnant women who catch the flu are at serious risk for flu-related complications, including death, and that risk far outweighs the risk of possible side effects from injectable vaccines containing killed virus, according to an extensive review of published research and data from previous flu seasons.
Older Patients with Dementia at Increased Risk for Flu Mortality
An epidemiological study on pneumonia and influenza (P&I) in adults age 65 and over reports that patients with dementia are diagnosed with flu less frequently, have shorter hospital stays, and have a fifty percent higher rate of death than those without dementia.
Triple-Combo Drug Shows Promise Against Antiviral-Resistant Swine Flu, UAB Researcher Says
An experimental drug cocktail that includes three prescriptions now widely available offers the best hope in developing a single agent to treat drug-resistant H1N1 swine flu, says a virology researcher in the University of Alabama Birmingham (UAB) Division of Pediatric Infectious Diseases.
Medical ethics experts identify, address key issues in H1N1 pandemic
The anticipated onset of a second wave of the H1N1 influenza pandemic could present a host of thorny medical ethics issues best considered well in advance, according to the University of Toronto Joint Centre for Bioethics, which today released nine papers for public discussion.
Texas A&M researcher shows possible link between 1918 El Niño and flu pandemic
Research conducted at Texas A&M University casts doubts on the notion that El Niño has been getting stronger because of global warming and raises interesting questions about the relationship between El Niño and a severe flu pandemic 91 years ago.
'Dung of the devil' plant roots point to new swine flu drugs
Scientists in China have discovered that roots of a plant used a century ago during the great Spanish influenza pandemic contains substances with powerful effects in laboratory experiments in killing the H1N1 swine flu virus that now threatens the world.
NIAID scientists study past flu pandemics for clues to future course of 2009 H1N1 virus
A commonly held belief that severe influenza pandemics are preceded by a milder wave of illness arose because some accounts of the devastating flu pandemic of 1918-19 suggested that it may have followed such a pattern.
Avian influenza strain primes brain for Parkinson's disease
At least one strain of the H5N1 avian influenza virus leaves survivors at significantly increased risk for Parkinson's disease and possibly other neurological problems later in life.
Flu mortality formula is potentially misleading, say scientists
A standard calculation used in forecasting potential numbers of deaths during the swine flu pandemic risks misleading healthcare planners by being open to both over- and under-estimation of the true figures.
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