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2005 Influenza vaccination programme plan

22 March 2005

Ministry of Health announces 2005 Influenza vaccination programme plan

The Ministry of Health today announced details of its plan for the 2005 influenza vaccination programme.

``We're confident we now have a plan that gives New Zealanders the protection they need against this illness. This includes our most vulnerable and at risk, as well as those who are fit and healthy,'' said Dr Don Matheson, Deputy Director-General of Public Health.

After taking advice from an expert group of clinicians and health professionals, the Ministry has developed a strategy that uses a range of vaccines to deliver similar levels of influenza protection as in previous years.

Dr Matheson said New Zealand's vaccine situation had changed significantly in the week since the Ministry confirmed the 2005 influenza programme would go ahead.

``In that time New Zealand has secured enough vaccine with the full three-virus constituents to cover those people who are eligible for the free influenza vaccination programme, and that's great news,'' he said.

``We've also received expert advice that in healthy adults, the immune response after the use of the Sanofi Pasteur vaccine Vaxigrip is not likely to be significantly different from that which follows the use of the full, three-virus vaccine.

``So if you're a fit and healthy adult, Vaxigrip gives protection against the three virus strains identified by the World Health Organization as most likely to circulate this winter.

``Because of this, we are able to use all the vaccines available to New Zealand in our immunisation programme this year.''

Dr Matheson said that for healthy individuals, using the full three-virus vaccines results in a one percent average increase in their immunisation response. For people who are most at risk from influenza, the improvement is six percent in their influenza protection. The Ministry is targeting the three-virus vaccine at this at-risk group.

From April 18, GPs and vaccinators will be able to offer one dose of Vaxigrip to the healthy population under 65 years.

From April 26, with the arrival in New Zealand of the three-virus vaccines, GPs and vaccinators will be able to start immunising those people eligible for the free influenza vaccination programme. High risk children and those adults with heart or lung conditions, particularly older people, are at the greatest risk from influenza and should be among the first to be vaccinated.

The programme will be available for all the eligible funded groups, all those aged 65 and over and those aged under 65 years who have chronic conditions. All the eligible groups will receive the full three-virus vaccine.

``As we introduce this immunisation programme, we'll be keeping a close eye on influenza data. If it indicates that the flu season is peaking earlier than usual, which is normally around the middle of July, the Ministry will re-evaluate its approach to the programme plan.''

Dr Matheson noted that historical immunisation coverage in at-risk groups was low; last year the uptake of the influenza vaccine among people aged 65 and older was about 54 percent, while immunisation coverage for at-risk individuals under the age of 65 years was estimated at about 33 percent.

But he stressed that early immunisation was still the best protection against influenza, and strongly encouraged people most at risk to be vaccinated.

The Ministry has set up a freephone information line, 0800 FLU INFO or 0800 358 4636. This is a recorded message which is updated regularly.


What has been decided?

Vaxigrip for the rest of the population will be available from 18 April 2005.

The full three-virus vaccine will be available for eligible funded groups from April 26 2005.

When will the most vulnerable groups get vaccinated, and which vaccine will they receive?

Immunisation for the eligible funded groups will begin on April 26. This group of at-risk New Zealanders will be given new supplies of the full-strength vaccine.

When will the average, fit and healthy New Zealander who is under 65 get vaccinated?

GPs and vaccinators will give one dose of Vaxigrip to New Zealanders who are well and aged under 65 years starting from April 18. When the full-strength vaccine becomes available for the most vulnerable New Zealanders, from April 26, vaccinators will be asked to concentrate on immunising the eligible funded, high-risk population.

Occupational programmes with Vaxigrip will be ongoing from April 18.

How effective is Vaxigrip?

Advice the Ministry has received from the expert group of clinicians is that Vaxigrip is expected to give an immunization response in healthy adults that is not significantly different from protection offered by other vaccines for this group.

Will the Ministry of Health monitor flu statistics and trends during winter?

Yes. If data indicates that the flu season is occurring earlier than usual -- the peak is normally around the middle of July -- the Ministry will reconsider its programme plan.

Why do people need to vaccinate?

Influenza immunisation is the best protection against influenza. Influenza infection in people with ongoing medical conditions, even if well controlled, may lead to more serious illness.

Influenza can cause pneumonia and can act as a trigger that makes existing medical conditions worse. In older people and those with ongoing medical conditions such as heart disease, other respiratory problems and diabetes, this can lead to hospitalisation.

What vaccine supplies are available to New Zealand?

New Zealand has access to up to 1.38 million doses of Vaxigrip.

Two of the three strains in the Vaxigrip vaccine meet all requirements for efficacy. The third strain is more dilute than was specified and may be less effective for certain older people with chronic conditions. The vaccine meets all standards for safety.

In addition, extra vaccine from three different pharmaceutical companies has been accessed. These vaccines will give protection against all three strains of influenza identified by the World Health Organization as likely to circulate this winter. They are:

-50,000 from Solvay Pharmaceuticals

-100,000 doses from Commonwealth Serum Laboratories (CSL) Australia

-368,000 from GlaxoSmithKline (GSK)

Who are the clinical experts advising the Ministry on vaccination options?

Professor David Murdoch (Physician)

Dr Richard Meech (Physician)

Associate Professor Glenn Buchan (Immunologist)

Associate Professor Stephen Chambers (Physician)

Dr Tim Blackmore (Infectious Disease Physician)

Professor Diana Lennon (Paediatrician)

Dr Lance Jennings (Virologist)

Professor Keith Grimwood (Paediatrician)

Dr Stewart Reid (General Practitioner)

What happened in the 2004 flu season?

During the 2004 influenza season, 3277 consultations for influenza-like illness were reported from a national sentinel network of 86 general practices. It is estimated that influenza-like Illness affected more than 35,186 New Zealanders during the season, compared with an estimated 46,116 in 2003.

Overall, 91.4 percent of influenza isolates in 2004 were influenza A and 8.6 percent were influenza B. Among the types and subtypes, the H3N2 strains influenza A/Fujian/411/2002 predominated with 47.4 percent and A/Wellington/1/2004 with 43.4 percent.

The full 2004 report is available at:

Why was PHARMAC given the responsibility of sourcing the supply of flu vaccine?

PHARMAC took over the responsibility for sourcing the influenza vaccine this year because it is a specialist agency set up to purchase medicines.

Why are annual recommendations for influenza vaccine composition necessary?

Circulating influenza viruses in humans are subject to antigenic changes that require the vaccine formulation to be updated each flu season. This is to ensure the closest possible match between the influenza vaccine strains and the circulating influenza strains.

How is it decided which strains should be included in the vaccine each year?

The World Health Organization (WHO) makes recommendations about which strains should be included in flu vaccines each flu season. There are two seasons each year, the Northern Hemisphere season and the Southern Hemisphere season.

Information on circulating strains and epidemiological trends is gathered by the WHO Global Influenza Surveillance Network administered by WHO since 1948, the year of WHO’s inception. The Global Influenza Surveillance Network currently consists of 112 national influenza centres in 83 countries and four WHO Collaborating Centres for Reference and Research on Influenza located in Atlanta, United States; London, United Kingdom; Melbourne, Australia; and Tokyo, Japan.

The National Influenza Centres sample patients with influenza-like illness and submit representative isolates to WHO Collaborating Centres for immediate strain identification. In addition to genetic and antigenic analyses of influenza viruses, the WHO CCs jointly with key national laboratories involved in registration and quality control of influenza vaccines (Australia, United Kingdom, United States) collaborate annually on serological studies to obtain evidence as to whether the current vaccines induce satisfactory antibody levels to new epidemic strains.

Twice a year, WHO organises a consultation with the Directors of the WHO Collaborating Centres and representatives of key national laboratories to review the results of these laboratory and clinical studies and make recommendations on the composition of the influenza vaccine (February: northern hemisphere; September: southern hemisphere). Immediately after this consultation WHO informs representatives of pharmaceutical companies on its decisions which are published in the press and the WHO Weekly Epidemiological Record. WHO collaborates with key national licensing agencies on the provision of viruses for vaccine production as well as vaccine potency testing reagents.

More than 250 million vaccine doses are produced annually based on the WHO recommendations. Since 1972 WHO has recommended 39 changes in the influenza vaccine formulation.

What are the three influenza strains identified by WHO for inclusion in the Southern Hemisphere vaccine this year?

A/Wellington/2004 (H3N2), A/New Caledonia/1999 (H1N1) and B/Shanghai/2002.

What is the difference between Northern Hemisphere and Southern Hemisphere vaccine?

The most recent Northern Hemisphere season vaccine did not contain the A/Wellington strain, which is the one that has not met efficacy specifications, and the manufacture for the next Northern Hemisphere season has only just begun.

Do flu vaccinations actually work?

Yes. For those at high risk, influenza vaccination reduces hospitalisation by 50 percent and mortality by 70 percent. In general the vaccine is 70-90 percent effective in preventing influenza in healthy adults.

Will I get influenza if I have a vaccination?

Influenza vaccine cannot give you the flu as it does not contain live vaccine, however you could still get a strain of influenza that is not in the vaccine you have been given.

What is influenza?

Influenza is a highly infectious illness caused by a virus.

What are the symptoms?

Influenza has a sudden onset and is accompanied by some or all of the following symptoms:

-‚· Fever and chills

-‚· Cough

-‚· Body aches and pains

- Fatigue

-· Headache

How can I tell the difference between a cold and influenza?

Influenza makes people feel miserable and is much more serious that a common cold. Influenza will leave you ill for up to 10 days. Most people suffer from a high fever and may require bed rest. Those affected can also suffer from shivering attacks, muscular pains, headaches a dry cough, possible vomiting and there can be complications like pneumonia. A vaccine is available to protect against influenza.

A cold however has much less severe symptoms and they generally last only 2-4 days. High fever is less common and shivering attacks and severe headaches are rare. Muscular pains and vomiting are infrequent and the cough will be less severe. There is no vaccine available.


Those people with chronic health conditions are more at risk of complications from influenza and that is why the vaccination is provided free to these groups. This includes those 65 years and over, and those adults and children with certain chronic conditions including:

-· heart disease

- stroke

-· ongoing respiratory (chest) diseases like chronic bronchitis or asthma (but only those requiring regular preventative medication)

- diabetes

- ongoing renal (kidney) disease

-· most cancers

-· other conditions affecting the immune system such as HIV/AIDS, rheumatoid arthritis and organ transplants.

Overseas research studies have shown that influenza vaccination cuts hospitalisations and deaths in the over 65 age group during the influenza season.

Vaccination is the best protection against influenza. For those in the ‘at risk’ groups, early vaccination is recommended even if they are fit and healthy.

Annual vaccination is also recommended as the virus is always changing so the vaccines need to be updated annually to provide optimal protection against illness. Therefore people must get vaccinated each year regardless of whether they’ve been vaccinated the year before.

A short timeline of recent events:

28 February 2005: New Zealand advised of a problem with the vaccine

28 February 2005: Medsafe advised Public Health Directorate and PHARMAC of problem

01 March 2005: Medsafe approves GSK vaccine for use in New Zealand

01 March 2005: Pharmac begins seeking alternative supplies

03 March 2005: Merck, Sharp and Dohme advises sector of delay in vaccine availability. Information sent to:

-GP practices

-All GP & Specialist Combined practices


-Hospital Pharmacies

-Endocrinologist Specialists

-Infectious Disease Specialists

-Microbiologist Specialists


-Paediatrician Specialists

04 March 2005: Australian authorities announce a problem with the vaccine supply

07 March 2005: Australia announces it has successfully sourced alternate supply of vaccine

10 March 2005: Medsafe approves Solvay flu vaccine for use in New Zealand

11 March 2005: Ministry announces problem with vaccine supply

15 March 2005: New Zealand confirms flu vaccine programme for 2005 will go ahead and outlines options under consideration

16 March 2005: Australian pharmaceutical company Commonwealth Serum Laboratories (CSL) agrees to supply New Zealand with 100,000 doses of influenza vaccine that contains the recommended strength for all three Southern Hemisphere strains.

17 March 2005: Pharmaceutical company GlaxoSmithKline (GSK) agrees to supply New Zealand with 8000 doses of influenza vaccine that contains the recommended strength for all three Southern Hemisphere strains

18 March 2005: GSK announces it can deliver a further 360,000 doses of influenza vaccine for New Zealand from its southern hemisphere network

22 March 2005: Ministry of Health announces details of influenza vaccination plan


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