Front-line workers priority for pandemic vaccine
6 December 2007
Front-line workers prioritised for pandemic vaccine
Nearly 100,000 front-line personnel in health, police and other essential services are in line to receive the two-dose vaccine against the current H5N1 strain of avian influenza, if it is required.
The vaccine, which is now in the country, will remain in storage until needed.
“This vaccine would only be offered to front-line workers in eight priority groups who provide essential services and are likely to have direct contact with people exposed to pandemic influenza,”Health Minister David Cunliffe said.
“Even though we don't know when we will face the next influenza pandemic, our aim is to be as prepared as possible,”Mr Cunliffe said.
It is planned that priority for the vaccine would be given to about 60,000 health personnel, 10,000 fire service emergency staff, 7000 policemen, 6000 defence personnel and 2300 NZ-based international aircrew.
"By offering early protection to these workers, it will help us to continue providing essential response services during a pandemic," Mr Cunliffe said.
The vaccine is made from a currently circulating strain of H5N1 avian influenza virus.
Mr Cunliffe said the best protection will be from a specific pandemic vaccine that can be used to immunise all New Zealanders.
"We have contracts in place to get priority access to such a vaccine once it's available, and we'll be getting enough to offer vaccination to all New Zealanders," he stressed.
"This again emphasises the importance of our future efforts to stop or slow down the entry of the pandemic strain into New Zealand, and to try to stamp out any early cases or outbreaks,"Mr Cunliffe said.
As part of an ongoing drive to further improve New Zealand's ability to meet existing health threats and counter new ones, laboratories will be required starting December 18 to report to the Medical Officer of Health when they have any case of 49 different diseases. Health professionals are already required to notify health authorities of any case of infectious diseases.
"Early warning of the presence and extent of these threats is essential for their prevention and control," Mr Cunliffe explained. "These small steps can help stop the spread of disease early."
Questions and Answers:
1. What is the difference between a pre-pandemic vaccine and a specific pandemic vaccine?
A pre-pandemic vaccine is made from a current strain of influenza (in this case, a currently circulating strain of the H5N1 avian influenza virus) that may or may not cause any eventual pandemic. A specific pandemic vaccine, on the other hand, is developed from a strain of the virus that is actually causing a pandemic. This difference is important because vaccines against influenza only protect against the particular strain of virus they are made from. No vaccine protects against all influenza strains.
2. What is this pre-pandemic vaccine made from? Who developed the vaccine?
The vaccine is made by Swiss company Baxter Healthcare S.A. using a currently circulating strain of H5N1 avian influenza virus.
3. What level of protection against a human H5N1 influenza virus or an emerging pandemic influenza virus will the vaccine provide?
This is a pre-pandemic vaccine. Therefore, the level of protection the vaccine will provide against any human H5N1 influenza virus or an emerging pandemic influenza virus will depend on how close (in the evolutionary sense) the eventual virus is to the virus the vaccine is made from. If the next pandemic is caused by a different strain of influenza (that is, not H5N1), then the vaccine won't be effective.
Although the vaccine’s effectiveness against a future pandemic cannot be determined in advance, the Government believes that it is sensible to keep some stocks of H5N1 vaccine in case that strain triggers the next pandemic.
The vaccine was bought to ensure there is enough vaccine to help protect key workers in health and other strategic areas (such as police, defence and border control) who will provide essential response services during a pandemic and who may be exposed to pandemic influenza due to their work.
4. How long will the protection from the pre-pandemic vaccine last?
The vaccine would provide protection from infection with H5N1 for many years.
5. How long does immunity develop after vaccination?
Effective vaccination requires two doses of the vaccine given at least three weeks apart. When both doses are given correctly, the vaccine produces a level of immunity to that strain of the virus that meets standards for seasonal influenza vaccine in about six weeks from the first dose.
A single vaccination (that is, only one dose of the vaccine instead of two) will not provide any significant level of protection.
6. What are the pre-pandemic vaccine’s possible side effects?
The vaccine does not contain any live influenza virus so it cannot give the person receiving the vaccination influenza.
Possible side effects include redness, tenderness or hardness at the injection site for a day or two; a mild fever, muscle aches or headaches within the first two days.
On rare occasions, an allergic reaction can occur.
7. Is this the same vaccine that will be used to immunise the general population in case of a pandemic?
No, this pre-pandemic vaccine would be offered:
- to key response personnel who are likely to have close and direct contact with people exposed to influenza, and
- if a developing pandemic is caused by an H5N1 strain
A specific pandemic vaccine to immunise the general population will be developed from the actual strain of the influenza virus that is causing a future pandemic.
8. Has the Government negotiated and awarded advance purchase contracts for a specific pandemic vaccine? If so, will there be enough stocks to cover the entire population?
The Ministry of Health holds a contract with CSL (Australia) to provide enough pandemic vaccine for the entire population. However, because of the time it will take to manufacture the pandemic vaccine, deliveries are expected to be received at least six months after the pandemic virus has first been recognised.
9. Who would receive the pre-pandemic vaccine?
It is planned that the vaccine would be offered only to front-line staff in priority groups, which include health, police, defence, border management and NZ-based international aircrew.
10. How many front-line staff in health and other priority groups would receive the pre-pandemic vaccination?
If a pandemic due to H5N1 influenza begins, about 100,000 front-line staff would be offered the vaccination. This includes personnel from health (60,000), fire service emergency (10,000), police (7000), defence (6000), corrections (4,500), social support (3000), NZ-based international aircrew (2,300) and border management (2000).
11. Are priority groups for pre-pandemic vaccination final or will they be reviewed in the future?
The priority groups for pre-pandemic vaccination were drawn up for the purpose of planning New Zealand’s pandemic response. They are provisional. If there is a pandemic, other at-risk groups may be identified and subsequently determined as alternative groups.
12. How long will the pre-pandemic vaccine last?
The vaccine currently expires in March 2009. It may be possible to extend this date, but a decision will be made only in late 2008.
If a pandemic due to H5N1 influenza has not occurred by that time, options at the end of the vaccine's lifetime include the offer of vaccination to the priority groups while the vaccine remains unexpired or destruction of the vaccine stocks on final expiry.
13. How is the pre-pandemic vaccine stored?
The vaccine is stored in a secure controlled temperature facility. As with ordinary seasonal influenza vaccines, the vaccine must be maintained between 2-8 degrees Centigrade until it is administered to the patient.
14. What other protection will be offered to the public?
The pre-pandemic vaccine is only one of the many strategies to protect New Zealanders from pandemic influenza. The "keep it out" phase of the plan aims to keep pandemic influenza out of New Zealand in the first place by using health checks, quarantine and other controls at the border.
If outbreaks do begin to occur,
public health authorities and district health boards will
work to "stamp out"the disease to prevent it from spreading.
Measures that will be adopted include providing anti-viral
to patients and their families, isolating sick people and putting affected households and communities under quarantine. The public will be advised about social distancing measures, hand hygiene, respiratory hygiene and other ways of staying safe.
15. How many treatment courses of Tamiflu are in the national reserve? What is the supply's value and expiry date?
There are over 1.22 million treatment courses of Tamiflu in the national reserve. Each treatment course is 10x75mg capsules of Oseltamivir.
The total supply cost is approximately $36 million (GST exclusive). The main supply will last to at least 2012/2013. It may be possible to extend this date, but the decision on this will need to be informed by testing at the time. The medication is very stable in storage.
There are no drugs other than Tamiflu held in the national reserve of anti-viral medicines.
16. What can the public do now to prepare?
It is important to prepare for emergencies of all kinds. Many of the preparations that the public should make in case of influenza will be useful in other kinds of emergencies as well. Advice is provided on the Ministry of Health's website at http://www.moh.govt.nz/pandemicinfluenza, and in the back of the phone book.
Some practical tips include:
- plan what you will do if schools or your workplaces are closed.
- ensure you know how to provide basic nursing care to people with influenza. (During a severe pandemic, the health services will be unable to provide care for everybody who becomes ill.)
- have enough basic supplies at home to keep going for a week or so in case you or your family gets ill.
- make sure you have supplies of basic medications such as paracetamol, and don't let your prescription medicines run out before restocking.
- know who you might be able to call on for help, and who might call on you for help; have a plan.
17. Why do laboratories now need to report these diseases?
Laboratory-based reporting helps give comprehensive and timely information about the presence and level of disease. Many years’ experience with surveillance of diseases (such as HIV/AIDS, tuberculosis, and meningococcal disease) in New Zealand has shown the value of an integrated approach of both clinician and laboratory-based reporting.
Both surveillance methods are needed and achieve different things: Notification by clinicians provides in-depth data on risk factors, case treatment, and outcomes. It also establishes a dialogue with public health agencies over the follow-up of contacts and outbreaks. Laboratory reporting helps identify cases that have not been notified, and provides supporting data on organism characteristics where these are important.
18. Will personal health information be safe despite this new reporting requirement on laboratories?
Yes. All personal health information is governed by the Health Information Privacy Code 1994 (www.privacy.org.nz). This code sets rules for agencies in the health sector to better ensure the protection of individual privacy. The code addresses the health information collected, used, held and disclosed by health agencies.
Existing law places the responsibility for ensuring the protection of that information on the organisation that collects and holds the information.
19. Who are authorised to look at personal health information?
Information about an individual who is suspected or confirmed as having one or more notifiable diseases is passed from either their GP or the diagnosing laboratory to the Medical Officer of Health.
In certain circumstances, such as where gastrointestinal or environment-related diseases require investigation, local territorial authorities (city or regional councils) will also be informed of any information required for them to take appropriate action in order to mitigate or prevent the spread of a disease.