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News Roundup [abridged Versions Appear In The Paper Journal]

UK will reserve bird flu vaccine for health workers

BMJ 2006; 332 doi: (Published 02 March 2006) Cite this as: BMJ 2006;332:506
  1. Michael Day
  1. London

    H5N1 bird flu vaccine will be for the exclusive use of NHS staff and other key public workers, ministers in the United Kingdom have confirmed. Contracts were announced with Baxter International and Chiron Corporation for about 3.5 million doses of the jab.

    Some experts have warned that British poultry workers might need the vaccine as the virus continues its move eastwards. Last week, H5N1 infection was confirmed in a turkey farm in France.

    But after announcing that the two batches were scheduled to arrive in May and October 2006, health minister Rosie Winterton made it clear that the vaccine was for public workers. “Building a stockpile will allow us to carry out more research and [the vaccine] could be offered as a possible first line of defence for NHS workers while the exact vaccine to match the pandemic flu strain is manufactured,” she said.

    A spokeswoman for the Department of Health confirmed that if, in the interim, British birds became infected with H5N1 there were “absolutely no plans” to give the vaccine to poultry workers.

    However, as the BMJ went to press, influenza expert Karl Nicholson, professor of infectious diseases at Leicester University, said that it was too early to make firm predictions on how the H5N1 vaccine might eventually be used. “It's going to be events that dictate how this develops,” he said. “If significant numbers of poultry farmers were infected then it could well be that some changes to the plans are made.” He added that he was confident that the department would “do the best it can” to protect those at greatest risk.

    In October, Alan Hay, the director of the World Health Organization's World Influenza Centre in north London, told the BMJ that if H5N1 virus became widespread in British poultry, then exposed workers might need the vaccine. “The issue of H5N1 vaccination for British farm workers may well arise,” he said. “We've seen poultry workers in the Netherlands get sick from another type of bird flu.”

    He said that European poultry workers were likely to be more vulnerable than their equivalents in the Far East, because their immune systems would have had no previous contact with H5N1-type viruses.

    Some experts have also noted that if the H5N1 vaccine were saved for a later date it is uncertain how much protection—if any—it would offer NHS workers against a mutated pandemic form of the virus.

    Ms Winterton admitted that the vaccine might not be effective if the pandemic strain of flu was significantly different to the H5N1 strain being seen now. Influenza experts have warned that significant genetic diversity has already arisen in H5N1 viruses.

    The health minister said that contracts had been placed for 120 million doses of pandemic vaccine, which would ensure that Britain had access to such a vaccine as soon as it had been developed. The chief medical officer, Sir Liam Donaldson, has warned, however, that a vaccine designed against a new pandemic form of influenza would not be available until months after a pandemic arrives.