Update: Japan’s Pre-Pandemic Vaccine
Updating yesterday's posting about Japan's plans to administer their stockpiled human H5N1 influenza vaccine to 6,000 health care professionals and quarantine officials a new story hit the wires today [thanks unpathedhaunts @ FluWiki] introducing the idea of expanding their preemptive vaccination program into the general population.
From the Daily Yomiuri Online and The Associated Press
The Health, Labor and Welfare Ministry on Wednesday began a feasibility study on inoculating the general public with avian influenza vaccine to prepare for the possible outbreak of a new strain of pandemic flu, sources said.
Under the ministry's current plan, the vaccinations for 10 million people engaged in occupations maintaining social functions, such as police officers and those working for water and electric utilities, will start in fiscal 2009.
Hoping to eliminate concern over a possible epidemic, the ministry also will discuss whether to include the general public in the vaccination plan.
The ministry currently stockpiles sufficient avian flu vaccine concentrate solution for 20 million people and has already indicated that it would increase the amount of the stock.
However, expanding the vaccination to the public at large could cause social confusion over possible side-effects.
The ministry, therefore, will discuss the target population and timing of vaccinations, among other issues, after examining the safety of the inoculation, according to the sources.
Even people who have been vaccinated will likely develop symptoms in the event of an outbreak of a new type of influenza from any source, avian or otherwise.
Taking these factors into consideration, the ministry plans to inoculate 6,000 people who wished to receive flu vaccinations by the end of March next year. Falling into this category are doctors and quarantine officers who will most likely come into contact with patients.
The vaccination will be administered on a clinical test basis as a preemptive measure against the possible outbreak of a new type of flu.
If the vaccination proves to be effective, the ministry plans to expand the program to 10 million people in preparation for an epidemic.
Switzerland also is considering conducting a preemptive vaccination for the general public, but has yet to introduce it.
The Health Ministry is laying groundwork to see how effective their stockpiled vaccine is in the first 6,000, then if proven effective the 10 million who are classed as critical infrastructure personnel, then, (or at the same time as the 10 million, the story is a bit fuzzy on the timing here) 10 million of the general population.
Japan has a population of roughly 127 million so if they vaccinate the entire 20 million it is about 15.5% of their population. While the percentage of total population is impressive in and of itself, the fact that their critical infrastructure personnel will be protected is even more so. A severe pandemic would likely be a terrible, frightening, and profoundly stressful situation, having no public utilities or fresh food shipments would likely cause unimaginable cascading misery and unnecessary deaths over and above the pandemic proper.
This proposed program of advanced protection for an uncertain future threat is interesting when one compares what Japan is exploring and a recent report by CIDRAP's Maryn McKenna:
Apr 9, 2008 (CIDRAP News) – Healthcare institutions still face significant hurdles in getting their staff members vaccinated against seasonal influenza, and fear of flu infection and caring for sick family will keep many staff home during an influenza pandemic, according to research released this week,
Four teams of researchers reported at the 18th Annual Scientific Meeting of the Society for Healthcare Epidemiology of America, held in Orlando, Fla., that large proportions of hospital staff believe that flu vaccine causes influenza or triggers other side effects. Others believe that previous bouts of flu have made them immune to contracting the flu again.
After reading Ms. McKenna's report I was left shaking my head in stunned sadness. Sad because I'm fairly confident that even if my government were as proactive as Japan's (and they are not by a long and wide margin) most of those offered this advanced protection in the US would decline the vaccine.
In fairness, many are not as big a fan of vaccines as I, some after rationally weighing the pros and cons, but many due to simple misinformation and downright ignorance of the facts. It's the latter that causes the dismayed shaking of the head.
If trained healthcare professionals can be so ignorant of such simple facts what hope the general public?
Not for the first time I find myself envious of Japan.
SZ
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