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Vaccination plan to target at-risk groups

An article released in the Irish Times today states that pregnant women and people with chronic underlying diseases will be the first to receive the H1N1 vaccination

TODAY MARKS the beginning of a national swine flu pandemic vaccine campaign organised by the Health Service Executive (HSE). It starts with the vaccination of those who are most at risk from the pandemic flu and its complications. Pregnant women and people with chronic underlying disease, aged between six months and 65 years will be vaccinated first.

Why have these 500,000 or so people been selected? About 50 per cent of those who have required hospital admission in Ireland to date have been in “at-risk” categories. In the case of pregnant women infected with the Pandemic (H1N1) 2009 bug, it is estimated they are four times more likely to require hospital admission than the general population. People who require intensive care usually do so as a result of developing pneumonia about three to five days after first experiencing swine flu symptoms.

In some cases this progresses to a condition called adult respiratory distress syndrome; the seriously ill patient requires mechanical ventilation and other specialist procedures at this point.

The flu virus can also trigger serious complications such as kidney failure and inflammation of the brain in a small minority of people.

If you are in an at-risk group what should you do? The best advice is to make contact with your GP to see if he or she is participating in the campaign and to request an appointment to get the vaccine.

The vaccine is supplied in 10 dose vials, so most GP practices will operate special clinics where they will vaccinate groups of patients together. While there is some disagreement about the level of GP participation nationwide, your family doctor is the best person to administer the vaccine because of his knowledge of your medical history and possible contraindications to you getting vaccinated. If your GP is not participating in the programme, you can be vaccinated at a HSE clinic.

Details of 45 HSE vaccine clinics are available at http://www.swineflu.ie: an online booking can be made on this site.

Alternatively, just turn up during clinic times and you will be vaccinated on a first come first served basis.

Who should not get the swine flu vaccine? It should not be given to children under six months and should be postponed if you have a temperature over 38 celsius.

Anyone with a severe allergy to eggs or other substances in the Pandemrix vaccine should not be immunised. (A separate vaccine, Celvapan, is not egg-based.) If you previously had Guillain Barré Syndrome, a rare neurological condition brought on by viral infection, then the vaccine is not for you.

How many doses of the vaccine will I need? Despite a declaration from the World Health Organisation on Friday that a single shot of swine flu vaccine is sufficient to offer protection, the HSE continues to advise that at-risk groups need a second dose of vaccine at least three weeks after the first dose. However, it is likely that one dose of vaccine will be enough to protect those aged 13 years and over, and expert advice may change to reflect this.

What side effects are linked to the swine flu vaccine? The most common side effects are mild and include soreness, redness or swelling at the injection site.

The use of booster adjuvants in some approved vaccines may increase the severity of local reactions.

Headache, fever, aches and tiredness may occur. Severe or life threatening allergic reactions to vaccines are rare.

Is it safe for pregnant women to be vaccinated? Expert advice, including that from the Institute of Obstetricians and Gynaecologists here, is that the H1N1 vaccine is safe in pregnancy.

Although there is as yet limited data on the swine flu vaccine, seasonal flu vaccines have been used for a number of years in pregnant women in North America without any major concerns emerging. Some pregnant women may wish to opt for Celvapan on the basis that it does not contain booster additives.

One study of influenza vaccination examining over 2,000 pregnant women demonstrated no adverse foetal effects associated with influenza vaccine.

Canadian researchers reported earlier this year that influenza vaccination is warranted to protect women from needing flu-related hospital admission during the second half of pregnancy.

However, separate research found that infants born to women with laboratory-confirmed influenza during pregnancy do not have higher rates of low birth weight babies or congenital abnormalities, compared with infants born to uninfected women.

VACCINATION: WHO SHOULD SEEK IT

Pregnant women – from 14 weeks of pregnancy to 6 weeks after giving birth.

Anyone aged over 6 months and under 65 years who has: Long-term lung disease such as asthma, cystic fibrosis and chronic obstructive airways disease. Long-term heart disease, for example heart failure or coronary heart disease. Long-term kidney disease such as kidney failure. Long-term liver disease such as hepatitis and cirrhosis. Long-term neurological disease like multiple sclerosis, cerebral palsy and Parkinson’s disease.

Immunosuppression: meaning those undergoing cancer treatment and those being treated with newer “biological agents” for rheumatoid arthritis and other diseases.

Diabetes, severe obesity, with a body mass index (BMI) greater than 40.

 

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