GPs have begun giving patients doses of last year's swine flu vaccine to try to overcome the shortage of seasonal flu vaccines, as the death count from this winter's outbreak rises to 50 people.
The Department of Health approved the move today, and Labour claimed that that was further evidence of ministers being "slow to act at every stage" as the threat posed by flu escalated.
Coming a week after it was forced to reinstate a national advertising campaign on good hygiene, it is the second unexpected step the department has taken to try to lessen the serious harm being caused by swine flu.
The government is releasing 12.7m doses of the Pandemrix swine flu vaccine, left over from the 2009-10period, when an outbreak killed almost 500 people.
"I'm writing to GPs to tell them that they can start using H1N1 vaccine on clinical need," said Dame Sally Davies, the interim chief medical officer for England.
John Healey, the shadow health secretary, said: "This is a sensible step, but once again late in the day from a government that has been slow to act at every stage of this flu crisis. And coming the day after calls for vaccine suppliers to scour Europe for stocks, this will add to public confusion about what treatment is available and where."
Eleven more people have died from flu in the last week, taking the toll from 39 to 50. Of those, 45 deaths were due to swine flu, the main strain of flu circulating this winter; the other five were influenza B.
Of the 48 cases where details were known, 33 people were in an "at-risk" group because they had an underlying medical condition such as diabetes, obesity or a breathing condition, or were pregnant. In 39 cases where vaccination status was known, 36 had not had this winter's seasonal flu jab at least two weeks before they fell ill, and 33 had not had a swine flu jab last year, despite vulnerable health.
Among the dead, five were aged under five, eight were five to 14, 33 were 15 to 64, and four were older than 64.
Ministers have now ordered a review of the way the NHS procures seasonal flu vaccines. This could lead to the health departments in England, Scotland, Wales and Northern Ireland taking over from individual GP practices the job of ordering and paying for supplies for next winter.
Meirion Evans, of the Faculty of Public Health, said doctors wanted the switch so as to prevent shortages. All childhood vaccines, such as for MMR, tetanus and diptheria, were already obtained this way.
However, any move to adopt the same system for seasonal flu vaccines could lead to a dispute between the health department and the BMA, because it would lessen GPs' income.
The number of people receiving critical care in hospital because of serious complications brought on by flu also rose this week, from 738 to 783, and a record number of people were receiving intensive support with breathing difficulties, called extracorporeal membrane oxygenation, .
Davies and the head of the NHS today were cautiously optimistic that the outbreak would peak soon then start to subside. They said that last week fewer people in England and Scotland went to see their doctor with flu-like illnesses; in England the rate dropped from 124 to 98 per 100,000 people. The rate of increase in people ending up in critical care also slowed sharply.
The Countess of Chester hospital, in Chester, has become the latest hospital to ask the public not to visit "in order to reduce the risk of patients and staff becoming ill". People have been advised to visit only come if "absolutely essential".
Comments
6 January 2011 9:50PM
This what it's like after 6 months of a Tory NHS - I dread to think what it may be like in the near future after they've been ruinously tnkering and underfunding it further.
6 January 2011 9:54PM
Did a minister take the decision not to pay for enough of the needed vaccine?
If so, which one?
6 January 2011 9:58PM
Plenty of vaccine and a mass swine flu awareness campaign last winter, with doctors getting in touch with high risk group patients. Oh but we didn't have a Tory government then did we?
6 January 2011 10:01PM
One worry is that GPs didn't order much vaccine and are now running out. The new NHS reforms will give far more responsibility to GPs to handle the budgets for a huge range of healthcare. If they can't all be relied on to get this right, what hope do we have that they'll be able to provide a decent standard across the UK in everything else? As they are trained in medicine, not accounting or logistics or contract law, many areas could find their GPs way out of their depth.
I guess that the new ministers also thought publicity was ripe for cutting and not 'front-line'. Shame that dropping the campaign to get people to arrange a jab means that more people will catch this flu. I'm sure our Tory commenter-bots will soon be here to tell us 'there is no alternative'.
6 January 2011 10:05PM
If last year's flu vaccine is suitably protective against this year's flu, then presumably they would have used the stockpiles previously rather than going through the trouble and expense of developing new vaccines.
6 January 2011 10:13PM
Tell you why they're using it now. It's because the last "epidemic" was a false alarm generated by the pharma industry, who sold a load of their vaccine on the strength of it.
6 January 2011 10:18PM
Why does the Guardian routinely support Big Pharma by uncritically parotting the old scares about influenza pandemics and the possibility that these experimental drugs might help you?
6 January 2011 10:20PM
Couple of simple observations...
Flu numbers are currently down this week because of the Christmas & New Year break. It would be expected that numbers will increase again over the next two weeks or so as people go back to work & school and start to congregate again so increasing the potential spread of virus.
Can't think that the BMA have got much of a leg to stand on regarding complaints about potential centralisation of vaccination next year - if the GPs were doing their jobs properly (i.e. identifying those at-risk patients on their lists who were suitable for vaccination & then giving those patients the vaccine) we wouldn't be seeing the mad rush to vaccinate patients that we're seeing now. As they don't seem to be vaccinating the patients that they should be (only 45% of at-risk patients vaccinated by year-end), then they're not going to lose the income they think they're entitled to. It's not like they haven't had the time & opportunity to get this done - the vaccine's been available since October...
Today's flu surveillance document from the HPA for reference & interest:
http://www.hpa.org.uk/web/HPAwebFile/HPAweb_C/1287148330414
And to respond to robbo100 - the vaccine uptake last year in terms of coverage was only slightly better than now (just over 50% of at-risk patients vaccinated last year in England) so regardless of the colour of the administration & the presence/absence of an awareness campaign (the cancellation of which I think was a mistake this year) we are consistently performing poorly in ensuring at-risk patients get vaccine.
6 January 2011 10:36PM
So the seasonal flue death toll has reached 50! What is it in a "normal" year.
And have people got such short memories that they can't remember last year's mainly journalist hyped "pandemic".
Personal responsibility is such a dirty thought now though isn't it.
6 January 2011 10:36PM
Sorry flu not flue - nothing to do with chimneys.
6 January 2011 10:37PM
My 12 year old asthmatic son received no referral from the GP this year for the flu vaccine despite being in a high risk group.
Therefore, booked an appt to see the aforementioned GP to ask for the flu jab, only to be asked why he needs it....
6 January 2011 10:37PM
I bet last year's figures weren't blamed on the administration.
6 January 2011 10:39PM
Cameron himself raged in a number of PMQs about how much money had been 'wasted' on government publicity. He wanted people to think that this money was being spent promoting the government and not, as it was in reality, spent on public campaigns to raise awareness of things like flu.
They've talked about putting a greater emphasis on 'preventative' health policy but slashed the money being spent on raising awareness of issues, the first thing you have to do to prevent anything.
6 January 2011 10:45PM
As someone on the front line of flu jab giving I have observed that you can identify (yes, we can do this) and invite patients in the at risk groups for the vaccine until you are blue in the face but short of holding them down I don't know how pharmacists et al think we're supposed to make them have it. All suggestions gratefully accepted.
The vaccine has been available in my neck of the woods since 6/10/10 and the uptake has been much the same as previous years until the last couple of weeks when, particularly, the parents of children with asthma who have never brought them them for vaccination previously are suddenly very keen for them to have it. We've had a fair amount of 'demanding' from these parents in particular.
Oh well, won't have to worry about about returning unused vaccine stocks this year - makes a change.
6 January 2011 10:45PM
Or a massive immunisation campaign actually helped to prevent the very thing it was meant to prevent and you just got suckered into believing the idiotic media and their doomsday predictions and therefore look for a reason as to why their prediction didn't happen?
And who said the alarm was generated by the Pharma industry? The alarm came from the WHO and the individual health services of various countries.
I'd say keep taking the medicine but Big Pharma would benefit.
6 January 2011 10:54PM
@Goonhilly
I can understand your frustration, but as with any vaccination programme it relies on good information, organisation and awareness campaigns.
Yes, you cannot make patients have the vaccine but that shouldn't be a reason for ceasing the campaign - if we took that line then no one would ever get vaccinated for anything and vaccination rates would steadily decline to near zero.
Labour did get the flu vaccine campaigns right in the past -as it probably prevented huge surges in patients exhausting the resources of the NHS every winter...
6 January 2011 10:56PM
Other countries get one corrupt thick headed lying tinpot dictator in power, Britain has landed up with three of them.
We are forced to contend with all of this as well as David Cameron "promising" no reorganisation of the NHS, now he is totally gutting, it, dismantling and selling the best bits off to private companies and if we lose our NHS, we will never, ever again have it, it will be impossible to take back into public ownership, this is the extent of the lying and utter betrayal of the British people by this TORY led government. Cameron, Osborne and Clegg.
6 January 2011 10:58PM
Goonhilly, my god, there's really no pleasing you lot is there?
One minute the peasants aren't taking them when they should, then when people ask for them who are in high risk groups you're moaning about that.
Why is returning unused stuff a 'worry'? Perhaps it might be more convenient to you to run short every year so you don't have to be a*sed to return any?
6 January 2011 11:01PM
Lansley is too busy fucking up the NHS to worry about its effectiveness.
6 January 2011 11:01PM
garyrobot, remember the year 2000 scare in computing? People said (after we'd all carefully checked our systems and amended them where necessary) it was obviously all a big scare because nothing happened...
if this is the way people reason....then we're all doomed, doomed....
6 January 2011 11:02PM
I've just listened to Lansley trying to smooth-talk his way out of this debacle on Newsnight. Perhaps of most interest is his intention to rely on PCTs to sort things out. That'll be those PCTs he's determined to abolish will it?
Oh - Healey has just made this important point clearly though Kirsty interrupted him!
6 January 2011 11:08PM
@HoldThemtoAccount
"That'll be those PCTs he's determined to abolish will it?"....
don't worry they'll just make another u-turn!
6 January 2011 11:10PM
Because 'Big Pharma' is an anthropomorphic entity invented by people with the paranoia but not the brains to address the shortcomings of the pharmaceutical industry. Anyone who uses the term should be backed away from quickly but with no sudden movements or eye contact.
The Guardian publishes the ramblings of Simon Jenkins, so it's hardly been 'uncritical' either.
'Normal' flu kills thousands of people each year, as some like reminding us; but they are being selective. Flu kills thousands of people despite massive efforts and resources mobilised to track it and develop vaccines as the strains mutate: it would be a damn lot more lethal without this as it once was.
Swine flu is different enough that it's simply sensible to make a bit of an issue about it now before it becomes a real problem. We live in a Smallpox-free world now because there are thousands of researchers ignoring what the 'hysterical anti-hysteria hysteria brigade' say about disease and the merits of modern medicine.
6 January 2011 11:12PM
In October I had to visit my surgery (in London) several times and on designated afternoons it was absolutely full of people who came because they were entitled to the free jab. In fact the nurse had warned me there would be chaos. The atmosphere was similar to an M&S sale or some sort of a free promotional giveaway. It seemed to me the take-up in this part of London was more than complete. In fact I sat there wondering if paying for the vaccine would really have burdened them financially as many appeared quite well off.
The prescription charges are high, too high in fact, so why are people reluctant to pay for this vaccination when they pay for holiday and travel vaccines?
Whether the GPs may have failed to contact those others who should have had it and did not come forward is another matter. I did not see any children or pregnant women, nor were there many who looked over 65 in that waiting room.
6 January 2011 11:34PM
As a GP surgery in South East London, our targets are to vaccinate 75% of over 65s and 60% of at risk patients. Therefore I ordered enough vaccine to vaccinate these people. It is not rocket science, to work out how many you need to meet your targets and order that number. Surgeries are running out because they didn't order enough.
Our current achievement is 67% and 48% respectively. So we are having problems getting people to have the flu jab, for the first time we are ringing patients to try to get them in and still they refuse. The only ones demanding the vaccination are the mothers of young children not in an at risk group, ie the worried well.
6 January 2011 11:39PM
@hoak
Well done hoak for not running to support the GPs who clearly didn't order enough vaccines.
Your vaccination rates are still impressive despite your concerns...
6 January 2011 11:46PM
Big assumptions made on here about people's personalties from short anonymous internet communications, but all forums are the same I suppose. Maybe I'll just be a*sed to stick to the crossword in the real world away from the ether as I'm too lazy to do anything else (the 'quick' one of course).
I'm very popular with my 'peasants'.
7 January 2011 12:13AM
The people need flue vaccine Milord Cameron.
Then let them have last years old stuff, they're just oiks who wouldn't appreciate the good stuff anyway.
Come back Marie Antoinette - all is forgiven.
7 January 2011 12:22AM
Says it all. God forbid that GPs income should be compromised for the sake of saving people's lives.
7 January 2011 12:49AM
oh my, how many die of smoking induced cancer each year and where's the nationwide campaign to vaccinate all smokers, how may died on average each year of seasonal flu for the past, say, 50 years? or is it just a monster swine-chicken strain that gets everyone moaning? and is there really no link between freak working hours, junk food, overstress, no exposure to nature and weakened immune system? vaccine please !
7 January 2011 12:55AM
Speaking as a high risk person you get a letter each year asking you to arrange an appointment. In fact in my case (dont know if other doctors do this) I was in the surgery for a completely different reason and as the computer flagged me up I got my dose there and then. Puzzled also about comments of pregnant women as they normally are attending surgeries in any case. However if they are like my daughter she politely refused it because of all the scares to do with drugs and pregnancy which are also usually exagerated by the media.
This is story whipped up by the media presumably because last years panic was a distinct damp squib. I think a few facts and some responsible journalism is required rather than the usual hysteria we seem to get on every subject under the sun, be it Snow, Flu, VAT etc.
I suggest instead concentrate on frightening us to death with road death and injury statistics and start a campaign to reduce speed levels to 5 miles an hour that will save tens of thousands of lives and injuries each year.
Get a life!
7 January 2011 1:38AM
The American Center for Disease Control (CDC) says last year's swine flu vaccine is not good enough for this year's strain.
7 January 2011 2:24AM
The media scares from last year's pandemic flu vaccine "conspiracy" have done a lot to damage people's willingness to take the vaccine this year. But year on year hundreds, if not thousands die from influenza. There is some apparent difference this year. Normally, it is the very old and the very young who are most vulnerable to death from influenza, but it seems that this year, as with pH1N1 influenza mortality is spread across the age spectrum. Another reason might be that many people saw last year's pandemic as "mild" and therefore the novel vaccine risk as greater than the influenza risk. That may have carried over into this year affecting uptake rates, especially in high-risk adults (who perceive themselves to be at less risk than is really the case). Influenza is a nasty disease that morphs constantly to evade immune surveillance and can kill. Don't underestimate it.
7 January 2011 7:28AM
I thought once you were vaccinated it lasted for several years?
I also thought that the virus has changed from last year (mutated) and as such last year's vaccine won't protect from one of the more virulent strains causing so much damage this year?
So...getting last year's shot is only any use if you didn't already have it last year, and its still not much use then...
7 January 2011 7:57AM
Botch up already seems to be a recurring theme for the coalition.
7 January 2011 8:47AM
@Goonhilly
"Big Pharma' is an anthropomorphic entity invented by people with the paranoia but not the brains to address the shortcomings of the pharmaceutical industry. Anyone who uses the term should be backed away from quickly but with no sudden movements or eye contact."
I used the term (10.18pm) and therefore am one to be backed away from. But I'll cheerfully use it again. It's a shorthard term for a group of powerful business interests focused on getting their products into our bodies. The WHO and various governments are lobbied by them much as other big businesses routinely do. Some of what goes on between the business interests and the governments has begun to come out in wikileaks revelations (eg how the US government gets heavy with European countries that don't support Montanto) and this may convince the doubters that this open door between government and multi-national corporations is routinely going on.
People with common sense don't really need to have the wikileaks evidence in front of them to "know" that business interests pull the strings in many western capitalist governments today. (So if you want to think all is OK, walk away from these people slowly with no sudden movement or eye contact.) Big Pharma will be doing it as much as they can with every government they have access to. Villifying people who use the term won't change that.
If it was really all for our good, wouldn't it be better to see some action on more dangerous health tendencies - the epidemic of autism, for example, or asthma or how to strengthen a person's immune system without drugs?
7 January 2011 9:15AM
'During a typical year in the United States, 30,000 to 50,000 persons die as a result of influenza viral infection. Frequently cited numbers are 20,000 deaths each year, and 37,000 annual deaths. About 5-10% of hospitalizations for influenza lead to fatal outcome in adults. '
http://www.globalsecurity.org/security/ops/hsc-scen-3_flu-pandemic-deaths.htm
7 January 2011 9:20AM
First they moan about not enough people have had the jab and then they moan that they're running out of vaccines.
S'funny you might think someone was just having a go at the government.
And thanks to Labour for stockpiling huge amounts of expensive and NOW out of date drugs!
7 January 2011 9:31AM
DianeDrinkwater
Thanks to Labour for reacting properly last winter or their wouldn't be any vaccine supplies at all now!
7 January 2011 9:38AM
goonhilly is spot on.
People are just to blaise about health risks.
It won't happen to me.
they think if they get ill the doctors will be able to cure them.
my surgery was well organised about the flu jabs and I had both last November.
I am in a high risk group and I DO NOT need telling every year by the govt. to have my flu jab.
People, take responsibility for your own body and stop making political capital out of other people's misery.
7 January 2011 9:50AM
I am certain that those skeptics who are parroting talking points would be wishing hey had been immunized if their life was in danger!
Can they put a value on life?
7 January 2011 10:09AM
the Pandemrix swine flu vaccine...
Great Marketing eh???
7 January 2011 10:11AM
I wouldn’t have the flu/swine flu jab if you paid me. My doctor rang me up in November to urge me to have a flu jab. He said that the jab means your flu would not last as long and it would be less virulent. Vitamin C does that. But how do flu jabs work? We are told that the flu virus mutates so much, you can’t produce a vaccine that will nab it. As for swine flu, Tamiflu was one of the drugs bought by the government. It was first tried as a treatment for AIDS!!!??? Then the chairman of Gilead - the company with the patent - thought it would be good for bird/swine flu!!!??? The chairman was Donald Rumsfeld. At the same time, we were being told that the really, really potent strain of bird/swine flu had not yet mutated into existence. That is, Tamiflu was being used to deal with a disease that does not exist. This is not how vaccines are supposed to work. So, last year, they said it was an ‘anti-viral’, meaning it does not stop you from getting bird/swine flu, you just have it a bit less, supposedly. But research show it does nothing for the complications of flu that might kill you!!!?? In other words, it’s useless. And lets not go into the possible side effects, which for a tiny minority includes death. Why are our doctors telling we should take this crap?
7 January 2011 10:33AM
Just another thing that displays the ConDems' contempt for ordinary people and fixation with free market ideology.
7 January 2011 10:43AM
If it's possible to use the flu vaccine from 2009 in order to supplement shortages to depleted stocks,that in it's self indicates surely that the vaccine must have a 'shelf life'. Why not then don't we stockpile,to safeguard against the possibility of shortages,especially when peoples LIVES are at risk,instead of the, 'made to order' system,that we seem to have now. Then perhaps it would give time for chemists and pharmacists to develop the vaccine in tablet or liquid form instead, that would be far easier to administer and obtain altogether.
7 January 2011 11:11AM
I'm more alarmed at the total lack of government understanding of how an epidemic/pandemic/call it what you will of influenza works, yet they still insist on issuing guidelines: "Not enough vaccine - use last years." Never mind the vaccine is individually tailored to a new forecast influenza subtype every year. Thus using last years supply merely provides a vaccine to a strain of flu which will most probably not be kicking around this year.
Pure genius.
7 January 2011 11:35AM
Basically the last government overbought flu vaccines that need to be flogged off before they go out of date. How do they do that? Tell people there's a shortage of the new ones, scare people with stories of people dying, and plenty of people will arrive at their GP surgeries demanding their injection!
7 January 2011 11:37AM
@ Manhattancat - "The prescription charges are high, too high in fact, so why are people reluctant to pay for this vaccination when they pay for holiday and travel vaccines?"
I don’t think that’s a great example - we pay huge amounts of national insurance to compensate any pandemic, plus the majority of us pay for prescription drugs when prescribed.
I do sing from your song sheet though, but I’m still stupid enough to think we should be entitled to free education..
Perhaps I need further educating here – are we now dealing with a new strain of swine flu? If so then surely there be will a need for an updated vaccination or.. err.. oinkment?
7 January 2011 11:37AM
We are led to believe that vulnerable people reading newspapers, watching TV, listening to the radio will be heedless of headlined news stories dealing new incidences of flu, swine flu and otherwise.
However, we are also led to believe that the self same people will be stirred to action (i.e. book a jab) only when they see a govt advert which tells them that the flu is a serious and potentially dangerous illness for many, and the vulnerable groups have been identified and warned from the beginning of the swine flu scare last year.
I think this is childish twaddle. Perhaps a left over from the nanny state syndrome so carefully cultivated by the previous administration. But equally likely it is a sign of desperation among those desperate to wishing to paint every situation as a 'faiure' of the coalition. (I understand that ordering dates for vaccines for this year was 1 May. For those who can't remember, this was before the election.)
From a medical point of view, continuous reference to stock piled vaccines as 'old' is insidiously evil. It deliberately plants doubt where there should be no doubt. Yet another example of scaremongering by the press and media.
7 January 2011 11:53AM
There is hype every year about flu - remember the avian flu scare ? ... and last year's scare ? The whole overreaction just profits pharmaceutical companies .
If someone downplays the annual scare ,well , good !
It seems to me that using last year's unused supplies is only common sense - indeed , it should not even make the headlines . Frankly this annual flu pandemic / panic is increasingly looking like over stated tosh , albeit it sells newspapers !