From Flu Wiki 2

Forum: Seasonal Flu Vaccine Question

31 May 2006

anonymous – at 15:17

OK, so I’m a bit ignorant about how strains for each seasons flu vaccine are chosen. For the upcoming 2006/7 fall winter season in the Northern hemisphere, have strains already been chosen and is vacine in production? Are any of the H5N1 strains being considered for inclusion and would they provide any protection whatsoever in the event of mutations/recombinations that result in efficient H2H?

crfullmoon – at 19:21

I’d guess no; H5N1 kills most chicken eggs pretty quickly and takes way more than normal ammounts to make a vaccine, too. There are also not enough places making vaccine; they just can’t make enough for most of the population.

The H5N1 strains already being made into vaccines are probably only getting enough for anyone involved in the vaccine research and manufacturing process, some military, essential federal workers, ect, and probably not really enough for all those who need the protection; health care workers, first responders, ect.

http://www.fda.gov/Cber/summaries/vacc012406jp.pdf

http://www.scoop.co.nz/stories/SC0605/S00079.htm

Nieman Watchdog “If there’s a pandemic, will there be enough vaccine? ASK THIS | April 30, 2006 Some questions about avian flu are answered and others raised in an authoritative report by a dozen medical experts. We examined one issue – vaccines – and found the U.S. and the rest of the world won’t be anywhere near ready in an emergency”…

…”The news comes from the Influenza Report 2006, a study that combines layman-friendly content with technical medical information.

Though the population of the world exceeds 6 billion, only 900 million single-dose flu vaccinations can be produced in a given year.

This number assumes that all available manufacturers will produce vaccines at full capacity. To arrest the progress of an outbreak, however, most experts believe that double, or “bivalent” doses would be necessary.

“In an ideal world,” the authors state, “12 billion doses of monovalent vaccine would be available in order to administer two doses of vaccine to every living human being.” According to the United Nations population clock, the world population has actually pushed past 6.5 billion, which would translate to an additional billion vaccinations”…

…”The discrepancies between populations and doses and between the first and third worlds arise from the immense cost of producing flu vaccines: They are cultivated in evacuated chicken eggs, an intensive process that forces health officials to guess in February which flu strains will be most deadly come September.”…

…”For any public policy approach to succeed, political commitment is fundamental. Commitment includes not only anteing up money and allocating resources, but honesty and cooperation among various nations and levels of government. The report states:

One of the most significant factors is political and social willingness to acknowledge and report disease dissemination. Without this key factor, no further national action to prevent pandemics can take place.

High-level political support and commitment are necessary to develop a preparedness plan. Increased regional collaboration and networking may not only lead to the mutual support of people involved in the planning, but can also be used as an instrument for increasing international pressure and thus political commitment.”…

[[ http://www.cidrap.umn.edu/cidrap/content/influenza/panflu/news/may0406vaccines.html | CIDRAP ]] …”It takes about 6 months to grow seasonal flu vaccines in eggs, and the eggs must be ordered well in advance. Growing vaccines in laboratory cell cultures promises to be a somewhat faster and much more flexible approach. The method is already used for a number of other vaccines, such as polio, hepatitis A, and chickenpox.

“Our current capacity of egg-based influenza vaccine production is not sufficient to meet increased demands during an emergency,” said Leavitt.

“Accelerating the development of this vaccine technology and creating domestic capacity are critical to our preparedness efforts.” …

01 June 2006

Leo7 – at 01:02

I don’t have a crystal ball but I’m predicting a shortfall in seasonal flu vacc’s this fall. No matter what some people hear or read they will believe it will prevent AF, and demand the shots. CDC recently changed the guidelines to include infants and if the reporting in MSM picks up people will clamor for it. If you take the seasonal vaccine it won’t protect you from H5N1 but it will keep you from having to recover from both which IMO is beneficial. After seasonal and childhood vaccines quotas are met etc, they will turn to AF vaccine production if they can synthesize one. I think TPTB are pretty successful with choosing seasonal strains overall, I think they have already chosen, but I don’t know which strains were selected. It should be on the CDC site.

Ralph – at 10:18

The strains selected for seasonal flu can be found here:

http://tinyurl.com/qxnxt

Leo7 – at 11:30

Thanks Ralph. On another thread Tom DVM expressed little confidence in seasonal flu vaccines. It was also suggested that so many elderly get it, that the numbers of effectiveness is off. With the addition of children I believe this will improve. I wonder how many at the Wicki got last years? I didn’t and got what was traveling around but tested my self care abilities and the usual medicines.

Janet – at 16:41

I got my flu vaccine last year (always do) and had my kids and husband get one also (not usual for them). I did so in that, if TSHTF at the same time that a regular flu is circulating, can you imagine catching both???

I know that the regular seasonal flu vaccine only provides 60 - 90% coverage but, I for one, will take those odds. Can’t imagine living through the bird flu only to catch the seasonal flu and die from it in that you were in a weakened state.

Guess I am willing to “shore up” wherever I can without too much additional risk.

CashBat 14:54

Well, for me, I used to get the flu every year and sometimes twice a year until I started getting the flu shot some years ago. I swear by them and will continue to get them every year they are available.

03 July 2006

anonymous – at 16:28

I read somewhere that they were expecting almost a surplus of seasonal flu vaccine this year. That was why more groups were being encouraged to get the vaccine— so some vaccine manufacturers don’t have the unused vaccine problem. I disagree with Leo7 who thinks that idiot general public will think that the regular flu vaccine will prevent avian flu and so there will be a shortage for that reason. It is possible that there could be a run on the vaccine, but I doubt it will be out of irrational fear. People might be more inclined to get the regular flu vaccine in response to the threat of avian flu but not because they think it will protect them from the bird flu. Janet stated one reason that concern about the avain flu might spur people to get the regular flu shot — because she’d hate to get both at once. Another reason might be that once H5N1 arrives in the US people would want to be vaccinated against the regular flu so IF they come down with flu symptoms, they will have erased SOME of the uncertainty about which flu variety they are dealing with. I’d be getting my flu vaccine anyway, but the two reasons I pointed out in reference to the avian flu make me inclined to get the vaccine as early in the season as possible instead of waiting until later.

glennk – at 18:11

I’m not wasting my Tamiflu on reg. flu! When I manage to find some that is.

lauraB – at 19:21

I think that if AI shows up in either domesticated poultry or wild birds in N America close to when the vaccine is available there will be a HUGE run on seasonal flu vaccine. Sure, some people don’t understand AF vs H2H. Others totally understand. Others realize that just the healthier you are if there is a pandemic the better.

Also, if one of the manufacturing sites gets shut down, etc. there will be another shortage like a few years back. Even last year I couldn’t get it and it was a “mild” season.

I wonder if the strain that is hammering S.Africa right now is included in this year’s version.

NJ. Preppie – at 19:50

Yes, we could have supply problems. I have found it hard the last couple of years to get flu shots, becuase they wanted the vaccines to go to elderly and high risk people. FDA Warning Flu Vaccine

WASHINGTON - The Food and Drug Administration issued a warning letter to drug maker Sanofi Pasteur over concerns about problems at a Pennsylvania manufacturing plant, the agency said Monday.

Sanofi Pasteur had reported that some batches of its influenza vaccine failed sterility tests in April, prompting an FDA inspection of the plant in Swiftwater, Pa.

Sanofi Pasteur issued a statement saying it is working closely with FDA and many of the agency’s concerns “have either been resolved or the FDA has accepted our proposed remediation plans.”

The company added: “With regard to the upcoming influenza season, we are confident that we will meet our manufacturing goal of approximately 50 million doses of influenza vaccine for the U.S. market.”

13 October 2006

anonymous – at 10:08

<u style=“display: none;”>… no changes … no changes … no changes … no changes … no changes … no changes … no changes … no changes … no changes … no changes … no changes … </u>

23 October 2006

Dennis in Colorado – at 10:48

Increased influenza vaccine production needed, says WHO

“… in order to develop a Global Vaccine Action Plan for Pandemic Influenza Vaccines, WHO organized a consultation in Geneva on 2–3 May 2006 and invited key stakeholders – from national immunization programmes, national regulatory authorities, vaccine manufacturers and the research community – to participate. The objective of the consultation was to identify and prioritize practical solutions for reducing the anticipated gaps in vaccine supply. The participants drew up an Action Plan with strategies for the short, mid and long term, aiming to increase influenza vaccine production and surge capacity before and during an influenza pandemic. They identified three main approaches: a) an increase in seasonal vaccine use; b) an increase in production capacity; and c) further research and development. The implementation of this plan will require the concerted efforts of countries, industry and the global health community.”

“The first approach relies on countries establishing clear immunization policies to increase the use of seasonal influenza vaccine. This will provide the vaccine industry with a solid demand forecast and stimulate it to increase production capacity.”


Notice that the WHO’s reason for wanting countries to increase use seasonal vaccine has nothing to do with the medical value of vaccinating against seasonal influenza. It is just to stimulate private companies to increase their production capacity, so they can be used to produce an H5N1 vaccine after the virus mutates to its pandemic form.
The WHO acknowledges later in the report that, “A vaccine cannot be developed with certainty until after the pandemic virus emerges.”

Leo7 – at 14:07

Dennis C:

I posted articles months ago on the news thread that said exactly this. And then what happens when flu season gets close? Webster with the AARP interview. You could hear the hoofs beating a path to the nearest flu clinic. This is all about making vaccines profitable for pharma—its working too—Pfizer just jumped in last month. They should focus attention on proving the medical value in the face of recent questions of how long they’re effective. But, why bother when everyone is demanding your product, never mind your plants have been cited over five times for contamination.

Dennis in Colorado – at 15:06

Actually, I don’t see it so much in the light of the short-term profits for the pharmaceutical companies — though that is a side effect of the WHO’s actions. What concerns me is the manipulating of various countries’ citizens in order to achieve the WHO’s goals. If the WHO wants nations to donate money to build vaccine manufacturing plants, that is one thing. But to ask nations to tell their citizens to be vaccinated, with the ulterior motive of that request being to increase demand for vaccines so that private businesses will increase their production capacity for the future … I find that reprehensible on the part of the WHO.

kc_quiet – at 16:20

This year , as usual, I was given my flu shot at work. What was unusual was that people who didn’t take the shot had to fill out a short questionaire about why they didn’t want it.

Madamspinner – at 20:41

kc_quiet – at 16:20

Us early birds were lucky ! On the KC news tonight, they said flu clinics have been suspended due to delayed vaccines…..now do we really believe that ???? NOT ME !

   Maybe they are switching game plans and starting productions of BF vaccine ???  Hmmm….I smell a rat. 

Considering that eggs are needed to produce vaccines,…what if ALL the USA chickens were to be culled = NO eggs for the vaccine producers …??????? Another Catch-22..

24 October 2006

kc_quiet – at 01:24

I just hope this wasn’t some that had frozen accidentally- I heard they recalled some vaccine because it was found to have been frozen. BTW I think its just the Health Dept clinics that are suspended. I hope!

Pseudorandom – at 09:46

kc_quiet - at 16:20

It’s not just your company. I just got an email from my university stating that everyone who doesn’t want the flu shot is now required to fill out a vaccine declination form, with a list of options as to why the shot was declined. They’ve never required this in the past.

crfullmoon – at 10:46

Perhaps so they can say you turned down offered vaccine, when they didn’t mention we are in a pre-pandemic alert period?

Then, if you don’t want to come in to work, because you haven’t even had the seasonal flu shot, or, if you get sick on the job they say, “you shouldn’t have refused the flu vaccine”? Will it affect businesses health insurance premiums or something?

(Never thought I’d be a curmudgeon already.)

Pseudorandom – at 10:54

crfullmoon - at 10:46

The timing of the new requirement (with respect to our pre-pandemic alert status) is certainly suspicious. I’ve asked them by email about their contingency plans and couldn’t get a response. And this is a medical university! You would think they’d have the decency to respond to legitimate requests for information about medically-related topics.

I’m currently taking the slightly-less-cynical route (rare for me) and hoping that they just want a record of who has/hasn’t had a seasonal flu shot to aid them in differential diagnosis when people come crawling into the clinic with the crud. Issues of vaccine efficacy aside, of course, because they would never admit to us that the shot isn’t perfect. ;)

Kim – at 11:00

Here’s one reason why employers (especially health care providers) might be requiring those who refuse a flu vaccine to state why they refuse…

(snip) Obtain a signed declination from HCP who refuse influenza vaccination for reasons other than medical contraindications (category II; suggested for implementation and supported by suggestive clinical or epidemiologic studies or a theoretic rationale).

http://www.medscape.com/viewarticle/523611

Kim – at 11:10

Yes, refusing a flu vaccine may put you on the list to attend “re-education camp”… ;-)

Pseudorandom – at 11:36

Kim -

Thanks for that reference! I particularly appreciated the following: “HCP who refuse influenza vaccination should document their reasons for denying the vaccine, as these providers may be candidates for targeted education regarding the benefits and safety of vaccination.”

Re-education camp, indeed. Fortunately, I’m not a health care provider. I will just end up attaching the declination form to a short stack of printed peer-reviewed references supporting my reasons for refusal.

Leo7 – at 14:11

I wonder if anyone wrote on the forms, “Lincoln freed the slaves.”

When smokers, Diabetics, and the obese sign off on why they smoke, don’t manage their blood sugar well enough, and why they take in too many calories to burn off, I’ll sign off on why I didn’t take the shot. I made a paper basketball and shot for two points. It’s not their business. It would be easy to lie and say when I took my mom for her shot, I got one too. I don’t give a damn about their sick call statistics. Can’t wait to see what happens next? Put me off on administrative leave?

banshee – at 14:26

Regarding the questionnaire as to why an individual is refusing a flu shot, it is possible that someone is conducting a public health study as to why people refuse to be vaccinated. Could be that they are trying to figure out ways to increase participation in vaccination programs. Do the questionnaires ask for identifying information like your name, employee number etc? If it doesn’t, I’d say you are just part of a study - although you should always tell study participants that they are study participants and people should always have the right to refuse participation!

Bluebonnet – at 14:52

It’s a new Joint Commission requirement for hospitals. See below from 6/13/2006.

Joint Commission Establishes Infection Control Standard to Address Influenza Vaccines for Staff

Media contact: Charlene D. Hill Media Relations Manager 630.792.5175 E-mail: chill@jcaho.org

(OAKBROOK TERRACE, Ill. – June 13, 2006) The Joint Commission on Accreditation of Healthcare Organizations today announced the approval of an infection control standard that requires accredited organizations to offer influenza vaccinations to staff, which includes volunteers, and licensed independent practitioners with close patient contact. The standard will become an accreditation requirement beginning January 1, 2007, for the Critical Access Hospital, Hospital and Long Term Care accreditation programs.

“Preventing the spread of the flu protects patients and saves lives. Encouraging health care workers to be vaccinated can play a vital role in stopping the transmission of this potentially fatal infection,” says Robert Wise, M.D., Vice President Division of Standards and Survey Methods, Joint Commission.

The Joint Commission developed the standard in response to recommendations by the Centers for Disease Control and Prevention (CDC) making the reduction of influenza transmission from health care professionals to patients a top priority in the United States. While the CDC has urged annual influenza vaccination for health care workers since 1981, the CDC’s “Morbidity and Mortality Weekly Report” published earlier this year calls for stronger steps to increase influenza vaccination of health care workers. Despite the recommendations, the vaccination rates as measured by the CDC remain low.

Studies show that influenza causes 36,000 deaths and over 200,000 hospitalizations on average in the United States annually. Furthermore, health care-associated transmission of influenza has been documented among many patient populations in a variety of clinical settings, and infections have been linked epidemiologically to unvaccinated health care workers. Typically, fewer than 40 percent of health care workers are immunized each year.

The new Joint Commission standard requires organizations to:

Establish an annual influenza vaccination program that includes at least staff and licensed independent practitioners; Provide access to influenza vaccinations on-site; Educate staff and licensed independent practitioners about flu vaccination; non-vaccine control measures (such as the use of appropriate precautions); and diagnosis, transmission and potential impact of influenza; Annually evaluate vaccination rates and reasons for non-participation in the organization’s immunization program; and Implement enhancements to the program to increase participation.

Leo7 – at 15:44

Bluebonnett:

Hospitals are open systems. Everyone from visitors, ministers, Fed Ex, UPS, water delivery people, floral shop workers, restaurant food delivery people, volunteers both retired and students, food vendors, buisness people, pharmaceutical salespeople, even JCAHO, visiting guest lecturers etc the list is endless who openly walk into hospitals, visit patient areas, eat in hospital cafeterials and don’t have to prove they’ve had a flu shot. And, yet they can say HCW’s are spreading influenza? We are one window of many many windows who might infect patients. I’ve said to several visitors who looked sick as stink to me that it probably wouldn’t be a good idea for them to visit in a critical care unit and they get mad because they are here to visit. I’m complaining but I’m getting out of the hospital when I finish my degree. All of those people manning the boxes in the stores giving flu injections are people who have left hospitals for various reasons. By the time PF gets here, who will be left? Paper pushers?

Pseudorandom – at 15:47

Bluebonnet - at 14:52 Heaven forbid that we disobey JCAHO. Thanks, that’s almost certainly why it was recently implemented. When asked, they say that it is to make sure that we are aware we should not be attending classes or clinicals if we are ill and have not had a flu shot. Duh. (sarcasm alert) Well, what about all of those people with non-influenza infections that have been vaccinated? Is it ok for them to go and cough and snot all over the hospital, just because it might not be influenza?

banshee - at 14:26 They do collect employee name and SS#, but they say that the information just goes into our file and won’t leave the clinic. I’m pretty sure our institutional review board would require them to notify us if it were a public health study, but I’ve been wrong before. Although if it is a new JCAHO regulation, it would certainly make a public health study along the lines of the one you suggested pretty simple!

Bluebonnet – at 16:20

Leo & Pseudo - agree with both of you. My fellow healtcare workers come to work desperately sick. We have just had a round of intestinal virus and colds due to folks who think they are soooooo important that they can’t miss a day or two. WTF??

Stay HOME if you are sick and leave the rest of us alone. Your germies are EVERYWHERE and we don’t want them.

Leo7 – at 16:41

Every Hospital pays JCAHO to make a visit. That’s right, hospitals pay JCAHO to give them a rating. Do you really think they will bite the hands that feed them? Hospitals know months ahead of time the exact day of a visit and there is a massive coverup of problem areas. HCW’s know this. At the last visit they spent less than 15 minutes in my critical care area-they walked through it. JCAHO recommendations carry no weight for me, I think of them as a coverup and farce, whose sole purpose has been to overwhelm us with useless layers of paperwork.

Leo7 – at 16:43

Bluebonnet: Didn’t know you were part of the pack. Didn’t mean to address you personally, just your topic. Sorry.

Kim – at 17:34

I’m not in the health care field, but I noticed something in Bluebonnet’s post at 14:52… look at the media contact’s name and info for this press release, then look at her email address. Okay, everyone, the JCAHO wants you to CHILL… too funny!

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