Vaccine information on Swine Flu

Dear friends,

I am in UK & EU since diwali & interacting with lot of official on vaccine issue & observing how they are implementing & giving swine flu vaccine programme

To start with every health care worker has to take swine flu. For which they have been given brief of vaccine, side effect, company information. History is taken on illness, allergies, sensitivities chemotherapy, steroids, neurological problem, diabetes, medication. Every person (doctor/nurses/supportive & technical staff) has to sign written consent.

I have visited Brussels, Geneva, Austria & Slovenia for this purpose also

 Two vaccine are introduced in UK GSK – (pandemrix) & BAXTER (celvapan)

 Here is recommendation of JVCI (joint commission on vaccination & immunization) uk

·         Both vaccine are available in multi dose only & are in activated contain same strain-wild type a/ California/07/2009-h1 n1 strain.

·         Baxter is non Thiomersal non egg protein whole cell, whole viron

·         GSK -needs reconstitution with adjuvant & contains Thiomersal& egg-  is split cell or spilt viron hence cannot be given to sensitive & allergic pt

·         Swine flu vaccine can be given simultaneously with seasonal flu.

·         Same needle used to withdraw & give vaccine(which is not regular guideline in  uk)

Dosages-

  Gsk:-  2 doses less than 10 yr—given at least 21 days apart ,can be given 1 month later

            1 dose more than 10 yr

            2 dose > 10 yrs if immunocompromised – 21-30 days apart

Baxter :–  2 doses in all ages

2^nd dose of same brand no mixing of brands

Swine flu vaccine is recommended to pregnant women

• vaccine can be given in patient group direction(pgd) / camp approach(India) under direct supervision & consent
• age-6month-65 yrs & >65 at risk
•  preg women in appropriate trimester subject to licencing
• Can be co-administer with any  child hood vaccine including seasonal flu
• legally-cleared by EMEA- European medicine agencies & are prescription only medicines given by trained & certified persons
• Side effects to be noted- immediately & lately
•  Chance of Guillian barre- 17 times higher with influenza like illness
• With vaccine 20 case/ million-stowe-2009-( am j epidemiology)
• Contraindication- confirmed anaphylaxis reaction  egg, component
• Egg allergies only Baxter- celvapan given
• Storage-- stored at 2-8 but after taking out less than 25 centigrade consumed with in 24 (gsk) or 03 hr (Baxter) after reconstitution. If not stored 2-8 than taken as expired
• Yellow card & pharmacovigellence to be kept strictly as influenza vaccine also follow  BLACK TRIANGLE DRUG CHART                                  
• Site- IM deltoid/ ant lateral-0.5ml 2 dose 3-4 wk apart- use 1.5 inch needle
• Can be used in lactating women & pregnancy as per adv of licensing in each country choice of authority to give Thiomersal vaccine or non Thiomersal but no contra indication in Europe  both are licensed  in pregnancy any stage. Gsk is preferred as only one dose is required in adult as compared to Baxters but some are debating role of adjuvants in pregnancy.

Dr. Ajay Gambhir

Administrator

www.vaccineindia.org