Wales Announces H1N1 Influenza Program
The independent experts who review the evidence on all vaccines, the Joint Committee on Vaccination & Immunisation (JCVI), have made recommendations on who the priority groups for H1N1 swine flu vaccination should be and Wales will be following this advice.
Preparations are being made to develop a comprehensive implementation plan for the vaccination programme including extending it beyond the initial priority groups in the future. Further details will be reported in due course.
Vaccine supplies and licensing
The Department of Health, on behalf of all UK countries, has placed orders for Influenza A H1N1 (swine flu) vaccines with GlaxoSmithKline (GSK) and Baxter but the vast majority of the initial deliveries are expected to be from GSK. Supplies to the NHS in each country will begin this autumn and we expect that there will be enough to vaccinate all those in the priority groups by the end the end of this year.
Both manufacturers are seeking approval for their vaccines from the European Medicines Agency (EMEA). Subject to satisfactory review of the data, the manufacturers anticipate that licenses may be granted in late September or October.
The vaccination programme will only commence once the vaccines have been licensed and stock distributed to all four countries.
Based on these assumptions, the earliest a vaccination programme could begin is mid-October. As is usual practice with the introduction of a new vaccine there will be post-marketing surveillance undertaken and this will include rare events such as Guillain Barre Syndrome (GBS).
Following advice from JCVI, the following groups should be prioritised for vaccination once the vaccines have been licensed:
1. individuals aged 6 months and up to 65 years in the current seasonal flu vaccine clinical at-risk groups
2. all pregnant women, subject to licensing conditions on trimesters
3. household contacts of immuno compromised individuals
4. people aged 65 years and over in the current seasonal flu vaccine clinical at-risk groups.
These groups were selected to protect those at highest risk of severe illness. JCVI will continue to review the situation and consider other issues such as the link to seasonal flu vaccination advice for all over 65 year olds to be eligible based on age criteria.
In practice, it is likely that as vaccines become available, the groups may be vaccinated concurrently rather than in order of priority.
Frontline health and social care workers
In addition to these groups, frontline health and social care workers will be offered vaccination at the same time as the clinical risk groups as they are at increased risk of infection and of transmitting the infection to vulnerable patients. Frontline healthcare workers eligible for vaccination are those also eligible for seasonal flu vaccination as detailed in the Immunisation against infectious disease (Green Book). Eligibility guidance for vaccination for frontline health and social care workers is at Annexes A and B.
Subsequent use of the vaccine in the wider healthy population will depend on information about the evolving nature of the pandemic as well as new and emerging clinical data on the use of the vaccine. These will be kept under close review.
We are working with the Health Boards to develop the practical arrangements for Wales. We will write to you to keep you up to date with new information as it becomes available and to confirm when the programme is to start.
I recognise that this vaccination programme will be challenging for the service. Thank you for your hard work and for your efforts in helping us manage the pandemic to date and plan for a successful national vaccination programme over the coming winter period.