Production and availability of pandemic influenza A (H1N1) vaccines
Up-to-date as of 12 July 2009 (Originally posted on 2 May 2009 and revised on 27 May 2009)
Is a vaccine against pandemic influenza A (H1N1) virus available to immunize people?
No, but work is well under way to develop such a vaccine. Making new influenza vaccines ready to immunize people generally takes five to six months after first identification of the pandemic virus. The pandemic influenza A (H1N1) 2009 virus was identified at the end of April 2009.
How quickly will pandemic influenza A (H1N1) vaccines be available for use?
The very first doses of influenza A (H1N1) vaccine usable to immunize people, from one or more manufacturers, are expected as early as September 2009.
What implications does the declaration of a pandemic (phase 6) have on influenza vaccine production?
When the WHO Director-General declared the influenza A (H1N1) pandemic on 11 June 2009, she noted that production of seasonal influenza vaccines would be completed soon and that full industrial production capacity would then be available to ensure the largest possible supply of pandemic vaccine in the months to come.
Which manufacturers will make pandemic influenza A (H1N1) vaccines?
There are currently around twenty vaccine manufacturers with licenses to produce seasonal influenza vaccines. There are other qualified vaccine manufacturers who are preparing to make influenza A (H1N1) vaccine, but do not yet have a licensed seasonal influenza vaccine.
What is the global manufacturing capacity for a potential influenza A (H1N1) pandemic vaccine?
Based on a global survey made by WHO on 15 May 2009, a maximum of 4.9 billion doses potentially could be produced in 12 months, but only if several assumptions are met. First, full global manufacturing capacity is devoted to this production. Second, production yields for influenza A (H1N1) vaccine are similar to those usually obtained for seasonal vaccines. Third, each manufacturer uses the vaccine formulation that is most "dose-sparing" (i.e. using a smaller quantity of active principle). A more conservative estimate of global capacity is at least 1 to 2 billion doses per year. The numbers of persons who might be vaccinated will not be known until it is determined whether one or two doses of the vaccine will be needed to achieve protection.
What technologies will be used to grow pandemic influenza A (H1N1) viruses to make vaccines?
Most of these vaccines will be produced using chicken eggs, while a few manufacturers are using cell culture technology for vaccine production.
How is the production capacity for influenza vaccines distributed geographically?
Around 70% of the global seasonal influenza vaccine production capacity today is located in Europe and North America, with further significant manufacturing capacity in Australia, Japan and China. During the past three years, six manufacturers in developing countries have begun to acquire the technology to produce influenza vaccines and have received technical and financial support from WHO. Since May 2009, five additional new producers have joined this initiative.
Will there be enough pandemic influenza A (H1N1) vaccine for everyone?
When pandemic vaccine first becomes available, it is anticipated that the demand will be greater than the supply. This gap will narrow as more vaccine becomes available over time.
Who will receive priority for vaccination?
WHO is working with the Strategic Advisory Group of Experts (SAGE) on Immunization and partners on the options for deciding in which target groups vaccination should begin first. At its July 7 meeting, SAGE recommended that health care workers worldwide should be immunized as a first priority (see: Pandemic (H1N1) 2009 briefing note 2 below). Ultimately, national authorities will identify priority groups for vaccination based on circumstances within the country.
Will developing countries have access to pandemic influenza vaccines?
The WHO Director-General has called for international solidarity to provide fair and equitable access for all countries to pandemic vaccine when it becomes available. WHO has requested that manufacturers set aside future influenza A (H1N1) vaccines for developing country populations, through donations or affordable pricing arrangements.
All the below are very much relevant to H1N1 disease. They would only take very little time to read.
* Keeping awake late-nights is not very good. Likewise, over-working (far too much of working until your body is totally exhausted) is not good. Starving without eating food is not good for this disease. Strenuous exercises are not good, as it would make the body acidic.
* Avoid consuming ACID foods, fruits and drinks. Examples of this: buah kundang, rambai, macang, mango, duku langsat, rambutan (a few ok), mangosteen (very few, ok), durian (not too much), green belimbing used for cooking (sweet buah belimbing, ok), strongly sourish Durian Belanda (sour sop) (sweet sour-sop, ok), sour plums, Roselle drink, Assam Jawa drink (using Assam Jawa for cooking, ok), (oranges, pomelo and lemons are ok, since they contain plenty of potassium), sour pineapple (a little of sweet pineapple, ok), China-imported tit-bits that taste sour: e.g., sourkana, sour orange skin, sour lemon skin, sour ginger, sour-tasting Bayam (pulicha keerai, in Tamil), etc., Generally rice and rice-based foods are good. All those bottled drinks that may contain citric acid (or any other acid or preservatives) should be avoided. Foods cooked 2 or 3 days ago (i.e., old food), if not sterilised properly) should not be eaten as well. This is especially true if the curry contains dhor dhall, kacang hijau (green gram), kacang tanah (groundnut), etc. Must avoid eating chocolates, ALL forms of nuts including groundnuts, pistachio, almond, etc. should not be eaten in large quantities / frequently (A few added to foods can be eaten).
* Better to eat: dragon fruit, sweet apples, honey melon, water melon, pears, bananas, cucumber, onions, pumpkin, grey 'pumpkin' (Poosanikkai, in Tamil), loofa (Peerkangai in Tamil), Drinking coconut water (and its meat) on alternate days (during day time and not by night) is good. Coconut water can be taken daily if one is travelling around, or is enggaged in strenuous physical work.
*The fruits of Sea Coconut (Borassus flaberllifers) is EXCELLENT if a person has already contracted the disease. It will give immediate cure. Now, it is available in supermarkets in canned forms: they call it Sea Coconut, imported from Thailand or Singapore : white syrup or gula Melaka preparation: both are OK. (Uninfected people can also eat this for prevention: dosage: just 2 or 3 pieces only in the mornings on alternate days, until the hot season changes.
* If infected, one should bathe 3 or 4 times a day in cool tap water. (Hot water is bad).
* Once infected, the person should eat RICE and rice-based foods, and should avoid high protein diet, chicken, soybean (all kinds), oily foods, Wheat items are not good. Powdered milk, papaya and other acid fruits mentioned above should be avoided altogether.
All the above should NOT be continued forever. Do all the above only for a month or so, until the HOT season changes. After that, should eat ALL things in moderation.
Health D-G says doctors must assume all flu cases to be H1N1
By Adib Zalkapli
PUTRAJAYA, Aug 14 — With the number of reported H1N1 cases continuing to increase every day, the government is concerned that the public, including health practitioners, are not taking the disease seriously.
“Today if I’m running a clinic, if anybody comes with a flu, I will assume it’s H1N1,” said Health director-general Tan Sri Dr Ismail Merican in an interview with The Malaysian Insider.
“Some doctors wait for results to start treatment, we said no need. Let us assume anybody who gets admitted with severe pneumonia in this country, assume it’s H1N1 and start antiviral treatment from Day One,” he added.
“We have seen from those cases, a lot of them were diagnosed late, they saw doctors, and there was a low index of suspicion, you must have a high index of suspicion,” said Dr Ismail on the reported deaths so far.
Malaysia first reported an H1N1 infection in May and the first death was recorded only late last month.
More than 50 people have died since and more than 2,000 people have been infected with the virus.
The government has also responded to the increase in the H1N1 infection, by doubling the antiviral drug Tamiflu stockpile from 10 per cent of the population to 20 per cent.
It is also prepared to increase the number of ICU beds nationwide.
But Dr Ismail said that Tamiflu should not be freely used as the virus may develop resistance to the drug.
“The worse case scenario is giving Tamiflu to someone who wants to go to Australia, to America just for prophylaxis, to prevent them from getting the disease; it is not on with Tamiflu,” he said.
He said the public should play their role in preventing the spread of the virus.
“My fear is the public is still taking things very lightly. If you go to supermarket or anywhere, you still see people going around coughing, sneezing and they don’t wash their hands,” said Dr Ismail.
“So we are telling the public, if you are sick, stay at home, if you have to go out, wear a mask,” he added.
But Dr Ismail said despite the seriousness of the disease, the recovery rate is around 98 per cent.
“What we are concern about are those in the high-risk category, people with lung disease, obese, pregnant women,” he said, adding that 70 per cent of the people who have died are from the high-risk groups.
１．我们的政府应对危机机制是有问题的。领导人到今天都没有从行动上显出有真正行动的紧急性。我国的悲剧是很多当家的领导人没有治理部门领域的专门知识，没有知识就不会有感觉，很多领导人还没有进入状况。“They just dont't get it”，人们是要用生命来帮这些部长们付学费！即使如此，与政府算帐也没有什么帮助，一个希望弥补的政府必须用果断的坚决的行动证明自己没有疏忽。今天马来西亚的死亡数据显示我们的防卫措施是有不足的地方。防疫的工作是要高度的果断，严格地纪律和严密的执行手法，政府必须能让人民放心； 有关单位必须呈现其指挥作用；卫生部长必须让大家感觉到他是在掌控局势；他知道应该做什么才有效。