Adam Morris: The swine flu fightback

Published on Tuesday 20 October 2009 09:40

IT IS the long awaited first visible response to the swine flu pandemic in this country. Tomorrow the vaccination of around 200,000 people in the Lothians against the infection will begin.

Although not compulsory, those asked to receive it are given considerable warning that should they refuse, their life will be at risk if they catch the H1N1 virus.

GPs are in the midst of contacting those in the first phase of vaccination and until the process is underway, it is difficult to know how many will accept a jab and how smoothly the process will run.

The priority groups are frontline health workers, pregnant women, those with respiratory problems like asthma, and anyone else who would be in the "at risk" category for seasonal flu.

People who share a house with someone with a compromised immune system, for example those receiving cancer treatment, will also be on the first list.

Dr Sheila Burns, an expert in influenza at Edinburgh University who is also one of the key members within NHS Lothian overseeing the preparations for the pandemic, said there was optimism within the health board that take-up of the vaccine offer would be high.

In England, some NHS trusts have expressed concern about staff opting to shun the vaccine, prompting the department of health to ensure all trusts south of the Border did more to safeguard workers.

But the same concerns do not exist in the Lothians.

"We can't force anyone to do anything," said Dr Burns. "But so far the signs are looking good.

"The feedback is telling us staff are anxious to get the vaccination. They are beginning to see the small number of people coming into hospital with swine flu and seeing that it is an issue.

"They do have the best interest of their patients, so I don't see any problem in convincing them."

Early indications also show the uptake of seasonal flu jabs is higher than previous years, suggesting the high profile of swine flu has had a positive knock on affect on its seasonal counterpart.

Dr Burns added: "We have said to the at-risk groups that it is in their best interests to get this vaccination and we are confident we will use all the doses we have been given.

"I suppose the only concerns we have are among pregnant women because we have never immunised them before.

"It will just be a case of talking them through the procedure and convincing them it is best for them and their child."

While the onset of the H1N1 earlier this year took the world by surprise, health officials in the Lothians were well drilled on what to do.

The avian flu scare in the Far East years before kicked off a series of training programmes and initiatives across the UK, and plenty has been going on behind the scenes at NHS Lothian and the Scottish Government in preparation for the vaccination programme.

Enough stock exists to immunise the whole 800,000 population of the Lothians, but getting it through to the public is clearly a trickier task.

It is expected this first wave will be completed by January, at which point the position will be reviewed and a decision taken on whether or not to move on with the vaccination.

Members of the public invited for an inoculation will probably have it at their local doctor, while NHS staff will be given theirs on hospital premises – another large-scale exercise health chiefs have long been preparing for.

Although confident of dealing well with a possible crisis, the worst fears of NHS Lothian in a doomsday scenario were revealed earlier in the year.

Worst-case possibilities included up to 2,000 people a week dying in the Lothians, as well as 50 per cent of the area's workforce absent.

To date the death toll in Scotland has been relatively low. The death of a pregnant teenage girl in the Borders last week took the tally to 15.

But in the past two weeks hundreds of pupils at two local schools –Linlithgow High and Merchiston Castle – have been laid low by the bug, proving that it is still very much doing the rounds.

To help speed up the vaccination process, retired nurses have been contacted to ask them to consider helping out in an emergency, while medical students may be temporarily promoted to administer injections if GPs start to struggle.

Initially, the vaccinations will be given in a single dose, but it is understood the long-term plan is to use two doses.

Unusually for the influenza infection, people over 65 who are otherwise healthy won't be encouraged to take up the vaccine, not at first anyway.

Because their immune systems have had more exposure to different flu strains over the decades, they are better equipped than anyone to withstand it.

Health chiefs have also pointed out that a swine flu vaccination doesn't prevent seasonal flu, and vice versa.