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Pandemic Flu

The clinical priority groups have been identified and prioritised based on those who are at greatest risk of complications if they become infected with swine flu. In order of priority, they are:
1. Adults and children between 6 months and 65 years of age who have a long-term health condition, including:
• Chronic lung disease • Chronic heart disease • Chronic kidney disease
• Chronic liver disease • Diabetes mellitus • Chronic neurological diseases
• Immunosuppression caused by a disease or treatment for a disease. For example, this may include people who do not have a spleen, and people who are on immunosuppressant treatment or are taking high doses of systemic steroids.

2. Pregnant women at any stage of pregnancy
Being pregnant can put you more at risk of being seriously ill if you catch swine flu. So far, evidence suggests that pregnant women are four times more likely to develop serious complications from swine flu and up to five times more likely to need to go to hospital. The risks of flu are highest in the later stages of pregnancy.

3. People who live in the same house as someone whose immune system is compromised by disease or treatment.
If you live with someone who is having treatment for cancer, for example, and you catch swine flu, they might catch it from you and become very ill. If you have a severely compromised immune system, ask the people you live with to think about getting vaccinated to help protect you against catching swine flu. If you are unsure about whether you should be vaccinated, speak to your GP or practice nurse.

4. People aged 65 and over and in the clinical at risk groups only (see 1. above) – i.e. not all over 65s
Clearly the speed with which we can vaccinate patients will be controlled by the vaccine delivery schedule.
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Vaccine Schedule
Following advice from the Joint Committee on Vaccination and Immunisation (JCVI), the following vaccination schedule is recommended in the UK:
Pandemrix
For all children aged from 6 months of age to less than 10 years of age:
• One half doses (0.25ml) of Pandemrix should be given
For individuals aged from 10 years to less than 60 years of age:
• One dose (0.5ml) of Pandemrix.
For individuals aged 60 years and over:
• One dose (0.5ml) of Pandemrix (this advice will be reviewed when more data become available).
For immunocompromised individuals aged 10 years and over:
• Two doses (0.5ml each) of Pandemrix should be given with a minimum of three weeks between doses.

Pandemrix can be co-administered with all other vaccines, including seasonal influenza and childhood vaccines.
Vaccines in pregnancy
JCVI have recommended that pregnant women should be given Pandemrix since a single dose of this vaccine gives adequate levels of antibodies. Expert scientific advice is clear that thiomersal-containing vaccines do not present a risk to pregnant women or their offspring.
Who can’t have the swine flu vaccine?
There are very few people who cannot have the swine flu vaccines. The vaccines should not be given to anyone who has had a severe allergic reaction to a previous dose of the vaccine or any component of the vaccine. If you are worried that this may apply to you, talk to your GP or practice nurse.
What about people with egg allergies?
The Pandemrix vaccine is prepared in hens’ eggs in the same way that seasonal flu vaccines are. It should not be given to people who have had a confirmed anaphylactic reaction (experiencing shock or difficulty breathing) after being exposed to egg products. Pandemrix should, however, be given to individuals, including children, with less severe allergic reactions to egg.
The Celvapan vaccine is not prepared using eggs, so you should have this vaccine if you have a severe allergy to eggs. We hope to be able to access this when required.
Why are healthy people over 65 and children not a priority for the swine flu vaccine?
Healthy people aged over 65 appear to have some natural immunity to the swine flu virus. And while children are disproportionately affected by swine flu, the vast majority make a full recovery - therefore the experts do not advise that children (other than those in at-risk groups) should be vaccinated initially.
What about everyone else?

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