Flu vaccines and swine tig

Vaccination plans for the UK are slowly beginning to emerge. On Thursday Sir Liam Donaldson confirmed that 60 million vaccines are scheduled to be produced by the end of the year with the first batches ready for administration within the next month. The two different vaccines (one made by Baxter, the other by GSK) each come in two doses to be given three weeks apart.

But who will they be given to and in what order?

A Department of Health letter on this subject was sent to immunisation leads last week.

The decision on prioritisation will be taken on the basis of epidemiological evidence, vaccine supply, and capacity of the NHS to implement the programme. This decision will be subject to further work over the summer period. Until further decisions on prioritisation are made, plans should be made to deliver vaccine to the following groups:

o Individuals aged between six months and 65 years in the current seasonal flu clinical risk groups.
o Pregnant women in their second and third trimester
o Health and social care workers directly involved in patient care.
o Other health and social care workers
o Children aged from 3 years to 16 years of age.
o People aged 65 years and over
o Poultry workers
o All others not in the above groups

The letter doesn’t say whether this is the exact order of prioritisation. Sir Liam said on Thursday that giving the vaccine out by geographical location was unlikely.

In the US, the Centers for Disease Control and Prevention (CDC) appears to have similar priorities.

…we want states and communities and health care providers to be thinking about how they would be able to vaccinate younger people, pregnant women, people who have underlying health conditions like diabetes and asthma.

However, if up to a quarter of those dying from H1N1 are previously healthy individuals, many of whom are under 65, is there an argument for giving under 65s a higher priority?

Avoiding swine flu is easy sneezy

Have you been catching it, binning it, killing it? Dirty Bertie has. “It’s easy sneezy” he says in a cartoon published by the DoH. His message seems to be getting through to some people according to a new study in the BMJ. The telephone study asked 996 people chosen at random questions about their behaviour over the last four days. 28.1% had washed their hands with soap and water more often than usual – as recommended by the government. 37.8% said they had performed at least one of the three recommended behaviours (the other two are increased cleaning or disinfecting of surfaces and discussing with a friend or family member what to do if either person caught swine flu). Those least likely to change their behaviour were people who were uncertain about the outbreak and those that thought the outbreak had been exaggerated. The survey was done in early May –  I wonder how many of those who had increased their hygiene levels have managed to maintain them?

Fancy a game of swine tig?

One age group that seems to have embraced the public health message is infants. I was told last week of a new playground game that’s sweeping the nation: swine tig. The rules are simple. One child pretends to have swine flu and has to infect others by catching them. Once you’re infected you have to chase other players until everyone has it. I think a nice add-on to the game might be to have a doctor player too. Perhaps their role would be to chase after infected players to give them Tamiflu – this would give an instant cure, of course.

As Dirty Bertie says, that’s snot funny.

Tom Nolan is the clinical community editor of doc2doc, the BMJ’s professional networking community.