WHO: First vaccinate doctors

Doctors and nurses should be the first in line to receive a new vaccine against pandemic H1N1 influenza, but difficulties in growing the virus indicate that the first fully licensed vaccine might not be available until the end of the year, a World Health Organization spokesperson said Monday.

The Strategic Advisory Group of Experts, the WHO’s top-level advisory group, met last week and concluded that health care workers should be immunized first “in order to maintain a functional health system as the pandemic evolves,” Dr. Marie-Paule Kieny, director of the WHO’s Initiative for Vaccine Research, said in a news conference from Geneva. “They put themselves at risk and need to remain in good health to care for pandemic influenza patients.”

Kieny noted that “people will also continue to be ill with other diseases which need to be taken care of by health care professionals.”

After that, it will be up to individual countries to decide their own priorities for vaccination, the group said, but those that should be considered include children, pregnant women, the obese and those with chronic health conditions, including respiratory diseases and asthma.

“If the first objective is to stop transmission,” the primary target should be children, who spread infection easily because they meet in groups, she said. If the primary goal is to keep death tolls down, then the latter groups should be first in line.

When the vaccine will be available is not clear, however. Some doses have been made, “but they are by no means ready to be licensed yet,” Kieny said.

They will require considerable testing to determine how large a dose will be required and to look at safety, and clinical trials are not expected to begin until September and October.

Some preliminary studies have suggested that vaccines made from the pandemic virus do not stimulate as strong an immune response as seasonal flu vaccines, Kieny said. That suggests that vaccines will require larger-than-normal doses or two doses of vaccine —- both of which will strain the supply.