Editorial: Flu vaccine debacle puts many at risk

Opinion

Mass immunisation against influenza is a relatively recent addition to the public health service. Not so many years ago the flu viruses that laid people low, particularly in cold weather, were just an accepted hazard of living and working together. Not now. Ever since effective inoculations have been available from doctors and workplaces, many people have become accustomed to living year-round with barely a cold, let alone the headaches, congestion and nausea that used to be at least an annual occurrence when there was "a flu going around".

Medical advances are quickly taken for granted and flu vaccinations are no exception. The news that the vaccine supplied for this winter might not guard against all likely strains of influenza will have disturbed many of the 700,000 New Zealanders who usually line up for an autumn jab. They will not be much relieved by the small quantities of comprehensive vaccine that have been hastily arranged. Those will give only 150,000 doses and priority will be accorded the elderly with chronic heart and respiratory illness.

The other 550,000 seeking immunisation will have to make do with the regular vaccine which the French manufacturer, Sinofi Pasteur, has discovered to be deficient. Although it will protect against two of the three strains of influenza likely to be in circulation in New Zealand this winter, it contains too little of the A/Wellington virus which first appeared last year. New strains of influenza appear in the world every year and epidemiologists believe fully 43 per cent of recent flu cases in this country were the result of the Wellington virus or variants of it. Plainly a vaccine which lacks sufficient of that virus is going to be of limited benefit to those who might still bother with an injection.

For them the Ministry of Health is considering giving a double dose of the deficient vaccine, either at the same time or staggered. "We need more information about these options, their safety and effectiveness," the ministry concedes. Officials are talking to Sinofi Pasteur and hope to make a further announcement within a week. Time is getting short. The vaccine is usually administered from late March, as soon as it becomes available.

In the meantime it is obviously vital that those precious 150,000 doses obtained from different international suppliers go to the people most at risk. Influenza might be a minor illness for most people but for some in a weakened state it can be fatal. The Wellington virus has been linked to several deaths.

Furthermore, immunisation is more effective when it is regularly administered. A six-year Dutch study has found that for patients above the age of 65 a single flu vaccination reduced the risk of death by about 10 per cent, which is not considered significant. But those who were vaccinated again the following year had a 24 per cent lower risk of death, which is significant. The study showed repeated vaccinations had the greatest efficacy and - chillingly for the elderly in the present predicament - among those who skipped a vaccination the risk of death rose 25 per cent.

Could the authorities have acted sooner to obtain supplies of an effective vaccine? Health Minister Annette King says she was told in February that there was a delay in the vaccine's arrival but that she was told only last week that there was a problem with it. Did officials know the reason for the delay? Did they try to find out? Had they done so, they might have begun the search for an alternative supply a few weeks earlier and might have come up with something better than the 150,000 doses they have come up with this week.

It is not as though shortages of flu vaccine are unknown. In the United States President Bush was assailed in the final days of last year's election campaign for a flu vaccine shortage that had just come to light. Medicine might find it harder than we suppose to keep up with new strains of flu but we can expect public officials to keep close watch on their supply. They have left us badly exposed this winter.