# Swine flu- general roll out and eligibility questions



## roze (Mar 20, 2004)

Yes, another question on the S word, so apologies, but this is more about the roll out and who to ask/consult/complain to. 

I had similar concerns to others re the vaccines. I went to my GP today who said apart from the DOH leaflet which you have pasted a link to earlier, she knew little more than that. She also said that the date of arrival of the vaccine stated by the reception staff as w/c 16th Nov was uncertain. Also, despite my being in late 40's , 34 weeks pregnant with twins, diagnosed with diabetes, and have asthma which is very reactive to flu and colds ( I was almost hospitalised a decade or so ago as developed severe asthma after the flu) , they were only getting 500 vaccines and I did not even qualify for this as they were prioritising the immune suppressed and people with various diseases.  So even if it does arrive when they say it could be a good few weeks further on before I am offered it. I am increasingly concerned now as regardless of my concerns, if I contract sf I may not be able to have my c section in early December- so where does that leave me with two currently twin breech babies- severely at risk I would think.  I know you can't answer that one but it is causing me considerable concern.

Do you know perhaps the answers to the following;
1) Can a Thimerosol free version be found in the UK even privately? I would be prepared to pay for it. My GP said they would administer it at the surgery but I would question whether at the end of the day they would administer a product not licensed in the UK.
2) Who is in charge with the number of vaccines made available to each surgery- the Government, local PCT, or the surgerys budget holders?

Many thanks


roze


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## mazv (Jul 31, 2006)

Hi Roze,

Hmmm GP doesn't do a lot of reading then or open their DoH circulars   I've spent the last 6 months immersed in information/circulars/NHS advice on swine flu, I'd love to escape it if I could and would love to know how they've managed to  If anything there is too much information out there and it's that that is causing the confusion! Slightly confused as to why your surgery are requesting pregnant women to wait though as my understanding was that they are in the first cohort to be vaccinated  The list on the DoH circular of those in the first wave gave 5 categories of patients but I didn't think that this was ranked in any priority order and that all were to be offered the vaccine? It may be that your individual surgery has made a decision on which patients to offer it to first though?

I'll try to answer what I know but bear in mind this is from the NHS Scotland perspective and I don't know if it's the same for England/Wales/NI.

1) No swine flu vaccine is available privately (at least not through legitiamte channels) Pharmaceutical wholesalers are not being supplied with the product so independant contractors i.e. high street pharmacy or GP surgery cannot buy it directly. In theory any GP could write you a private prescription for it but you wouldn't be able to buy it anywhere. The Celvepan brand is licensed in the UK but even if you did manage to procure it from somewhere I very much doubt you would be able to find a healthcare practitioner to administer it.

2) In Scotland it is the Scottish Governemnt who have purchased the vaccine for the entire population (I think this is the same for the rest of the UK but not denfintely sure) They placed orders with both companies for 5+ million doses. Both compaines claimed they could deliver in time for an autumn vacciantion programme. To date neither have delivered in the quantities or to the timescale specified in the order. Celvepan isn't yet available in Scotland and it is only Pandemrix that is. The doses received have been allocated to each Health Board on a per capita baisis. To give an idea of how short the orders were, in my area we were expecting 45,000 dose to start vaccinating on 21st October; we got 7,500 We get new supplies every week but only know 2 days before hand how much we will get (as you can imagine the logistics are a total nightmare; I have colleagues putting in 14 hour days to try and ensure suppies are available in the places required for 9am clinics) In terms of what your individual GP surgery gets at any one time then it is the responsibilty of the PCT but they are restricted to what they get from the government stock and that in turn is dependant on what the pharmaceutical company can supply that week, and this is all done on a maximum of 3 days notice.

In relation to your own situation I would perhaps speak to your consultant obstetrician for advice on risks/benefits and see if that can help clarify the best course of action for you.

Hope this helps explain the current situation in repsect to UK supply. The NHS is trying it's best, honest!
Maz x


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## roze (Mar 20, 2004)

Thanks, Maz, would have replied earlier but have been in hospital for a few days.  No, my GP surgery doesn't instill a lot of confidence and when you ring up the practice manager to discuss your concerns they just say ' whats pandremix?.  I think they have a generally older population hence their policy but my obstetrician has written saying I must have both swine flu and seasonal flu jabs so all booked for next week. I am very scared of catching it as I know I will take it very badly and will have three young children to look after so it could otherwise be a disastrous Xmas. I would prefer Celvepan as I think I would sleep more easily  but is there anything if you don't mind I have a few more questions for you;

1) In respect of the Thimerosol in Pandremix, how much does this compare with recommended limits of tuna given that the vaccine is administered intravenously and the mercury in tuna will be metabolised by the liver before getting into the bloodstream. If people could put it into perspective then it might be more palatable (!) for them to get it.  Do you perhaps have any figures on this?

Many thanks once again for your help in this matter,

roze xx


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## mazv (Jul 31, 2006)

Hi Roze,

Sorry to hear you've been in hospital  Hope all ok  Glad to hear you have support from obstetrician that you should be offered the vaccine in the first phase of the programme and that things are sorted with the surgery.

I've replied elsewhere in relation to levels compared to amounts in fish http://www.fertilityfriends.co.uk/forum/index.php?topic=215988.0 Direct comparison can't really be made though as the mercury content is in different forms that behave differently in the body. Thiomersal is metabolised to ethylmercury which has substantially different pharmacokinetics to methylmercury (the organic form that accumulates in fish). Ethylmercury is more rapidly excreted and does not accumulate in the body in the same way that methylmercury does (takes a year to excrete this form and hence the reason why certain fish intake should be limited to stop potential build up of levels in the body and any resultant neurotoxicity)

Mercury is ingested into the body in organic forms via the diet and the amount introduced from a one off injection containing thiomersal is pretty much insignificant compared to the cumulative amounts injested from food sources (and breastmilk in the case of infants) over a lifetime.

Maz x


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## mazv (Jul 31, 2006)

Hi Roze,

Found the info relating to roll out of the vaccination programme in England. Thought it might be of use..... http://www.dh.gov.uk/prod_consum_dh/groups/dh_digitalassets/@dh/@en/documents/digitalasset/dh_106299.pdf

Maz x

/links


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