swine flu vaccine- dr. parvej shaikh

8/8/2019 Swine Flu Vaccine- Dr. Parvej Shaikh

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PRESENTATION ON:

Dr. Parvej Sheikh Rafik


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H1N1

PANDEMIC UPDATE

12 July 2010- >214 country

Over 18337 deaths.

India, transmission of pandemic influenza virus remains active

but stable in the southern state of Kerala. The extent of illness

in the community is currently being assessed and monitored

by the Government of India.

Total cases in India : 34115 [deaths 1646]

Rajasthan: 3380 [deaths 198]


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THE VIRUS

WHAT IS IT?

Novel H1N1An Unusually Mongrelised Mix.

Anne Schuchat, head of science and public health at the CDC,said that the US virus is an unusually mongrelised mix ofgenetic equences from NorthAmerican pigs, Eurasian pigs,

birds and humans.

(http://www.newscientist.com/article/dn17025-deadly-new-flu-virus-in-us-and-mexico-may-go-pandemic.html )


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THE VIRUS

WHEN & WHERE DID IT

EMERGE?

MIT Engineering Systems Division White Papersays:

Epidemiologists believe first identified case found in

Mexico in March 17, 2009.Other analyses suggest it may have begun circulating inJan. 2009 and possibly even fall of 2008.(http://esd.mit.edu/WPS/2009/esd-wp-2009-07-072709.pdf)

CDCsays:

Novel H1N1 was first detected in the U.S. insouthernCalifornia inApril, 2009.(http://www.cdc.gov/h1n1flu/qa.htm)


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THE VIRUS

WHAT IS ITS ORIGIN?

Natural mutation?

Govt says it arose naturally from existing viruses in either

pigs or humans.

Manmade?

Russell Blaylock, MD, Neurosurgeon

This virus continues to be an enigma for virologists. In the

April 30, 2009 edition of Nature, a virologist was quotedas saying, Where the hell it got all these genes from we

dont know.(http://www.pandemicfluonline.com/wp-content/uploads/2009/07/BlaylockArticle_IO.pdf)


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THE VIRUS

WHAT IS ITS ORIGIN?

The swine flu virus had three parents from two continents and

appeared suddenly without warning, evading all routine flu

surveillance and quarantine; sequence data suggest it mayhave been created from a faulty vaccine given to pigs in North

America.

Prof.Adrian Gibbs and Dr. Jean Downie

http://www.i-sis.org.uk/swineFluVirusFromPigVaccine.php


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THE VIRUSWHAT IS THE SEVERITY?

OF THE 2009 H1N1 FLU? (1 OF 4)

Very mild

James Chin, professor at the University of California,

Berkeley, and former WHO epidemiologist:

My bet is that the coming [U.S.] season will not be toosevere at or below that of a usual flu season.

(http://www.pandemicfluonline.com/?p=1058#more-1058)

Compared with avian influenza H5N1 and seasonal

influenza epidemics, the 2009 outbreak of H1N1 is

relatively mild in terms of mortality rate.

(http://download.thelancet.com/flatcontentassets/H1N1-

flu/virology/virology-39.pdf)


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"Everything we have seen, both in this country and abroad,shows that the virus has not changed to become more deadly.So although it may affect lots of people, most will not be

severely ill, Dr. Frieden [U.S. CDC Chief] said.(http://www.thelancet.com/H1N1-flu/egmn/0c03b5b8)

[Australian] Health ministerreassuresparents overswineflu"Most people, including children, will experience very mildsymptoms and recover without any medical intervention," shesaid. (7/02/2009)(http://www.abc.net.au/news/stories/2009/07/02/2614972.htm)


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BowdoinCollege (Brunswick, Maine)[Bowdoin spokesman Doug] Boxer-Cook says that, so far,none of the confirmed cases has been particularly severe. "Inour experience, the symptoms have been milder than those ofthe regular seasonal flu, and the students are cycling through itgenerally in three days or so, so we feel really fortunate thatit's been this mild.(9/10/09)

(http://www.mpbn.net/Home/tabid/36/ctl/ViewItem/mid/3478/ItemId/8970/Default.aspx)


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TYPES OF VACCINE

Live attenuated influenza vaccine:[laiv]

given as nasal spray

Injectable killed vaccine

administered as im injection


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WHAT IS THE DIFF. FROM

SEASONAL FLU VACCINE?

Contain one instead of three strain of influenza virus

So called as monovalent laiv


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WHO SHOULD GET

VACCINATED?

Healthypeople aged 2 to 49 years of age


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CONT5.

Followingare nota contraindication for live h1n1 vaccine

Breast feeding mother

Health worker working in nicu

Health care provider working in hematology dept other than

bone marrow transplant unit


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CONT5.

Can laiv vaccine be givento personwho is ill?

Yes. Minor illness is not a contraindication.

But avoid in nasal congestion as it affect uptake of vaccine.

Canpeople receiving laiv pass vaccine virusto others?

Very rarely. Risk [0.6-2.4%] . Does not result in illness, as

virus is attenuated.


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EFFECTIVITY

In one large study among children aged 15-85 months, the

seasonal nasal-spray flu vaccine reduced the chance of

influenza illness by 92% compared with placebo


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Whenshould the 2009 H1N1 nasal-spray flu vaccine be

given?

Flu vaccination should begin as soon as vaccine is

available and continue throughout the influenza season, into

December, January, and beyond may be up to may.

TIMING


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DOSES

How many dosesare necessory of laiv?

Controversial issue

Adult only one dose is needed.

Children less than 9 year of age

o CDC recommends two doses 1st as soon as possible 2nd 28

days afterward.

o WHO says only one dose is enough. Though more studies

needed for confirmation.


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Can laiv be givenwith other vaccine?

yes it can be given with other killed as well as liveexcept the seasonal flu nasal spray as it may not be that

effective.


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Can laiv be givenwith antiviral drug?

If a person is taking an influenza antiviral drug (including

Tamiflu or Relenza, then the nasal spray flu vaccineshould not be given until 48 hoursafter the last dose of the

influenza antiviral medication was given. If a person takes

antiviral drugs within two weeksof getting the nasal spray flu

vaccine, that person should get revaccinated. (The antiviral

drugs will have killed the vaccine viruses that are supposed to

cause the immune response against those viruses.)


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Whatpersonal protection equipmentare needed to

administer laiv?

none.

Does laiv containthiomersal?

no.


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RISK FACTOR

Isthere arisk of catching illness from the vaccine itself?

Inactivated vaccines contain killed viruses or parts of viruses,

which cannot cause disease. Live influenza vaccine containsweakened influenza virus that multiplies poorly but is unable

to cause disease.

Both vaccines can cause some flu-like side effects (e.g.muscle ache, fever) but the symptoms, sometimes associated

with vaccination, are generally less pronounced and of much

shorter duration.


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INJECTABLE

H1N1 VACCINE

PANENZA

VAXIFLU


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It isasplit virus, inactivated, non-adjuvant, monovalent vaccine

againstpandemic influenza.

A/California/7/2009(H1N1)v- like strain (NYMC X-179A)15 micrograms in 0.5 ml (Propagated in eggs)

Other ingredients

Thiomersal (45mcg per 0.5ml), Sodium Chloride, Potassium

Chloride, Disodium Phosphate Dihydrate, Potassium Dihydrogen

Phosphate and water for injection

INJECTABLE FLU VACCINE


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VACCINE

ADMINISTRATION:

For adult up to 60 years of age

Route of administration Intra muscular

Dose 0.5ml


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INSTRUCTION FOR

ADMINISTRATION OF THE VACCINE

After the first opening the vial should be used within 7 days

To facilitate tracking the timely disposal of multidose vials, it is

suggested that the date of opening be clearly written on the vial

Partially used multi dose vial should be kept at the required

temperature between 2*C 8*C.

(Never place the product in Freezer)


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PRECAUTIONS

DO NOT TAKE INJECTABLE FLU VACCINE IF:

A person previously had life threatening reaction to any ingredient of

Allergic to egg protein, chicken protein, ovalbumin, neomycin,octoxinol-9, formaldehyde.

TAKE SPECIALCARE IF:

The person being vaccinated is allergic to the above said ingredients.

The person is having high temperature ( Over 38*c).


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SIDE EFFECTS

Very common ( 1 to 10 users in 100)

Headache, Muscular pain, Pain at the injection site

Common (1 to 10 users in 1000)

Feeling generally unwell, shivering, fever, redness and swelling at the

injection site

These side effectswill usually disappearwithin 1 to 3 daysafter

onset.


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VERY RARE

SIDE EFFECTS

The followingside effects have occurred with routine Influenza

vaccine. These side effects may occurwith I .F .V.

Skin reaction that may spread throughout the body

( urticaria, pruritis, rash)

Convulsions, Neuralgia, Parasthesia, encephalomyelitis, neuritis,

Gullian Barre Syndrome. Anaphylactic shock, Vasculitis and temporary Kidney problems.


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THE VACCINES

Safety Testing - Whatsafety testing?

And WHO likewise says:

Time constraints mean that clinical data at the time whenpandemic vaccines are first administered will inevitably belimited. Further testing of safety and effectiveness will need totake place after administration of the vaccine has begun.

http://www.who.int/csr/disease/swineflu/notes/h1n1_safety_vaccines_20090805/en/index.html


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THE VACCINES

All four H1N1 vaccines that were approved by the FDA earlierthis week contain inserts that state the exact same thing as

Novartis in terms of testing for carcinogenicity, mutagenicityor fertility impairment.

Meaning.NONE of them have been tested for these things.

(And neither have the seasonal flu vaccines that these vaccinesare based on.)


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THE VACCINES

Conclusion

Though oficial hasstrongly recommended vaccine for h1n1

Furtherstudiesare needed forsafety estblishment.


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THE VACCINES

swine flu vaccine- dr. parvej shaikh

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