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October 8th, 2009
Early Vaccinations for H1N1 Swine Flu mean Less Death, Less Spending

It is not a surprise that a new U.S. study is saying that in order to minimize deaths from H1N1 Swine flu pandemic vaccination should start as quickly as possible.
“Earlier — October versus November — vaccination saves more lives and costs less,” says Dr. Nayer Khazeni, the study’s lead researcher, from the division of pulmonary and critical care medicine at Stanford University Medical Center.

She adds, “We find that vaccinating 40 percent of the population in October would decrease viral transmission and shorten the pandemic.”

The U.S. Centers for Disease Control and Prevention has announced that the delivery of H1N1 injections has started on a small scale.
Most cases of the H1N1 Swine flu are mild, yet there have been close to 1,000 flu-related deaths from August to September, and the major flu season is just beginning now.

The study was conducted by Khazeni’s team and included constructing a computer model of a hypothetical city similar to New York. The city was given 8.3 million residents and infected with the H1N1 swine flu. They found that giving vaccinations to 40 percent of the population in October or 35 percent in November helped save lives, cut medical costs, and decrease the time of the pandemic, compared with later vaccination.

This vaccination model would save 2,051 lives and $469 million. The vaccinations in November prevented 1,468 people from dying and save $302 million.
In both those scenarios, vaccination would still save more lives than cause side-effect related deaths,” Khazeni said.

U.S. health officials are saying that 45 million doses of injectable vaccine will be ready by late October. Supplies will then increase at a weekly rate, with 190 million doses by the end of the year. Researchers say that there is no way to tell if people will get their shots in time to support the research model’s benefits.

One limitation of the research model is that many variables from reality cannot be captured, leading to uncertainty in the prediction. Dr. Thomas A. Farley, New York City health commissioner and co-author of an accompanying journal editorial, said that “The greatest specific benefit of the Khazeni models is to demonstrate that, under some assumptions, early vaccination can greatly blunt an epidemic of influenza even if the vaccine efficacy is relatively low.”

Though the vaccination looks effective, it may not be as effective as others. “One specific implication of this model is that, if we achieve high vaccination rates, this vaccine should have a very good population-wide benefit nonetheless,” Farley said.

Initial shipments of the H1N1 vaccine will be small, leading experts to expect that most states will reserve the early vaccinations for children and health-care workers. It is predicted that it will not be until mid-October before the vaccinations are available for everyone.

Using the same modeling techniques, Khazeni and coworkers studied the outcome of the dangerous H5N1, or avian flu, virus. Their conclusion was that the government needs to stockpile vaccines and antiviral prescription drugs, such as Tamiflu, to prepare for potential outbreaks.

“The H1N1 pandemic has been mild in many respects, but H5N1 and other viruses with pandemic potential exist, and we need to be prepared for a severe pandemic,” Khazeni said.

To find more about the study visit http://www.annals.org/cgi/content/full/0000605-200912150-00161v1

For more information about the H1N1 swine flu visit http://www.flu.gov

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