[Australia] Doctors warn: swine flu vaccine poses too many risks:

http://www.abc.net.au/pm/content/2008/s2662248.htm

MARK COLVIN: The country's top infectious diseases body has written to the Government to warn that the swine flu vaccine is being distributed too hastily, with too many risks for the public.

The Australasian Society for Infectious Diseases says the vaccine will come in multi-dose vials.

It says these have been shown to transmit infection, spread HIV and hepatitis and even cause death.

The Federal Health Minister Nicola Roxon says the Government expects to receive two million doses by the end of next week, and a widespread immunisation program could start by mid-September.

But the infectious diseases doctors say the swine flu threat has now passed, and there's no need for urgent mass vaccination.

Dina Rosendorff reports

DINA ROSENDORFF: It's unusual to hear a doctor speak out like this:

TOM GOTTLIEB: To rush to a massive vaccination using multi-dose vials that have been associated with problems in the past, seems too hasty and perhaps not measured enough for our society.

DINA ROSENDORFF: Dr Tom Gottlieb is the President of the Australasian Society for Infectious Diseases, which represents about 400 clinicians nationally.

The doctors are worried about the method that will be used to deliver the swine flu vaccine, when the national immunisation program starts in the next few weeks.

The plan is to use multi-dose vials of the vaccine. That means a health worker will use needles to take more than one dose out of each vial.

TOM GOTTLIEB: There have been episodes of bacterial contamination of vaccines, where there has been perhaps a bacterial organism growing in the vaccine, and when the patient's been injected they may have become infected with a bacteria.

Now that's largely been addressed with preservatives that are used in vaccines, but nonetheless, there are potentials for viruses from one patient to be transmitted if vaccination is not done correctly. And in most circumstances it would be done correctly, but when things are rolled out hastily and multi-dose vials are used that potential exists and there are certainly examples of spread of infection between patients with HIV, hepatitis B, hepatitis C and so on and that's our concern.

DINA ROSENDORFF: The group of infectious diseases doctors is so concerned that they've written to Australia's Chief Medical Officer, Jim Bishop, urging him to reconsider the vaccination strategy.

In the letter, the doctors point out that many international agencies including The World Health Organisation prefer the use of single-dose vials.

But the drug company making the vaccine says it would take too long to make enough single-dose vials.

Dr Rachel David is a spokeswoman for CSL.

RACHEL DAVID: It would delay the role out of the vaccine by a long time. The other reason is that with pre-filled syringes you need to order a lot of syringes to roll out the vaccine for 21 million doses as the Government has ordered. So I think on balance the decision to use multi-dose vials is completely justified.

DINA ROSENDORFF: Is it a cost saving measure?

RACHEL DAVID: Look, although it will work out being cheaper to use multi-dose vials, it's not being done this way to save money. It's been done this way to vaccinate a large number of people quickly, which is our best chance of stopping the flu epidemic.

DINA ROSENDORFF: But Dr Gottlieb says there's no real need to rush.

He says there have been fewer deaths linked to swine flu than initially feared, and the epidemic has now subsided.

TOM GOTTLIEB: Our society, all the members are strong advocates of vaccinations, so in no ways do we want to undermine vaccination as a very effective strategy. But in this particular influenza season, we have to determine which are the risk groups that need vaccination, and the probable urgency is no longer there as it was perhaps a few months ago. And we would caution for a more measured approach and for single dose vaccines to be used preferably to multi-dose vials.

DINA ROSENDORFF: But that argument has done nothing to change the mind of Australia's Chief Medical Officer.

Professor Jim Bishop is yet to sign off on the swine flu vaccine rollout, but he's indicated that when he does, multi-dose vials will be used.

In a statement, he's told PM that health workers will be trained to maximise infection control and minimise wastage.

The Federal Health Minister, Nicola Roxon, says the Government is likely to take delivery of two million doses by the end of next week.

NICOLA ROXON: It's anticipated that by the middle or end of September we would be starting to vaccinate the priority groups and those priority groups are of course the most vulnerable that we would hope to be able to reach as quickly as possible. And we are certainly doing everything we can to make sure that the vaccine is available and that implementation plans are ready to go as soon as we do get that tick off.

DINA ROSENDORFF: The first jabs will go to pregnant women, health workers and people with underlying medical conditions.

MARK COLVIN: Dina Rosendorff.