Swine flu: is it too late to vaccinate?

Warning that jab may no longer prevent infection

It could be too late for those still unprotected against swine flu to gain maximum benefit from the vaccination, experts admitted yesterday, as deaths and serious illness caused by the disease continued to soar. Latest figures show that the number of cases with flu in intensive care has risen to 738, a 60 per cent rise in a week.

The total is now four times higher than the peak during last year’s pandemic, and international evidence suggests that 10 to 15 per cent of those in intensive care may die, implying around 100 further deaths.

The Health Protection Agency reported 39 deaths up to 30 December and the Department of Health will today launch an advertising campaign to attempt to curb the spread of the disease.

However, experts said yesterday they expected the flu outbreak to peak within the next two weeks and that getting vaccinated now could be too late. The jab takes seven days to produce partial immunity and two to three weeks to provide maximum protection.

Latest available figures show that less than half (43 per cent) of under-65s in at-risk groups have been vaccinated and just over two-thirds (68.5 per cent) of those over 65.

The lowest levels are among pregnant women – 25 per cent with risk factors had received the jab and rates among healthy pregnant women are thought to be lower still. The vaccination is recommended for all older people over 65, for all pregnant women and for adults and children under 65 in at-risk groups, such as those with asthma or neurological problems.

Douglas Fleming of the Royal College of GPs' Research and Surveillance Unit in Birmingham, which monitors the prevalence of flu in 68 GP practices around the country, said: "Evidence shows that most flu outbreaks reach their peak within four to five weeks from onset. I reckon this one has been going for three weeks."

Asked if it was too late to vaccinate, he said: "It is too late for the majority to benefit. Whether it is too late for anyone is hard to say. The elderly have not been hard-hit so far. The evidence is they are getting it now – they may have a bit more scope."

The Joint Committee on Vaccination and Immunisation (JCVI) reiterated the advice it gave on Thursday, urging all individuals in at-risk groups to be vaccinated "as soon as possible, particularly those aged under 65."

The advice was repeated by Andrew Lansley, the Health Secretary, who said: "The first line of defence against flu is to be vaccinated – I urge everyone in an at-risk group who hasn't been vaccinated to contact their GP."

Asked if vaccination was still worthwhile at this stage of the outbreak, Professor Andrew Hall, chairman of the JCVI, said: "It may peak this week or next but there will continue to be new cases for four or five weeks. If these are in risk groups – such as those with serious asthma and neurological problems – then they are still at risk of hospitalisation or death. Getting vaccinated now would provide them with some protection."

Health professionals appeared confused about vaccination with reports that pregnant women had been turned away from GP surgeries, or by midwives, after being wrongly advised that they were not in an at-risk group. Contributors to the Mumsnet website reported surgeries running out of vaccine, causing further delays.

One Mumsnet correspondent reported her GP surgery as saying there would be no vaccine available for three weeks. "The only way to get it, apparently, is to make an appointment with my GP (earliest available: one week) get a prescription, go to the pharmacy, collect vaccine, get another appointment with the GP and get him to administer it."

The Department of Health campaign to be launched today will feature national press and radio adverts urging people to "catch it, bin it, kill it". But it will not mention vaccination.

A Health Department spokesperson said: "We are not doing a vaccination campaign. We never thought that was the right way forward."

The catch it, bin it, kill it campaign first aired last year in response to the swine flu pandemic but has been hastily resurrected, prompting opposition jibes of a U-turn. The usual annual flu vaccination advertising campaign was abandoned in the autumn, a victim of government cuts.

Richard Vautrey, deputy chairman of the British Medical Association's GPs committee said practices had to order their vaccine in the autumn before the flu season began and some could run out early while others found themselves with an excess depending on the local uptake.

"There will be variation and we do find a need for practices to share supplies. In some situations, you may hear of patients going to their GP and finding they don't have any vaccine immediately ready."

Dr Vautrey said there had been some confusion about who was eligible for vaccination because of changes to those officially designated at risk. "Healthy" pregnant women, without risk factors, had only been included this year. "That is one challenge. It has taken some time for everyone to be clear who was or wasn't in the various risk groups," he said.

Official figures show 39 people had died from flu up to 30 December, 36 of them from swine flu. All but one were under 65 and at least 15 were "healthy" with no risk factors. Of the total, 11 were children under 15, including four under five.