The swine flu vaccination programme is to be extended to almost one in three of the UK population, the Government's Chief Medical Officer, Sir Liam Donaldson, announced yesterday.
It will include all children aged over six months and under five years and carers who provide assistance to the elderly and sick.
They will be offered the jab after the current priority groups – people with chronic conditions, pregnant women and frontline health and social workers – and will take the total number vaccinated to 19.2 million. The announcement came as NHS authorities in Berkshire revealed that a five-year-old girl from Slough, Nida Qureshi, had died from swine flu. Admitted to St Mary's Hospital, London, she died on 11 November.
Despite signs that the pandemic may be slowing – latest figures show a decrease in cases – Sir Liam said its severity in very young children appeared to be increasing, with 176 in hospital, a rate three times that in adults and 19 in critical care.
"Hospitalisations of under-fives have jumped right up in the last week. There has been a very striking increase. The numbers in critical care have also shown a jump up," he said.
Deaths also increased sharply last week to 214 in the UK, from 182 the previous week. More than half were in people aged under 44. Sir Liam said it was unclear why the virus appeared to be causing more serious illness now than it had in the summer, even though it remained mild in most people.
There had been no change in the virus and it could be that it simply had a worse impact in winter. "It might be just the way it happens to behave."
There were an estimated 53,000 cases of swine flu last week, down from 64,000 the previous week, just above the baseline for seasonal flu. The number of cases has plateaued or drifted downwards for the past three weeks.
Sir Liam said it was too early to say if the pandemic had peaked. "We are not interested in the trends, we are interested in dealing with those individuals who need intensive care," he said.
He dismissed a suggestion that the cost of the pandemic flu programme might be considered excessive when set against other demands, such as for cancer drugs. "We have patients dying and parents standing by intensive care beds in life and death situations. When we have got the weapons to do something we should use them. We are out to save lives and fight this pandemic all the way."
The flattening off of the pandemic, in terms of the number of cases, could be because there was a "fair amount of herd immunity in the younger population" who were "badly hit" by the virus in July, he said. Improved access to anti-viral drugs and the roll out of the vaccination programme made any repeat of deaths and illness on the scale of previous pandemics unlikely.
"Never before have we been able to vaccinate while a pandemic has been running," he said.
"Protecting those most at risk for the disease will reduce the levels of serious illness and deaths. That's why we will shortly offer the vaccine to young children. Vaccination remains a personal choice but I urge everyone who is offered the vaccine to accept it and protect themselves. While the risks of serious complications from flu may be small, the impact on those affected can be devastating."
Parents will receive letters from their GP inviting them to bring their children into the surgery, with vaccinations expected to start some time in December. They are expected to be vaccinated with one children's dose, which is half the usual adult dose. The vaccine does not produce enough of an immune response in children under six months old to provide protection.