# 4303
While the H5N1 bird flu virus has thus far not managed to adapt to humans well enough to spread among them easily, there are scientists and governments around the world who believe that may still happen.
With a CFR (Case Fatality Ratio) that has run 50% or greater in some countries, an outbreak would be far worse than anything the H1N1 virus has produced.
Although the probability of this happening is unknown, having a vaccine on hand would greatly reduce the impact of an outbreak.
Singapore, with a population of roughly 5 million and neighbor to bird flu endemic Indonesia, is looking to stockpile roughly 1 million doses of H5N1 vaccine.
This is a bit of a gamble, of course, since vaccines have a limited shelf life; generally 18 months to 2 years.
This from the Singapore Times.
Jan 29, 2010
1m doses of bird flu vaccine
By Jessica Jaganathan
THE Health Ministry will be buying about one million doses of H5N1 avian flu pre-pandemic vaccine soon.
Health Minister Khaw Boon Wan revealed yesterday that his ministry is evaluating a tender to stock up on the vaccine.
'It's one of those insurance policies that we have to buy and we will stock it up and hope never to have to use it,' he said.
'The virus is still out there and it may flare up, so we cannot afford not to do anything.'
The World Health Organisation's director-general, Dr Margaret Chan, had recently said that countries remain ill-prepared for mass outbreaks of the bird flu virus, which affects humans in contact with sick birds.
It has a mortality rate of more than 60 per cent, leading to fears that a pandemic with this strain of virus could prove lethal. Scientists also fear that it could achieve efficient human-to-human transmission at any time and trigger a pandemic.
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5 comments:
Dear Minister Khaw,
Thank you for MOH's kind reply.
In MOH's reply below, MOH made the statement that 'the pre-pandemic vaccine to be stockpiled has demonstrated good cross-protection capability, even if the mutated form is genetically different from the pre-pandemic strain.'. Could you kindly clarify on how has the pre-pandemic vaccine been demonstrated to have good cross-protection against a pandemic virus that has not appeared yet?
Is the cross-reactivity MOH mentioned equivalent to cross-protection when challenge studies are not done since this is not possible as the pandemic virus has not appeared yet?
If MOH does stockpile the pre-pandemic vaccine, will MOH perform challenge studies when the pandemic virus does appear before offering the pre-pandemic vaccines to the public so as to be sure that the pre-pandemic vaccines are effective and safe?
Would it not be worse off to offer pre-pandemic vaccines if they have no protection against the yet-to-appear pandemic virus than to wait for a vaccine to be developed against the pandemic virus when it appears?. Is it not true that modern vaccine production methods using genetic engineering has shortened the vaccine making process considerably?
Will it not be more likely that a person vaccinated with an ineffective vaccine may be less concerned with preventive measures against infection than one who is not vaccinated at all?
Minister Khaw, I do hope that you can answer my questions. Thank you.
Regards
Kim Seng
From: MOH QSM
To: tkimseng71@yahoo.com
Cc: MOH QSM
Sent: Tue, February 2, 2010 3:05:54 AM
Subject: Re: Fw: Stockpiling bird flu vaccines
Dear Mr Tan,
We refer to your feedback below to the ministry recently.
We wish to share that while it is possible that the bird flu virus may mutate into a form that increases its transmissibility in humans, and thereby has the potential to cause a pandemic, with devastating consequences, the pre-pandemic vaccine to be stockpiled has demonstrated good cross-protection capability, even if the mutated form is genetically different from the pre-pandemic strain. Hence, it will still be able to protect against drifted (i.e small, gradual changes to the virus which occurs through genetic mutation) strains.
In addition, it takes a few months to develop a vaccine against a particular strain of an influenza virus, and even longer before the vaccine is made commercially available. This was demonstrated during the H1N1 flu pandemic when it took about six months after the pandemic began before the vaccine arrived in Singapore. Furthermore, even with the availability of the vaccine commercially, there would be no guarantee of adequate vaccine stocks to meet the local needs as there would be significant international demand for the vaccine then. We were fortunate that the H1N1-2009 strain generally caused mild disease. The next pandemic may be much more severe. If we were to wait for a pandemic to occur before procuring a vaccine, it might be too late. The costly damage would have been done.
We hope to have addressed your queries.
Thank you and we wish you good health.
Yours sincerely,
John Heng
for Quality Service Manager
Ministry of Health, Singapore
Tan KimSeng
29 Jan, 2010 09:53 PM
To
Hariharan SUBRAMONY/MOH/SINGOV@SINGOV,
Has the Singapore MoH alraedy acquired the above referenced vaccine for stockpile? If yes, who is the manufacturer? If still in the bidding process, who are the bidders?
Jay,
According to a follow up article in Asia One last March and some additional details on another site.
The contract is with GSK, and the vaccine will be delivered by `the end of the year'.
It sounds as if this is a done deal.
I found more details here:
http://wanderingchina.wordpress.com/2010/03/18/spore-buys-1m-bird-flu-vaccine-doses-asiaone/
Hope this helps
Dear Michael - Thank you for this information. I am currently doing market research for a client on human Avian flu vaccine stockpile efforts by Ministries of Health worldwide. Any guidance will be much appreciated.
Best, Jay
Jay,
If you want to email me using the link in my sidebar, I might be able to give you a few more leads.
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