Finland: THL Announces the Start Of H5 Vaccination For High Risk Groups

 

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Finland has been hit unusually hard by HPAI H5N1, with more than 70 fur farms infected, and > 500,000 animals culled since last summer. Reporting on this crisis dropped off abruptly last December, and follow-up reports have been rare. 

The economic toll of this outbreak has been enormous, with compensation to affected farmers often delayed. Two months ago, we saw a disturbing announcement that Finland's Food Agency To Curb Services & Lay Off Animal Disease Investigators, where they reported:

. . .  The Food Agency has to lay off personnel and . . .  leave unfilled vacancies.

The cost-saving measures also affect the Food Agency's service ability in laboratories investigating animal diseases. We try to serve our customers as well as possible, but there may be a delay in the completion of studies during the rest of the year.

This could explain why we've heard so little about HPAI H5N1 out of Finland since late last year.  It may boil down to a lack of resources.  But few details are being shared. 

Shortly after this statement, Finland's MOH announced their acquisition of a limited quantity of an older HPAI H5 vaccine for high risk individuals, including farm workers and veterinarians.  

Today, Finland's Institute for Health and Welfare (THL) announced that vaccinations could finally begin - but that the vaccine they received will expire at the end of September - and recipients will need to get their first shot in August and their second shot before the end of next month. 

The (translated) announcement follows.  I'll have a bit more after the break. 

Avian flu vaccinations underway - to get full vaccination protection, those at risk of infection should receive the first vaccine in August

Release date 6.8.2024

According to the recommendation of the Institute of Health and Welfare (THL), bird flu vaccination is offered to those over 18 years of age who, due to their work or other circumstances, have an increased risk of contracting bird flu. The vaccination series includes two doses. The batch of vaccine received in Finland expires at the end of September, so those at risk of infection should take the first vaccine dose during August.

Bird flu vaccinations aim to protect those at risk of contracting bird flu from serious disease caused by the virus.

Taking the vaccine is voluntary. THL has drawn up a recommendation in cooperation with the Food Agency, according to which bird flu vaccination is recommended:

• for those in contact with fur animals in fur farms
• for those working with poultry who are in contact with poultry, excluding slaughterhouse workers
• for those involved in the handling and disposal of sick or dead birds or other animals or in the cleaning of facilities, such as those working in animal by-product processing facilities
• for bird ringers
• for those working in aviaries caring for wild birds
• for workers in animal farms and aviaries
• for official veterinarians
• for laboratory workers handling avian influenza virus or samples that may contain it
• for close contacts of a suspected or confirmed bird flu case, should human cases occur.

For the vaccination of these groups, Finland has received 20,000 doses of H5N8 bird flu vaccine through EU joint procurement. The amount is enough to vaccinate 10,000 people with two doses.

The batch of vaccine received in Finland must be used by the end of September, so those at risk of bird flu infection should take the first vaccine during August. The second vaccine dose is given at least three weeks after the first vaccination. Those who were vaccinated in August or earlier must take the second vaccine dose by the end of September.

Welfare areas responsible for organizing vaccinations. You can inquire at health stations about where you can get the vaccination.

The bird flu vaccine is expected to provide both immediate protection against infection and long-term protection against severe forms of the disease. When the vaccines are administered before the autumn flu season, a situation is prevented where the bird flu virus would infect a person at the same time as the seasonal flu virus, which could enable the emergence of a new type of virus.

"Since vaccines also offer long-term protection, it is important that those at risk of infection take the vaccine now. Although there is no certainty about the effectiveness of the vaccine against the viruses that occur during the spring migration of next year's birds, the vaccine is still an important means of protection against a serious disease," says THL's leading expert Mia Kontio .

So far, there are no human bird flu infections in Finland

Although the bird flu epidemic continues around the world, bird flu has occurred in wild birds in Finland this year significantly less than last year. There have been no cases of bird flu in fur farms in Finland this year.

The bird flu virus is weakly contagious to humans, and cases of infection are very rare. So far, no human infection with bird flu has been detected in Finland.

You can get infected from sick or dead animals or their secretions. Around the world, bird flu has been linked to serious and even fatal disease cases in humans.

The Food Agency monitors the occurrence of bird flu in wild birds in Finland and prevents the spread of the disease on animal farms. Fimea and THL are responsible for safety monitoring of vaccines.

Additional information

Avian flu vaccinations begin - the vaccine is offered to those at increased risk of infection

The concern, as we've discussed previously, is the potential for a farm worker to be infected with both H5N1 and seasonal flu simultaneously, providing the H5 virus with an opportunity to reassort with a more humanized virus. 

Vaccinating high-risk individuals against H5N1 sounds good in theory, but these vaccines were formulated against an older H5 strain, and no one really knows how effective they will be in preventing infection against the current H5N1 virus (or the one that emerges tomorrow).   

Normally, influenza vaccines do best reducing the severity of infection, rather than preventing it.  And previous studies on H5N1 vaccines have suggested they may be less immunogenic than seasonal flu vaccines. 

There is an argument to be made that having these 20,000 doses of about-to-expire H5N1 vaccines in the arms of farm workers is preferable to pouring it down the drain, a strategy we've seen employed previously in Japan and Taiwan (see Japan Begins Pre-Pandemic Inoculation Of Health Care Workers and Taiwan Offers Public Bird Flu Vaccinations.) 

Here in the United States, the calculation has been made to promote the seasonal flu vaccine among farm workers (see CDC: $5 Million Initiative to Improve Uptake of Seasonal Flu Shots For Livestock Workers), rather than roll out an experimental (and potentially divisive) H5N1 shot. 

Last May the CDC contracted with CSL Seqirus to prepare 4.8 million doses of two different H5N1 vaccines, but so far they see little value in releasing it. 

That could change over time, of course.  But it is likely we'd need to create, manufacture, and deploy a an updated strain-specific vaccine - a process that could take months, possibly years - to effectively deal with a severe H5 pandemic.