H1N1 UPDATE:FLU SHOTS IN THE UK: THIS DOES NOT SOUND GOOD: likely done by "private contractors"- never heard of THAT in medicine, who are they? - with little or no medical history prior to the shot: THIS IS VERY BAD MEDICINE, if it is medicine at all

• JULY 15, 2009

U.K. Aims for Broad Vaccination Program

Officials Scramble to Protect Citizens Amid Flu Outbreak

Wall Street Journal Online

LONDON -- The medical establishment in Britain, the nation hardest hit by swine flu outside North America, is scrambling to roll out a large-scale vaccination program in an effort to protect its population against a virus that threatens to spread rapidly here in coming weeks.

The state-run health system is deciding whether to hire private contractors to help doctors carry out the vaccinations, as a recent jump in phone calls and visits related to swine flu has fueled concerns that physicians won't be able to keep up with routine care, said Peter Holden, a general practitioner who represents the British Medical Association in pandemic-flu planning with the government.

News International/ZUMA Press

The British government is taking steps to protect its citizens amid the worst H1N1 outbreak in Europe.

[DS: TAKE A GOOD LOOK AT THAT PICTURE: WHAT DOES A POLICEWOMAN HAVE TO DO WITH VACCINATIONS? PRETTY STRANGE, WOULDN'T YOU SAY? STILL, AT THIS STAGE AT LEAST, THE POPULATION WILL NOT BE FORCED TO TAKE THE INJECTIONS, IT WILL ONLY BE BRAINWASHED TO COMPLY]

In his own practice in the Peak District in central England, Dr. Holden is making plans for each doctor or nurse to vaccinate between 30 and 40 people an hour. "There'll be no chitchat. It will be, 'Are you allergic to anything? Bang, in, out,'" he said.

It isn't yet clear how many doses will be needed per person, but many flu experts believe it will be two.

Since the spring, 17 Britons have died after being infected with the H1N1 virus that is causing the swine-flu pandemic, according to U.K. officials. The U.K. recently recorded its first swine-flu death in an otherwise healthy patient, an event that set off further concern, even as other deaths, including that of a six-year-old girl last week, have gained attention. [DS: NOTICE THE UBIQUITOUS YOUNG GIRL MENTIONED; BUT ALSO NOTICE HOW 17 SICK PATIENTS DIED over a few months: what is so strange about that? I don't like this whole story, it is fishy, fishy, fishy]

As of July 6, there were 7,447 confirmed cases in the U.K., ranking the country fourth in the world, behind the U.S., Mexico and Canada, according to the World Health Organization's most recent figures. Worldwide, 429 people have died from swine flu and 94,512 have been infected, according to the WHO.

The number of U.K. cases is several times greater than in any other European country. Ian Jones, professor of virology at the University of Reading, says the U.K. has been hit hard because many Britons were traveling to Mexico and the U.S. when the virus first appeared there. Wendy Barclay, chair in influenza virology at Imperial College London, said the U.K. also has a good surveillance system that ensures that a high percentage of infections are reported.

The country has ordered enough vaccine to cover all 60 million of the country's residents. The government plans to offer everyone free shots as soon as they become available, a Department of Health spokeswoman said on Tuesday. It won't require people to get the shots, but will make vaccine available to everyone, she said.

The health department expects the first doses to arrive in the fall, and will start vaccinating certain groups first, including health-care workers, pregnant women and children. The U.K. expects enough vaccine for 30 million people, or about half the population, to be available by the end of the year, the health department spokeswoman said.

However, the H1N1 vaccine will first need to be approved by the government, she added.

The companies supplying Britain with the vaccine -- GlaxoSmithKline PLC and Baxter International Inc. -- have already won preliminary approval for their pandemic vaccines from the European Medicines Agency, or EMEA, Europe's top medicines regulator. Preliminary approval is possible because flu vaccines are generally made in the same way, with the same basic ingredients. The main element that changes is the type of virus used in the vaccine.

Because the companies have already supplied the EMEA with plentiful data on their vaccine ingredients and won preliminary approval, it shouldn't take the agency long to review their completed H1N1 shots, an EMEA spokeswoman said on Tuesday. The agency expects to receive more information from the companies around the end of September, and could make a decision within five days after that, she said.

The U.S. is also making plans for a voluntary vaccination program. Health and Human Services Secretary Kathleen Sebelius said last week that as many as 100 million doses of vaccine would be available in the U.S. by mid-October.

U.S. health officials have said clinical trials must be conducted first to be sure the vaccine is safe and effective. They expect those trials to get underway in early August, with some results in early October.

Earlier this month, U.K. Health Secretary Andy Burnham said that if current infection rates continue, new swine flu infections could rise to 100,000 a day by the end of August. But he stressed that this was a projection, and also that the vast majority of cases so far have been mild.

Dr. Jones said he didn't think infection rates would grow as quickly as the health minister projected, but that the U.K. could have half a million cases by the end of the year. There is a good chance that many of these cases will be mild, he said, because the H1N1 virus has shown little evidence yet of becoming more virulent.

A public awareness campaign organized by the Department of Health has done a good job of teaching people how to avoid infection, which should help reduce infection rates, he said. Ads telling people to wash their hands frequently and cover their sneezes have been running for months in women's magazines, bus stations, and on the London Underground. They've also appeared on supermarket trolleys and ATM screens.

Prime Minister Gordon Brown has called the U.K. one of the countries best prepared to cope with swine flu. In addition to ordering vaccine, the U.K. has stockpiled enough antiviral medication, including Tamiflu, to treat 50% of the population, and is aiming to increase that to 80%. Antivirals are used to reduce symptoms in a person already infected with the flu, while vaccines are used to prevent infection.

Write to Jeanne Whalen at jeanne.whalen@wsj.com