Opinion
Preparation before H1N1 vaccine introduction
The World Health Organisation (WHO) has pledged to ensure vaccine for all to prevent H1N1 influenza A virus (commonly known as Swine Flu virus). Initial doses of 2009 H1N1 flu vaccine has already been introduced recently in some countries. The Ministry of Health and Family Welfare of Bangladesh has proposed vaccination against pandemic flu when it will be available in the global market. As the vaccine is a new one, we have to keep certain things in mind before its introduction. We have to ensure the safety and make it accessible specially to the vulnerable groups like health workers, pregnant women and children. The following points should be considered with great importance: 1. Approval of the use of new pandemic influenza vaccine A (H1N1) will have to be given by National Regulatory Authority who will certify the safety of the vaccine. 2. Before the use of pandemic influenza (H1N1) vaccine, it must be tested in a few people before it is used for mass population in Bangladesh. The Clinical trial must be performed in Bangladesh. Regulatory agencies in Bangladesh may require clinical testing before approval of vaccine which adds to the time before the use of vaccine. Trials are to be performed to get essential information on immune response and safety. 3. Target groups for vaccination by pandemic vaccine are to be considered. Target group consist health care workers in the first priority to protect the essential health infrastructure. Second group consist of pregnant women, children aged about 6 month with several chronic medical conditions, healthy young adults of 15 to 49 years of age. There should be post marketing surveillance of the highest possible quality. 4. Pandemic influenza (H1N1) vaccine should be subjected to field trial reaction and antigenicity in Bangladesh. 5. A serological survey for this swine flu vaccine has to be undertaken to observe the development of antibody in a control population and relation of the antibody titre to the pattern pandemic swine flu. 6. Intensive monitoring should be conducted for safety and to observe any adverse effects. During vaccination, observation should be made for side-effects and to see if the side effects are similar to the side effects observed with seasonal influenza vaccine. 7.Whether vaccination will produce any major symptoms like Guillain Barre Syndrome (GBS), acute febrile polyneuritis which means ascending type of paralysis from leg to hands up to head. 8. Before vaccination, antigenic drift and antigenic shift of group A virus are to be considered because the degree of mutations are different between A and B type of virus. The writer is a Professor Emeritus and Founder Director of National Institute of Preventive and Social Medicine (NIPSOM). The article is completely the opinion of the writer himself and does not necessarily reflect the views of Star Health.
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