Live webchat with Professor David Salisbury, Dept of Health director of immunisation, Mon, November 2, 1pm

[GeraldineMumsnet]

We're very pleased to have Professor David Salisbury, the Department of Health's director of immunisation, as our guest for a live webchat this Friday, 30 Oct, at 1pm.

Professor Salisbury, who originally trained as a paediatrician, and also works extensively for the World Health Organisation including his role as chairman of the WHO Strategic Advisory Group of Experts on Vaccines, is a timely guest given that the swine flu vaccination
programme is now being rolled out. Pregnant women are one of the first 'at-risk' groups being offered the jab.

There has already been a large amount of discussion about the vaccine, so this is your chance to put your questions, concerns and comments to the government's top vaccines expert.

As usual, if you can't join us on the day, please post your question here and Prof Salisbury will try to answer as many as possible.

I have 2 children under 3, when will they have the vaccination?

Squalene is included to boost the immune response, I believe - so I ask again why not more vaccines without it for those of us whose immune systems don't need a boost.

Lomorising and mummyzanne ask about vaccination and pregnancy. We do recommend that pregnant women with flu risk factors should be vaccinated every year and we know that seasonal flu vaccine is safe in pregnant women. With H1N1 swine flu virus it is clear that younger people are more likely to get the disease as opposed to seasonal flu that mostly affects older people. Some of those younger people are going to be pregnant. The latest WHO advice shows that between 7 & 10% of all hospitalised patients are pregnant women in their second or third trimesters and pregnant women are up to 10 times more likely to need admission into intensive care than the general population. The WHO data also shows that between 5 and 30% of the deaths are in pregnant women. This means that it is really clear that pregnant women are at risk from H1N1 swine flu and it is circulating now. We don?t test drugs or vaccines in pregnant women but we do test them on pregnant animals and this has been done with our swine flu vaccines. We also know that over 90 women became pregnant shortly after having the GSK vaccine and 50 of them have now completed their pregnancies and have normal babies. The others are still being followed up - which explains why it is so difficult to do clinical trials in pregnant women .

What kind of fish oils? My child has allergy to prawns would this cause a reaction?

Over what period of time has this vaccine been tested on individuals?

Both myself and my son have ASTHMA and so have the regular flu vaccine

How long should be between regular flu vaccine and Swine flu vaccine should there be?

ie is there any problem with having both vaccines at same time?

Thanks

RTKM

I am being offered both seasonal and swine flu jabs together as an NHS worker. When our children have their innoculations we are advised to wait until they are well, should I do the same and should I avoid having both jabs together?

Hi... below are similar various concerns which other pregnant women have raised on the forum site. Please can you confirm whether or not their concerns are correct:

What concerns me the most is the use of adjuvants in Pandremix which boosts the effectiveness of the drug. The risk with this ingredient is that it promotes the body to fight all foreign bodies in the blood. Fine for a normal person but whilst pregnant, your immune system is surpressed specifically to support your unborn child.

The risk of hyper immune response has been raised which means that your body could go into overdrive and attack/reject your baby.

Its not the thermisal in the preg woman vaccine i'm concerned about its the adjuvant which can make your immune system overact and cause pre-emclampsia !!!

I have an auto-immune condition which is made better by pregnancy. If I were to have the Pandemix and it boosts my immune system would it cause a flare of my underlying medical condition?

I think also that Celvapan would encourage more pregnant women to be vaccinated. I know that supplies are not as great as Pandremix however when will this situation change and what is being done to make it change. Will pregnant women evantually be offered Celvanpan and within what time scale.

Many thanks for taking the time to come and chat to us all.

I posted this earlier as I didn't think I'd get to attend the webchat live....

Every year around 4000 babies in the UK are stillborn and about the same number die soon after birth, often the cause of these deaths are not known*. This is a risk every one of us takes (whether we acknowledge it or not) when we chose to have a baby. We take this risk because life must go on, and because in reality whilst this number is very scary it is still a small percentage of the 600,000+ babies born in the UK each year. We can?t vaccinate against all eventualities.

With this in mind, I would like to understand the statistics/Government expectations on the following to enable me to better assess the risk:

1. How many pregnant women have/are expected to contract swine flu this year?
2. Of those women what percentage are expected to develop severe complications (& is this number any higher than those expected to develop severe complications with seasonal flu?)
3. How many miscarriages, stillbirths & newborn deaths are expected to be directly contributable to swine flu?

Colette J - 30 weeks pregnant, fit & healthy and currently NOT planning to have the vaccine.

*NHS: The Pregnancy Book. Published by COI for the Department of Health

Sorry, I should clarify, I'm in my second trimester.

So far, Professor Salsibury, I haven't seen any information we don't already know. Could you answer some of the questions please.

I am 25 weeks pregnants, can you clarify the following:

• what conditions are classed as 'underlying health conditions?'
• if someone in my workplace (an office environment) has been diagnosed with swine flu and has returned to work after a week off am i still at risk? should i ask to work from home?
• what is the main 'risk' to a normal healthy pregnant woman if they catch swine flu?

many thanks

I would like to answer Waitingwaiting and others who have asked about choice of vaccines. If choice is neutral we have no problem about people choosing what they want but when choice is not neutral we have to advise people to have what we believe to be the best protection. We know that in healthy adults one dose of Pandemrix protects almost everybody with very high levels of antibodies. With Celvapan the proportion of people who will be protected after one dose is considerably fewer. For this reason, the European commission still recommends two doses of Celvapan. At q time when H1N1 viruses are circulating it has to be better for everybody to be protected after one dose than fewer and with lower antibodies. The other side of the balance that we always think about when we make decisions, is whether there is risk as well as benefit. I have already answered on the adjuvant and it is correct that there is thiomersal in the GSK pandemrix. It is there for a good purpose, because it keeps the vaccine sterile after the vial has been opened. There are now numerous studies from many countries one indifferent ways that all come to the same conclusion that we cannot identify harm from thiomersal in vaccines. Indeed the US Courts threw out thiomersal as a cause of autism. One of the most compelling pieces of evidence was that when thiomersal was taken out of US childhood vaccines, autism rates continued to rise. Under those circumstances you really cant implicate thiomersal.

Of course mercury is toxic if you were exposed to a large quantity but so is water is you drink enough of it. The minute quantities of thiomersal in vaccines have been shown not to be harmful.

Tatt
I agree this is little more than PR statements, I'm giving up my lunch to attend this

Hi, I have been asked to bring in my DD (5) for a swine flu jab as she has asthma but I have found out that the Glaxo Smithkline jab has an aluminium based adjuncta (sp?) to speed up getting the vaccine around the body.

I can find no info about tests on children for this.

Do you have, or know where I can find, information about any research on giving children this aluminium based adjuncta??
Thanks

SSB aluminium is in DTP, your child will ahve been given it already.

MGMidget and others ask about allergies. if you or your child have such severe egg allergy that you have an anaphylactic reaction immediately after exposure to egg then you should not have Pandemrix but you should have Celvapan. The reason for this is that the viruses that go into Pandemrix have been grown on eggs whilst Celvapan is made using cell culture with no egg material. We have made supplies of Celvapan available to Primary Care Trusts so that arrangements can be made for people who have extreme egg allergies to get that vaccine If you or your child have more general allergies then there is no problem with having Pandemrix.

In relation to your comment:
The minute quantities of thiomersal in vaccines have been shown not to be harmful.

Why then have companies cut down on the use of this?

Also why is the government not doing anything to find a single mumps vaccine but allowing us to have the choice of single vaccines. The company that used to make the single mumps vaccine continues to make the triple? It does not make any sense. I have been waiting for a year for a single mumps.
When is it coming?

Will you comment on 2 things please - safety of the vaccine for those with varying types of allergy and the impact on breastfedding. Will a mother who is vaccinated pass any immunity to their child?

Is Pandemrix significantly cheaper than Celvapan?

Will under 5's be offered swine flu vaccine? Indeed will it be offered to over 5's?

Will they need vaccinating for several years in a row against all new and emerging strains until the disease is eradicated?

How soon is the vaccine going to be available and which groups of people will be offered it first?

ohyoubadbadkitten and others ask about vaccine deivery schedules.

Starting last week we have been shipping vaccines out to GPs as fast as we get it in from the manufacturers. We are sending one box of 500 doses to every practice in the country and as soon as we have completed that first wave of distribution, we will then allow practices to order more as they need it. A week before practices will get their delivery the information is posted onto a website that PCTs and practices can see the date of their delivery. We do depend on the practices actually registering onto the website but we have told them what they need to do.

How do we find out about possible allergic reactions to other vaccines then?

Czech Republic canceled its orders with Baxters (company who makes the Swine flu vaccine) when Baxters made serious errors in the Avian Flu vaccines. What assurances do we have in the UK that Baxters vaccines are not contaminated?

Deerfield, Illinois-based pharmaceutical company Baxter International Inc. was caught shipping LIVE avian flu viruses mixed with vaccine material to medical distributors in 18 countries earlier this year. The ?mistake? was discovered by the National Microbiology Laboratory in Canada.

...The contamination incident, which is being investigated by four European countries, came to light when the subcontractor in the Czech Republic inoculated ferrets with the product and they died. Ferrets shouldn?t die...

Baxter International adheres to something called BSL3(Biosafety Level 3) ? a set of laboratory safety protocols that prevent the cross-contamination of materials so how could this happen?

Hi there,
Dr Salisbury, you mention that the choice of vaccines is not neutral, and that one of the reasons why we are being given pandemix is that only one dose is needed....
My question is why can't pregnant women be given the choice? why isnt it neutral? (other countries are giving pregnant women the vaccines without the adjuvants...) surely its up to us to decide whether to take the risk with the time scales involved with full protection from Celvapan? An awful lot of women are deciding not to have the vaccine because of the adjuvant, so isnt it better to give them Celvapan, so they have some protection?
what is the problem with us having Celvapan? if its short supply, then when are supplies being increased?
Thanks.