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Pandemic (H1N1) 2009 briefing note 2
WHO recommendations on pandemic (H1N1) 2009 vaccines
13 JULY 2009 | GENEVA -- On 7 July 2009, the Strategic Advisory
Group of Experts (SAGE) on Immunization held an extraordinary
meeting in Geneva to discuss issues and make recommendations
related to vaccine for the pandemic (H1N1) 2009.
SAGE reviewed the current pandemic situation, the current status of
seasonal vaccine production and potential A(H1N1) vaccine
production capacity, and considered potential options for vaccine
use.
The experts identified three different objectives that countries
could adopt as part of their pandemic vaccination strategy:
* protect the integrity of the health-care system and the country's
critical infrastructure;
* reduce morbidity and mortality; and
* reduce transmission of the pandemic virus within communities.
Countries could use a variety of vaccine deployment strategies to
reach these objectives but any strategy should reflect the
country’s epidemiological situation, resources and ability to
access vaccine, to implement vaccination campaigns in the targeted
groups, and to use other non-vaccine mitigation measures.
Although the severity of the pandemic is currently considered to be
moderate with most patients experiencing uncomplicated,
self-limited illness, some groups such as pregnant women and
persons with asthma and other chronic conditions such as morbid
obesity appear to be at increased risk for severe disease and death
from infection.
Since the spread of the pandemic virus is considered
unstoppable, vaccine will be needed in all countries. SAGE
emphasized the importance of striving to achieve equity among
countries to access vaccines developed in response to the pandemic
(H1N1) 2009
The following recommendations were provided to the WHO
Director-General:
* All countries should immunize their health-care workers as a
first priority to protect the essential health infrastructure. As
vaccines available initially will not be sufficient, a step-wise
approach to vaccinate particular groups may be considered. SAGE
suggested the following groups for consideration, noting that
countries need to determine their order of priority based on
country-specific conditions: pregnant women; those aged above 6
months with one of several chronic medical conditions; healthy
young adults of 15 to 49 years of age; healthy children; healthy
adults of 50 to 64 years of age; and healthy adults of 65 years of
age and above.
* Since new technologies are involved in the production of some
pandemic vaccines, which have not yet been extensively evaluated
for their safety in certain population groups, it is very important
to implement post-marketing surveillance of the highest possible
quality. In addition, rapid sharing of the results of
immunogenicity and post-marketing safety and effectiveness studies
among the international community will be essential for allowing
countries to make necessary adjustments to their vaccination
policies.
* In view of the anticipated limited vaccine availability at global
level and the potential need to protect against "drifted" strains
of virus, SAGE recommended that promoting production and use of
vaccines such as those that are formulated with oil-in-water
adjuvants and live attenuated influenza vaccines was important.
* As most of the production of the seasonal vaccine for the
2009-2010 influenza season in the northern hemisphere is almost
complete and is therefore unlikely to affect production of pandemic
vaccine, SAGE did not consider that there was a need to recommend a
"switch" from seasonal to pandemic vaccine production.
WHO Director-General Dr Margaret Chan endorsed the above
recommendations on 11 July 2009, recognizing that they were well
adapted to the current pandemic situation. She also noted that the
recommendations will need to be changed if and when new evidence
become available.
SAGE was established by the WHO Director-General in 1999 as the
principal advisory group to WHO for vaccines and immunization. It
comprises 15 members who serve in their personal capacity and
represent a broad range of disciplines from around the world in the
fields such as epidemiology, public health, vaccinology,
paediatrics, internal medicine, infectious diseases, immunology,
drug regulation, programme management, immunization delivery, and
health-care administration.
Additional participants in the SAGE meeting included members of the
ad hoc policy advisory working group on influenza A(H1N1) vaccine,
chairs of the regional technical advisory groups and external
experts. Observers included industry representatives and regulators
who did not take part in the recommendation process in order to
avoid conflicts of interest.
RELATED LINKS
Strategic Advisory Group of Experts (SAGE) on Immunization
Pandemic (H1N1) 2009: full coverage
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massel
PS: WHO-Update 59 fehlt immer noch (letztes ist nun 1 Woche her !!)