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Tuesday, Nov. 10, 2009

Flu vaccines scarce, get divvied up

Staff writer

Vaccinations for swine flu started Nov. 2 for pregnant women and people with chronic illnesses in some prefectures, but many medical institutions are still struggling to keep ample stocks to inoculate their staff, who are the most prone to be exposed to the H1N1 virus.

News photo
Still standing: A medical worker gets vaccinated for swine flu in Habikino, Osaka Prefecture, on Oct. 19. KYODO PHOTO

"Although we prepared vaccines for 1 million medical staffers, local governments told us that was not enough," said an official in the Health, Labor and Welfare Ministry's division handling the swine flu epidemic.

The Tokyo Metropolitan Government meanwhile reported medical institutions requested vaccines for 280,000 people but received only 100,000.

Chiba provided vaccines for only 40,000 people, although doctors requested enough to cover 110,000 medical workers, an official in the prefecture's health and welfare division said.

"Medical institutions said all staff who have contact with patients, including receptionists, should be vaccinated," he said. "But (the amount we received) is clearly not enough."

Tokyo Metropolitan Geriatric Hospital received vaccines for 500 people but managed to inoculate 600 employees by reducing the dosage to 0.45 milliliter from 0.50 milliliter.

"But this is only for medical staff, and strictly for preventing infections inside the hospital" said Takashi Inamatsu of the hospital's infectious disease division. He reached the decision as a last resort, based on his experience and clinical tests on the vaccine.

To speed preparations of the vaccination, the health ministry decided to use 10-milliliter as well as 1-milliliter vials. The smaller ones are usually used for seasonal influenza vaccines. In September, the ministry called for an increase in the vaccine to cover 27 million people by March instead of 18 million.

One problem, however, is that loading syringes from 10-milliliter vials wastes 10 percent of the vaccine, according to the health ministry.

Thus 10-milliliter vials can cover 18 0.50-milliliter doses, assuming residual liquid remains in the vials, whereas 20 people can be inoculated if 101-milliliter vials are used.

Last month Terumo Co. began selling syringes that save about 10 percent of the vaccine if 0.50-milliliter inoculations are employed.

"The syringe with a needle embedded in it reduces the vaccine that remains in the nozzle gap," a Terumo spokeswoman said, noting it usually takes about eight months to receive permission to manufacture their product, but this time it only took three months.

Pregnant women will start receiving inoculations in many cities no later than next Monday after safer, preservative-free vaccines become available.

Currently, pregnant women and the chronically ill are urged to take two doses — one each on two separate days. This could be reduced to one dose after the government reviews the latest clinical trials.

The Chiba official said: "(The prefecture) has just started vaccinating pregnant women. We have to wait for a while to see if enough vaccine will be provided (for pregnant women and people with chronic illnesses)."

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