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Influenza Pandemic

Volume 698: debated on Monday 4 February 2008

asked Her Majesty’s Government:

Whether the concept of key workers still exists in planning for a possible influenza pandemic.

My Lords, our approach to responding to a pandemic requires employers to take responsibility for deciding how best to protect their staff during a pandemic. Our plan is for symptomatic patients to be treated irrespective of the profession to which they belong. If the pandemic virus necessitates any form of prioritisation, the decision will be taken in the light of evidence available at the time. This would also inform our plans for any subsequent vaccination programme.

My Lords, I am grateful to the Minister for that reply. If the Government are to defer the decision on how best to use the pandemic-specific vaccine, which I believe can be prepared only five or six months after the first wave of outbreak, will the noble Lord say which criteria they will use, whom they will consult before arriving at a decision, and whether other partners such as faith leaders will be part of that consultation?

My Lords, this will be a clinical decision, based on the prevailing circumstances and certainly on the stocks that become available. Decisions of this nature are difficult. However, we believe that initially limited supply will depend on the clinical impact of the pandemic. For example, if certain population groups are more severely affected, other members of the same group might be inoculated once a vaccine becomes available. A pandemic-specific vaccine could also play an important role in preventing a second pandemic. As for consultation, we will consult our advisory groups, which include both the scientific and ethical communities.

My Lords, a short time ago a government Written Answer said that supplies of the H5N1 vaccine were being held by the Department of Health on behalf of the Ministry of Defence. Will the Minister say what proportion of the antiviral stockpile has been allocated for the exclusive use of the Armed Forces, and how many courses of antivirals have been taken out of the country?

My Lords, the stockpile of antivirals is currently for about 25 per cent of the population whom we envisaged will be infected. That stockpile—that resilience—is being increased to 50 per cent. I am not sure of the exact number that has been assigned to the Armed Forces, but I will be more than happy to respond in writing.

My Lords, would the Minister care to comment on recent press reports suggesting that recent strains of the H5N1 virus isolated from birds on the Continent have proved to be resistant to the Tamiflu remedy which has been stockpiled by the Government to be used in the event of an epidemic?

My Lords, I am not aware of that scientific study. However, so far as we are aware, while one of the antivirals we have is Tamiflu, we are looking at other antivirals in the field. One of the issues in relation to pandemic flu is knowing exactly which strain it is and its sensitivity to antivirals.

My Lords, does the noble Lord accept that H5N1 is turning out to be a fairly stable virus and that it is now considered unlikely that humans will get it? Does he agree, however, that a number of bird flu virus strains might be potentially much more dangerous because they are not so stable?

My Lords, I agree with the noble Countess. The issue is not knowing which of the mutated viruses will be responsible for the next pandemic, or whether it would be through the mutation of a human or an animal virus. What is important from the Government’s perspective is to be ready for a pandemic irrespective of the virus or the strain, and that is what the Government are providing leadership for with stakeholders involved in the management of such a pandemic.

My Lords, in November 2007 the Minister in another place said that the Government were undertaking research into prioritising at-risk groups for vaccination. Can the Minister tell us what progress has been made in identifying those at-risk groups and on the prioritisation of resources?

My Lords, as things stand at the moment the Government have a stockpile of H5N1 vaccine. If that is the strain responsible for a pandemic, the NHS will provide that vaccine for health workers within the NHS.

My Lords, I think I am right that the Minister has said that it would take five or six months to produce a vaccine. How long does he anticipate that a pandemic would last? Would there be time to produce a vaccine?

My Lords, it is very difficult to predict the exact timing of a pandemic. Indeed, we are not even sure whether we would get a second or even a third wave of it. The first pandemic in 1918 had a second and a third wave, while the pandemics of 1957 and 1968 both had a second wave. In our modelling we usually predict that it would take about six months, giving us enough time to create a vaccine against the strain that was infective in the first pandemic.

My Lords, in the event of an influenza epidemic in this country, would GPs deliver all the vaccinations required in their surgeries or are there other plans to make sure that the population is properly dealt with?

My Lords, the primary care community will have a significant role to play in the provision of vaccinations, but the national flu line will be available during a pandemic which will ensure that supplies are sent through the mail for GPs’ patients or to local communities in order to provide vaccinations. We have highlighted through a number of educational websites and through the BMA and colleagues at the way in which we could educate healthcare workers in the provision of vaccinations.

My Lords, can my noble friend tell us what the situation is with our friends on the Continent with regard to vaccines? If there was a shortage of vaccine on the Continent, would we supply stockpiled vaccines from this country even if for no other reason than to protect ourselves from a possible spreading pandemic?

My Lords, we have taken precautions to avoid that eventuality. The possibility of export bans was discussed during the negotiations process for the advanced supply contract. As a result, the risks of nationalisation or the closure of borders have also been minimised as far as possible with the following provisions. First, the production facilities must be located in the EU and remain within the EU unless the UK Government give written consent otherwise. Secondly, manufacturers have warranted that the host country of production has either already sourced all the vaccines it needs for its own population or it is aware of its commitments to the UK Government.