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In Germany, A Better H1N1 Vaccine For Politicians?

For additional reading on the swine flu vaccine situation in Germany, see the article at the end translated by my friend Bob, in red.  Thank you Bob. - Ilene

In Germany, A Better H1N1 Vaccine For Politicians?

vaccinesBy Tristana Moore / Berlin, Courtesy of TIME

Critics are calling it a two-tier health system — one for the politically well-connected, another for the hoi polloi. As Germany launched its mass vaccination program against the H1N1 flu virus on Monday, the government found itself fending off accusations of favoritism by offering one vaccine believed to have fewer side effects to civil servants, politicians and soldiers, and another potentially riskier vaccine to everyone else. The government had hoped that Germans would rush to health clinics to receive vaccinations against the rapidly spreading disease, but the rising anger over the different doses may now cause many people to shy away.

Amid growing fears over a possible global flu pandemic, the German government prepared for its mass vaccination campaign earlier this year by ordering 50 million doses of the Pandemrix vaccine, which would be enough for a double dose for 25 million people, around a third of the population. The vaccine, manufactured by GlaxoSmithKline, contains an immune-enhancing chemical compound, known as an adjuvant, whose side effects are not yet entirely known. Then, after a report was leaked to the German media last week, the Interior Ministry confirmed that it had ordered a different vaccine, Celvapan, for government officials and the military. Celvapan, which is made by the U.S. pharmaceutical giant Baxter, does not contain an adjuvant and is believed to have fewer side effects than Pandemrix.

Anger at the news was widespread in Germany. "If mass vaccination is considered to be necessary, then everyone should be treated the same way," says Birgitt Bender, the health spokeswoman for the Green Party. Ulrike Mascher, head of the VdK social welfare association, said giving government officials a different vaccine from the rest of the population sent the "wrong signal" and gave many people "the impression that they are second-class patients." A story on the front page of the mass-circulation Bild newspaper accused the government of giving "second-class medicine" to regular Germans.

Doctors and medical experts are divided over the safety of Pandemrix. While some say it’s the best vaccine available, others have serious misgivings about it. "The Pandemrix vaccine can’t be recommended for pregnant women or young children because it has an increased risk of side effects. Pandemrix has an adjuvant which hasn’t been tested sufficiently up until now," Alexander Kekulé, a virologist at the University of Halle, tells TIME. "Celvapan is a whole virus vaccine, which has fewer side effects than Pandemrix, but it leads more often to fever or local swelling when compared with the normal seasonal flu vaccine," he adds. Although Kekulé called the government’s handling of the vaccination program a "scandal," he said government officials and soldiers are not necessarily getting a better deal with Celvapan. "Neither Celvapan nor Pandemrix are ideal," he says.

The Interior Ministry hit back at suggestions of preferential treatment, saying that it had ordered around 200,000 doses of the Celvapan vaccine from Baxter before the differences between the two vaccines were documented, and the government was bound by the terms of its contract. The government also points out that both Pandemrix and Celvapan have been approved by the European Union, and that other countries such as Britain and Sweden are using the Pandemrix vaccine. In an attempt to put a lid on the simmering controversy, Chancellor Angela Merkel’s spokesman, Ulrich Wilhelm, said that the German leader would consult with her doctor in the next few days and if she decided to receive a jab, it would be Pandemrix.

At least 26,000 people have been infected with swine flu in Germany, resulting in three deaths. Although the majority of patients have experienced only mild flu-like symptoms, a steady increase in the number of cases of H1N1 in recent months has raised alarm across the nation. In its latest report, the Robert Koch Institute, the federal agency for infectious diseases, said that new cases in Germany have jumped to around 1,600 each week, double the 700-800 weekly cases reported in early autumn. With the onset of winter, when seasonal flu infections typically peak, many experts are concerned that H1N1 infections will spike dramatically. Klaus Osterrieder, a virologist at the Free University of Berlin, now fears that with the worries over the possible risks associated with Pandemrix, many people will avoid getting a vaccine altogether. According to a survey conducted on Oct. 23 by the Emnid Institute, only 13% of Germans said they wanted to receive a swine flu vaccine this winter.

"The public debate is bad because it raises questions about the whole vaccination program," Osterrieder says. If the government doesn’t find some way to remedy the current public relations disaster and clear up the confusion over the different swine flu vaccines, it could be faced with an even greater emergency if the country’s hospital wards start overflowing with flu patients in the coming months.


Super-Impfstoff für die Kanzlerin und ihre Minister

(Super-vaccine for the chancelor and her ministers)

Die Mitglieder der Bundesregierung sollen laut "Spiegel" einen Impfstoff gegen Schweinegrippe ohne umstrittene Wirkstoffverstärker erhalten. Auch Deutschlands Soldaten werden mit einem solchen besseren Mittel geimpft. Nach Ansicht einiger Ärzte hat die Impfung ohne Wirkstoffverstärker weniger Nebenwirkungen.  DER SPIEGEL reports that members of the federal government get a vaccine contra swine flu without "boosters". Also german soldiers will be vaccinated with such a better serum. Some physicians expect these vaccines without booster to cause less side effects.

Some docs warn of side effects which are more serious in sera with boosters than in sera without boosters.  

Die Kanzlerin, die Mitglieder ihres Kabinetts und Beamte der Ministerien sowie nachgeordneter Behörden sollen mit einem Impfstoff ohne Verstärker vor Schweinegrippe geschützt werden. „Wir haben 200.000 Dosen des nicht-adjuvantierten Impfstoffes Celvapan der Firma Baxter gekauft“, sagte Christoph Hübner, Sprecher des Bundesinnenministeriums, dem Nachrichtenmagazin „Spiegel“. Auch die Bundeswehr soll einen Impfstoff ohne Zusatz- und Konservierungsstoffe bekommen….  

The chancellor, members of the cabinet and staff of their administrative bodies shall get the anti-swine-flu vaccine without booster. "We have bought 200,000 doses of Celvapan (without booster) from Baxter Company" Christoph Hübner, speaker of the secretary (minister) of interior affairs, told the news magazine DER SPIEGEL. Also soldiers.

Unlike the 50 Million doses of the vaccine of GlaxoSmitKline which will be dispensed to the people starting this week, the serum from Baxter does not contain any boosters and this will be given only to civil servants, including the staff of the Paul-Ehrlich-Institute, the institute which approves all vacines and which defended their decision in favor the GSK vaccine several times last week…  

"It is a scandal" the chaiman of the "Physicians’ Comission for Medicaments" Wolf Dieter Ludwig said, a scandal which we can hardly sell the people. "We are very unhappy about this vaccination-campaign." There are many problems, the risk/reward ratio is unknown. "Government authorities were misled by a campaign of big pharma, which wants to earn money by intimidating the people"

Weil der GSK-Impfstoff nicht an Schwangeren getestet wurde, muss auch für sie kurzfristig nicht-adjuvantierter Impfstoff besorgt werden. Der zuständige Staatssekretär im Bundesgesundheitsministerium, Klaus Theo Schröder, sagte dem Magazin:…   because the GSK-vaccine was not tested on pregnant women, a vaccine without booster has to be ordered urgently….  

(Open rebellion among primary care docs and pediatricians.)  The president of the society of general practitioners and family docs, advises general practitiones not to apply the vaccine. The Professor of the University of Göttingen says: Risk is higher than reward.

The chaiman of the society of paediatrics, W. Hartmann, accuses the government of giving "false scientific statement." What applies for pregnant women applies for children below 3 years of age. The vaccine is not tested on them. Therefore the risk is too high to apply the vaccine.

Kinder hätten ein Immunsystem, das zu Überreaktionen neige. Genau die aber könnten durch den Zusatz von Wirkverstärkern ausgelöst werden. Zusätzlich sei dem Impfstoff auch noch ein Quecksilber-haltiger Konservierungsstoff beigefügt. „Das Zeug hat man in heutigen Impfstoffen für Kleinkinder bewusst herausgehalten“, sagte Hartmann…  Children have an immune system which tends to overreact. This may be triggered by the boosters. On top of that there is some mercury-containing preservative. "Vaccines for children are forbidden to contain such stuff" Hartmann said.

In the EU, three vaccines against swine-flu or H1N1 are approved so far: Focetria, Pandemrix und Celvapan. Focetria and Pandemrix contain boosters. Celvapan does not because it contains twice as many inactive viruses than the other two.



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