By Shabtai Gold Nov 26, 2009, 1:08 GMT
Geneva - Initial concern over the spread of the A(H1N1) pandemic virus is now being echoed by different worries - over anti- viral drugs, vaccine supplies and the actual or perceived safety of the inoculations.
However, reactions across the glove have varied as the death toll from the virus - popularly known as swine flu - mounts.
In the United States, where 41 per cent of parents tried to obtain a shot, most people who attempted were unsuccessful, according to a recent poll from the Harvard School of Public Health.
In Germany as well, there have been signs of shortages. Around 9.3 million vaccines will have been distributed to doctors by the end of November, for a population of around 82 million.
It's hoped that around 20 million vaccines will be available by the end of the year.
However, in Australia, where getting a jab is free, the reaction was surprisingly muted.
'The expectation was that everyone is going to be overwhelmed with the numbers of people flooding to have their vaccinations,' said Australian Medical Association chief Brian Morton. 'That hasn't happened.'
France's population has also been sceptical, although the government has allocated large resources to acquire more than a sufficient supply of doses for citizens.
In contrast in Poland civil rights groups have threatened legal action against the government, saying it has failed to protect the people, after it refused to purchase of vaccines until they were proven safe.
It was back in April that the World Health Organization (WHO) first noted the current wave of the non-seasonal version of H1N1, also known as swine flu, and in June declared it as the first influenza pandemic since 1968.
Some 80 million doses of pandemic vaccine have already been distributed and around 65 million people have been vaccinated world- wide, the WHO said on November 19. Many countries are waiting for more shipments.
In response to some safety fears, voiced both by worried patients and online, WHO said: 'All data compiled to date indicate that pandemic vaccines match the excellent safety profile of seasonal influenza vaccines, which have been used for more than 60 years.'
Initially, when the virulence of the virus was unclear and young people seemed to be getting more ill than the elderly, panic erupted in various parts of the globe.
The disease though, has shown itself to be relatively mild and the death rate remained low, although exact statistics are still unavailable.
Best estimates say about 6,500 people have died from H1N1 globally - although many of them had serious underlying medical conditions.
During the initial period of concern, drug companies and health authorities began to map out plans for developing a vaccine quickly, as none yet existed for this H1N1, though the virus was responsive to anti-virals.
These drugs, shortages of which are being reported in cities in the United States, are taken after a patient has become infected, but an inoculation acts in a preventative manner.
However, as the first doses of vaccines began being rolled out, albeit with some teething problems affecting production, questions started being raised.
One Egyptian man, Ahmed Betr Edeen, voiced concerns being aired by many in private. 'There is not a high death rate, and if someone is infected, he can be treated, and the treatment rate is high. So why risk it with a vaccine if it is not safe?' he asked, rhetorically.
'We don't want vaccine-induced problems. That's why we will purchase foreign vaccines only when they have been tried on the Indian population to ensure there are no serious side-effects,' said VM Katoch, director-general at the Indian Council of Medical Research.
In the Netherlands, where enough doses were purchased for all citizens, only vulnerable groups have received vaccinations.
'Most people who are offered the vaccination want it,' according to Roel Coutinho, epidemiologist and director of the Royal Public Health Centre. 'However parents of young children are more hesitant, often fearing possible side effects,' he admitted.
To counter fears that the vaccine can cause sterility or is made from unclean animals, health authorities in some countries have embarked on public information campaigns to dispel unfounded fears about the vaccines.
There was also a view that swine flu has been hyped beyond all sensible proportions. In Africa, for example, observers have noted that endemic diseases like cholera and hepatitis kill many more than H1N1 would affect.
Jean Zeigler, who works with the United Nations on human rights issues, has said the efforts being put into coping with swine flu would be better spent on fighting hunger.
Nevertheless, the mutations of the virus has given ammunition to those who want further government action. = The WHO said it was monitoring confirmed cases of mutations, but that there was no evidence this was leading to an increase in cases, or greater severity.
Also - while isolated - reports of strains of the virus resistant to anti-virals continue to be confirmed, most recently in Wales.
Meanwhile, winter approaches in the northern hemisphere, fears that inadequate national health systems may be overwhelmed by a heavy influenza season, whilst further mutations could occur, are keeping health authorities on their toes.
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