Vaccine
Q: Why should I be vaccinated against the new A(H1N1) influenza?
A: There are two main reasons for becoming vaccinated:
1. To prevent you catching influenza and to prevent serious complications
arising in people who have a serious underlying condition or chronic illness
(at-risk groups).
2. To prevent the flu virus from spreading to members of your own family or
others with whom you are in close contact.
Q: Is there a vaccine against the new A(H1N1) influenza?
A: Yes. The pandemic vaccine used in Norway is called Pandemrix. The
vaccine is being delivered in successive consignments to areas throughout
the country. Distribution depends on how much vaccine is delivered by the
manufacturer.
Q: Who is responsible for buying in and distributing the vaccine?
A: At the behest of the Ministry of Health and Care Services the
Norwegian Institute of Public Health signed a contract with the producer
GlaxoSmithKline (GSK) for the delivery of vaccines in the event of a
pandemic outbreak of influenza. Norway has ordered a total of 9.4 million
doses of the pandemic vaccine.
The vaccine is being distributed by the Norwegian Institute of Public Health
to all the country’s local authorities and health trusts in the same way as
the annual influenza vaccine to at-risk groups. The local authorities are
responsible for further distribution and administration of the vaccine to
permanent and temporary residents within their area of jurisdiction. The
health trusts are responsible for vaccinating their own staff and
inpatients.
Q: Who should be vaccinated and who will be offered vaccination first?
A: People at risk of becoming seriously ill if they catch the flu are
being vaccinated first, along with healthcare personnel. After that the
general population will be offered the chance to be vaccinated. When
vaccination of the general population starts, it is recommended that the
youngest age groups be vaccinated first. This is the order of priority for
vaccination:
- Women in the second and third trimester of pregnancy. Women in the first
trimester who are at risk of becoming seriously ill* may be vaccinated
after a careful assessment by their doctor.
- People aged from 6 months to 64 years who are at risk of becoming seriously
ill *. In the event of limited vaccine availability, it is recommended
that the youngest age groups be vaccinated first.
- People aged 65 or more who are at risk of becoming seriously ill*.
* People with the following conditions are considered to be at risk of
becoming seriously ill:
- Chronic respiratory conditions (including patients with asthma requiring
regular medication or admittance to hospital), particularly those with
a reduced lung capacity.
- Chronic cardiovascular conditions, particularly those with serious heart
failure. Those with uncomplicated high blood pressure are not
considered to be at risk.
- Reduced immune response, irrespective of cause.
- Diabetes mellitus type 1 or 2
- Chronic renal failure (GFR<30 ml/min)
- Chronic neurological illnesses or injuries
- Extreme obesity, ie a body mass index (BMI) of over 40 kg/m2
It is recommended that healthcare personnel be vaccinated because they have an
increased risk of becoming infected at work. It is also important that
healthcare personnel do not infect patients with whom they come into
contact.
Q: Can the vaccination against normal seasonal flu and the new A(H1N1) flu be
administered at the same time?
A: Those whose vaccination against seasonal flu coincides with their
vaccination against A(H1N1) flu can have both vaccines administered at the
same time, through an injection in each arm. Pandemrix should not be
administered at the same time as any other vaccine than the vaccine against
seasonal flu.
Q: Does everyone have to be vaccinated in the area where they are registered
as being domiciled in the National Population Register? What about weekly
commuters, students and other people who are staying in another local
authority area?
A: Local authorities have a duty to provide necessary health services
to all permanent or temporary residents in their area of jurisdiction. This
also applies to the recommended vaccination programme.
Q: Many people’s GP is located in another local authority than the one in
which they live. Who do they contact for vaccination, the local authority
where they live or their GP irrespective of local authority?
A: This will depend completely on the service being provided by the
local authority concerned and the extent to which GPs are involved in the
vaccination effort. Many GPs are vaccinating people in at-risk groups, while
the rest of the population is being offered vaccination in their area of
residence.
Q: Will Norwegian citizens who are living/staying abroad be offered
vaccination?
A: Vaccines and antiviral medication (such as Tamiflu) from Norwegian
emergency supplies cannot be sent abroad. Norwegians abroad must comply with
the recommendations of the national health authorities and contact the local
health service, as indicated by their travel insurance provider, if
appropriate. In addition, the Norwegian health authorities will provide
information to Norwegians abroad by means of the internet.
Q: Will foreign nationals who are living/staying in Norway be offered
vaccination?
A: Yes, anyone who is living or staying in Norway long enough to follow
the correct vaccination programme will be offered vaccination.
Q: Do I still need to be vaccinated even if I have already had the flu?
A: If you have had the new A(H1N1) flu you may have built up an
immunity, while other kinds of flu/flu-like illnesses will not provide
immunity. Since the majority will not know for sure which flu virus they
have had, or if their illness was caused by some other virus or infection,
the safest course of action is to take the vaccine if they want to be
protected. There is no risk attached to vaccination even if you have already
had the new A(H1N1) flu.
Q: Is the pandemic vaccine safe?
A: All medicines that work can produce side effects. Compared with
normal seasonal flu vaccines people vaccinated with the pandemic vaccine
Pandemrix can expect a slightly stronger reaction at the site of the
injection, and other normal side-effects which rapidly disappear. Pandemrix
has been approved throughout Europe on the basis of an evaluation of the
vaccine’s efficacy and safety, in accordance with the model vaccine concept.
This means that the model vaccine has been tested on around 5,000 people in
a clinical trial. The model vaccine uses a stem from another influenza
virus, H5N1 bird flu. Experience from annual changes in virus stems in
seasonal flu vaccines over several decades, and from the development of
pandemic vaccines, shows that a change in the virus stem to the new A(H1N1)
flu will not have any significant effect on the efficacy or safety of the
vaccine. Any rare side-effects will only be discovered in the course of
ordinary use of the vaccine in large population groups, and a comprehensive
system to pick up on such side-effects has been established both nationally
and internationally.
Q: What kind of side-effects does the vaccine produce?
A: Just like any other vaccination, side effects can occur. An
assessment of the model vaccine (see question: How is the pandemic vaccine
produced?) shows that the normal side-effects are headache, fatigue, pain,
redness and swelling at the site of the injection, a raised temperature,
aching muscles and joints, influenza-like symptoms and swollen lymph nodes.
These normally disappear over the course of 1-2 days. The data indicate that
side-effects occur somewhat more frequently after inoculation with the
pandemic vaccine than after the normal seasonal flu vaccine.
Q: Who cannot be vaccinated?
A: If you have previously experienced an allergic reaction to any of
the components of the vaccine, or any serious reaction to earlier doses of
the same vaccine, you should not be vaccinated. Even though there are
medical grounds for not being vaccinated (contraindications), it may, under
certain circumstances, be necessary to consider vaccination even for people
in this category. If the pandemic becomes serious, and the danger of
infection becomes considerable, vaccination could represent a smaller risk
than remaining unvaccinated. If someone cannot be vaccinated it is important
to protect them from infection by, for example, ensuring that people with
whom they are in close contact are vaccinated. It is usual to postpone
vaccination in the event of acute infectious illness with a temperature in
excess of 38 °C.
Q: Can I have the vaccine if I am allergic to eggs?
A: This vaccine is cultured in eggs, so caution is advised with regard
to those who are allergic to eggs. If you have suffered a serious and
immediate allergic reaction (anaphylactic shock) as a result of eggs, you
should refrain from vaccination. People with mild egg allergies may be given
the vaccine under heightened emergency preparedness. If someone cannot be
vaccinated it is important to protect them from infection by, for example,
ensuring that people with whom they are in close contact are vaccinated.
Q: Can the vaccine be given to people with reduced immune responses?
A: Yes, just like the vaccine against normal seasonal flu, the pandemic
vaccine does not contain live virus. It is not harmful to give it to people
with reduced immune responses, but as with other vaccines the protective
effect may not be as strong. They will therefore require two doses of this
vaccine.
Q: Do you have to be healthy to have the vaccine?
A: If you are suffering from a serious infection, with a high
temperature (over 38 °C) vaccination will normally be postponed until you
feel better. A slight infection, like a cold, should not be a problem, but
you doctor will determine whether you can be given the Pandemrix vaccine or
not.
Q: Does the vaccine contain live virus?
A: No. The vaccine does not contain any live virus. It can therefore
not give you the flu or any other infection.
Q: Can I be vaccinated even though I am breastfeeding?
A: Yes. The vaccine can be given to women who are breastfeeding.
Q: Will I protect my child if I am vaccinated while I am breastfeeding?
A: Some studies show that infants who are breastfed can obtain a
certain amount of protection if their mothers are vaccinated against
influenza. The youngest children can be protected indirectly by family
members and other people with whom they come into close contact being
vaccinated. People who have been vaccinated will run a smaller risk of
falling ill, and in this way reduce the risk of infecting the children. If
children are not themselves vaccinated, they will gain a degree of
protection if those with whom they are in close contact are vaccinated.
Q: Should I be vaccinated if I am pregnant?
A: Women who are in the second and third trimester of pregnancy are
recommended to have the vaccine against the new strain of flu. Women who are
in the first trimester of pregnancy, who are at risk of becoming seriously
ill, may be vaccinated after a careful assessment of the seriousness of
their underlying condition. If the pregnant woman herself is not vaccinated
it is important to protect them from infection by, for example, ensuring
that people with whom they are in close contact are vaccinated.
Q: I am trying to get pregnant, but am unsure whether I am or not since it is
too early to take a pregnancy test. Should I have the vaccine?
A: Planning a pregnancy does not in itself mean you should not be
vaccinated. Women who are trying to get pregnant and those who may be
pregnant (but at such an early stage that it will not show up on a pregnancy
test) can have the vaccine. There is no evidence that this can have a
harmful impact on either fertility or foetal development.
Q: Can young children be vaccinated?
A: The vaccine can be given to children over the age of 6 months.
Q: Where can I go to get vaccinated?
A: Vaccination against the new A(H1N1) influenza will be organised by
the local authorities. The local authorities decide who shall administer the
vaccine and how this is to be carried out locally. If you have any questions
about vaccination where you live, contact your local council.
Q: What does it cost to be vaccinated?
A: The cost of vaccination will vary depending on the local authority.
This also applies to children. The charge payable is not covered by the
medical fee exemption card (blue prescription scheme and medical fees
ceiling 1).
Q: How many doses of the vaccine do I need to obtain protection?
A: The health authorities recommend one dose for both children and adults
(both in the risk groups and others). Persons with an impaired immune system
should have two doses in order to secure a better and more lasting
protection from the virus. The second dose should be given at least three
weeks after the first one. Future investigations will determine whether a
second dose will be needed for other groups than persons with an impaired
immune system.
Q: How is the vaccine administered?
A: The vaccine is given by injection in the upper arm.
Q: How long does it take before the vaccine begins to take effect?
A: The vaccine begins to take effect gradually. Experience from other
influenza vaccines shows that immunity is achieved after one to two weeks.
Control measurements of this vaccine have shown such high levels of
antibodies after three weeks that we can conclude that it has conferred
immunity against the new influenza.
Q: Will vaccination be registered?
A: All vaccinations with the pandemic vaccine will be recorded in the
national vaccination register. This will apply to vaccination of both adults
and children. Registration is important to keep an overview of who has been
vaccinated, how many doses the individual has been given and to follow up
and look after those groups prioritised for vaccination. Registration is
also important in order to follow up any side-effects of the vaccine.
[Publisert: 25.11.2009]
[Sist endret: 12.01.2010]
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