Vaccination against the swine flu virus for primary school students has begun while the vaccine for pregnant women is due soon, reports Reem Leila The ministries of health and education started vaccinating school students against the swine flu virus on 3 January in six governorates. The campaign started with schools in Cairo, Helwan, Giza, 6 October, Alexandria and Qalioubiya governorates which had the highest infection rate among primary students. The first phase of student vaccinations will end on 13 January, to be followed by another phase for preparatory and secondary schools. The H1N1 vaccine for pregnant women is due to arrive in Egypt within three weeks. Pregnant women have accounted for 18 per cent of the total number of swine flu deaths in the country. Primary school students constitute more than 30 per cent of the country's swine flu infections. The only preventive measure against the virus, according to health officials, is the vaccine which they say is completely safe. The first phase of vaccinating school students targets 2.1 million primary school students in the six governorates. Abdel-Rahman Shahin, official spokesman of the Ministry of Health, said there were currently 800,000 doses of the vaccine, enough to immunise 1.6 million students. "Each student takes five microgrammes of the H1N1 vaccine, while adults will take 10 microgrammes," Shahin explained. An extra 1.6 million doses will arrive in the country next week, 250,000 doses of which will be allocated for the rest of the primary school students. The remaining vaccines will go to pregnant women. Only 10 per cent of them were vaccinated on the first day of the campaign. Shahin expects that this percentage will increase by the seventh day. "The vaccine is totally safe. Rumours being circulated by some media channels, newspapers and doctors about health dangers which might be caused by the vaccine are void from truth," Shahin confirmed. All school students are to be vaccinated for free. Parents must sign the consent form not to take responsibility for possible side effects of the vaccine, but to ensure that the child has no medical history or a condition that might cause him to develop an allergy from the vaccine. Twenty-five doctors from the Ministry of Health are supervising the medical teams working on the campaign. Raba El-Moqadem, a housewife, said her eight-year- old son Ayman panicked when his teacher handed him the form in which his parents should sign whether they agree he be given the stab. "Mum, please, I don't want to take the shot. I don't want to be paralysed," El-Moqadem said, quoting her son. "Definitely neither I nor my husband or any of my two schoolchildren will take the vaccine. Some doctors are saying it is very risky, while others are saying the contrary. I will not take the risk." Housewife Sally Walid, 34 and five months pregnant, said she wanted to take the vaccine to protect herself. "I do not want to die. Most pregnant women who got the virus died. But my gynaecologist advised me not to take it," Walid said. "My doctor said the vaccine has not been thoroughly tested," Walid added. On the other hand, Dalia Hegazi, a university professor, believes that the vaccine is safe and will give it to her two kids. "I waited until the pilgrims returned from the hajj and saw that they all returned safely without any side effects from the vaccine. Though I was a bit hesitant about the vaccine because it was not tried enough, I know now it is safe after I surfed the Internet and saw that it is 100 per cent safe." Thimerosal, a mercury-containing organic compound, is among the components of the current H1N1 vaccine. Since the 1930s, it has been widely used as a preservative in a number of biological and drug products, including many vaccines, to help prevent potentially life threatening contamination with harmful microbes. Visibly frustrated by the circulation of what he described as false and insufficient information about the vaccine, Shahin said the amount of Thimerosal used in one can of tuna is 20 fold more than the amount used in a vaccine vile sufficient for 10 people. Thimerosal is also used in all canned food to preserve it for long periods. Zuheir Halag, regional counsellor to the World Health Organisation in Cairo, pointed out that Thimerosal is a preservative element used to prevent the contamination of the vile which is valid for only 24 hours after being opened. At the same time the ministry will refrain from vaccinating children less than six years old because in rare cases one or two children in one million have suffered from autism. "Though the percentage is very small, we cannot risk the health of our children," Shahin said. Within three weeks, the Health Ministry will set up mobile units located in Egypt's hospitals and health centres to vaccinate high risk citizens. For people with chronic health problems, the ministry will establish 32 fixed units in the six governorates. "Patients with chronic illnesses will be requested to submit any document proving their illness before taking the shot," Shahin said. Among the country's total amount of five million doses, the ministry will allocate only 50,000 doses to be distributed to the country's 29 governorates. This amount will be dedicated for citizens who do not suffer any health problem. The single dose will be sold for LE80. The ministry has also set the price of the imported treatment drug Tamiflu at LE150 and announced in a press release that it will be available in pharmacies within the next three weeks. It will be sold only upon a doctor's prescription. The alternative, locally- packed Taminil which, Shahin says, is equally effective, will be sold for LE70 within the same time frame. The Health Ministry will import special doses of H1N1 vaccine for pregnant women. "These doses are adjuvant free. Though they provide less immunity against the virus by nearly 15 per cent when compared to the doses with adjuvant which provide 98 per cent immunity against the virus, they are safer for pregnant women," Shahin stated. Halag refuted reported claims of 12 people in the world becoming paralysed after being vaccinated, or what is known as the Guillain-Barré Syndrome (GBS). According to WHO records, GBS is a rare disorder in which a person's own immune system damages the nerve cells, causing muscle weakness and sometimes paralysis. "This happens to about one to two cases of GBS per 100,000 people. GBS can cause symptoms that last for a few weeks. Most people recover fully from it," Halag confirmed. According to the WHO, many more people are expected to become sick with swine flu in January and the death toll in Egypt is projected to rise to 350. Though the worst of the swine flu outbreak is over in the United States, Canada, Britain and some other countries in the northern hemisphere, there is still intensive flu activity in Egypt, India and elsewhere. According to WHO reports, the H1N1 vaccine played a significant role in controlling the spread of the virus. The WHO has warned that the virus could have a devastating impact in countries across Africa which has large numbers of people with health problems. Halag said the side effects of the vaccine are "very mild", limited to headache, fever, slight pain in the muscles, dull pain and inflammation where the shot was taken. Drug makers and countries have promised to donate nearly 190 million doses of vaccines to the WHO, up from 150 million doses two months ago. Since flu viruses constantly evolve, experts fear swine flu could mutate into a more dangerous form. Last month, the WHO warned that with fresh bird flu cases reported in poultry in Egypt, Indonesia, Thailand and Vietnam, the risk of bird flu and H1N1 viruses mixing is heightened. Scientists fear that bird flu, which remains difficult for people to catch, might combine with the current swine flu virus which spreads easily among people. Ahmed Abdel-Latif, WHO representative in Egypt pointed out that taking the H1N1 vaccine is highly recommended for everyone except those who are allergic to eggs, women less than five months pregnant and those who are in their ninth month. "Women who are pregnant in their last month usually have a weak immunity system and anemia. Therefore, it is not very safe to take the vaccine, especially if it is produced from the attenuated H1N1 virus," Abdel-Latif stated. According to WHO reports, although countries are now better prepared to cope with a global disease outbreak than a few years ago, the swine flu epidemic has shown that there remains numerous gaps in the health systems of many countries. The Cabinet's Information and Decision Support Centre (IDSC) announced that the number of confirmed cases of swine flu in Egypt has passed 13,000 with 4,653 cases among school students (mostly in Cairo, Helwan and Giza) and more than 2,200 cases among primary school students as well as 529 university students. The death toll is 159, while the number of those cured is 11,828 -- 97.7 per cent of total infected cases.
