By JUDY SIEGEL-ITZKOVICH
Prime Minister Binyamin Netanyahu and senior Health Ministry officials on Monday put all their weight behind their national campaign for vaccination against the H1N1 flu virus.
Since April, the virus has reportedly led to the deaths of 39 Israelis, most of them already suffering from chronic illness, and infected nearly 5,000.
In an early-morning launch of the vaccination campaign by the four health funds at Tel Aviv's Sourasky Medical Center, Netanyahu said the aim "is that Israeli citizens enjoy the protection offered by the vaccine. It is the job of the government to allocate resources, and we decided to fund the vaccines and forgo other expenditures. Now it is the citizens' job to go and get vaccinated and observe rules of good hygiene. I believe [that way] we can get through this winter safely."
Netanyahu added that just as the state was concerned with national security, it also worried about ensuring the health security of the population. He advised residents not to rush in a panic to get vaccinated, but for those at highest risk to go first.
The government decided not to purchase the vaccines at the expense of expanding the health services basket for 2010, but to allocate an extra NIS 500 million for it. Extra manpower costs in the health funds such as overtime will probably increase the total cost.
The Prime Minister's Office denied The Jerusalem Post's report on Monday that the press conference was supposed to have been held at the Health Ministry in Jerusalem last week but had been delayed and its venue changed so Netanyahu could find time in his busy schedule to attend and speak.
The government has ordered enough doses for 7.3 million people from three foreign pharmaceutical companies - Novartis, GSK and Sanofi Pasteur. A survey conducted for the ministry a few months ago found that a quarter of those polled would refuse to be vaccinated. A more recent survey has not been conducted.
Deputy Health Minister Ya'acov Litzman declared Monday that "in the beginning, we were accused of not making sure there were enough doses of vaccine, and as time went along critics argued that we bought too many. In any case, we are used to absorbing criticism."
While the ministry has listed 39 casualties, it has stated in every case that a link between the H1N1 infection and the victim's death could not be proven. One case was a 19-year-old construction worker who had the flu, felt weak and fell to his death from a third-floor scaffolding.
Ministry director-general Dr. Eitan Hai-Am, who bared his arm to get the vaccine, said that the number of infections and deaths in various parts of the world, including the US and the UK, had increased in recent weeks and that more infected Israelis were going to hospital emergency rooms.
According to ministry public health chief Dr. Itamar Grotto, H1N1 flu is "four times more infectious" than the seasonal flu (although scientific reports show that H1N1 cases are usually milder).
"We don't know who is liable to be infected, but the vaccine is the most efficient way to prevent the disease," Grotto said. The vaccine is said to offer protection to 90% of those who are immunized.
Netanyahu did not get a vaccination at the press conference, and his spokesman Mark Regev explained that the prime minister would consult with his personal physician, as on other health matters.
Vaccines will be offered first to medical staffers in the hospitals and community clinics, who will get it at their workplaces. Then, starting Wednesday, children aged three through adults up to 65 who are at high risk of complications of H1N1 will be accepted at the health funds for free vaccination. These include people with chronic respiratory illness; chronic cardiovascular disease (not including hypertension); weak immune systems due to conditions such as cancer, HIV, organ transplantation, and receiving drugs to weaken their immune systems, including long-term treatment with steroids; chronic metabolic disorders such as diabetes; chronic kidney disease; thalassemia and other hemoglobin-deficiency disorders; and chronic neurological diseases such as multiple sclerosis, as well as the morbidly obese and children up to 18 who receive long-term aspirin therapy.
Because the 350,000 doses of vaccines imported so far contain a substance called adjuvant (a pharmacological or immunological agent that boosts the effect of vaccines), they are not suited to pregnant women, children aged six months to three years, or people over 65 with chronic illness. Pregnant women are at higher risk for complications of the flu.
Vaccines without adjuvant are due to arrive in December. The rest of the population is invited to go to health funds for shots starting at that time.
Shots are not recommended for infants younger than six months.
Although the prime minister did not mention the urgency of getting vaccinated against the ordinary seasonal flu, the Health Ministry has stressed that the H1N1 shot does not offer protection against that annual danger, which kills hundreds of people - mostly the elderly, those with weak immune systems and the chronically ill - and chokes hospital internal medicine departments during the colder months. For protection against the seasonal flu, people should get separate free vaccines at the health fund clinics, which have been giving it since the day after Rosh Hashana.
More information (in Hebrew) can be obtained from the ministry Web site at www.health.gov.il.
Clalit Health Services, which recently polled its general practitioners, found that three-quarters of them were willing to get H1N1 shots. The representative sample of 1,100 health fund community physicians exhibited the surprisingly high willingness to be vaccinated, even though doctors tend to be much less likely to get flu shots than the general public. The survey also found that two-thirds of the primary care doctors who did not get vaccinated against seasonal flu last year were planning to do so this year. Among the reasons given for this willingness were that the doctors feared getting infected by their patients or infecting them through close contact, or that the combination of seasonal and H1N1 flu would make infection more risky.
Meanwhile, the British Medical Journal (BMJ) said in an editorial on Monday that the effects of the H1N1 virus "have so far been less severe than many had feared, raising the question as to whether this infection has in fact reached pandemic proportions."
The author, Dr. Peter Gross of Hackensack University Medical Center in New Jersey, stated that "many more flu viruses could qualify as pandemic strains" as a result of recent changes to the World Health Organization (WHO) criteria for a flu pandemic.
Also Monday, Jerusalem's Alyn Hospital for the Rehabilitation of Physically Disabled Children reported that four patients/residents had been diagnosed in recent days with H1N1 flu, and all had recovered. Six more children were suspected of having the H1N1 flu, but only one was found positive for it. She was treated and put in isolation and is doing well. All children in need of vaccination, and most of the staff, have already received shots. One family chose to take their child home on vacation, but the child will return by the end of the week.
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