Healthcare workers should get swine flu vaccine first, WHO says

Doctors and nurses should be the first in line to receive a new vaccine against pandemic H1N1 influenza, but difficulties in growing the virus indicate that the first fully licensed vaccine may not be available until the end of the year, a World Health Organization spokeswoman said today.

The Strategic Advisory Group of Experts, the WHO's highest-level advisory group, met last week and concluded that healthcare workers should be immunized first "in order to maintain a functional health system as the pandemic evolves," Dr. Marie-Paule Kieny, director of the WHO's Initiative for Vaccine Research, said in a news conference from Geneva. "They put themselves at risk and need to remain in good health to care for pandemic influenza patients."

Kieny noted that "people will also continue to be ill with other diseases which need to be taken care of by healthcare professionals."

After that, it will be up to individual countries to decide their own priorities for vaccination, the group said, but those that should be considered include children, pregnant women, the obese and those with chronic health conditions, including respiratory diseases and asthma.

"If the first objective is to stop transmission as much as possible," the primary target should be children, "who are an amplifier of infection because they meet in groups," she said. If the primary objective is to reduce morbidity and mortality, then the latter groups should be first in line because they are the most likely to suffer serious illness requiring hospitalization.

The importance of vaccinating healthcare workers was demonstrated in June when the Centers for Disease Control and Prevention reported that at least 81 healthcare workers had suffered confirmed cases of the pandemic H1N1 virus, known colloquially as swine flu. And British health authorities reported today that Dr. Michael Day of Dunstable, Bedfordshire, died on Saturday from complications of the flu, becoming the first known physician to die in the pandemic.

Protecting healthcare workers is crucial not only because they are necessary to treat victims, but also because infected workers can readily transmit the virus to people hospitalized for other conditions and thus at high risk for complications from the virus.