FACTBOX-Asia prepares for 2nd wave of swine flu infections

Thu Oct 8, 2009 5:43am EDT

HONG KONG, Oct 8 (Reuters) - Health experts in Asia have urged people against underestimating an expected second wave of infections from the pandemic H1N1 swine flu, even though the virus appears to have been mild for most people so far.

The second wave is expected to occur during the winter months in temperate countries in the northern hemisphere and around the end of the year for tropical countries.

"Flu is not a trivial disease, it is not always mild, children can die. When that happens, people get agitated but that is no surprise, flu can turn severe and people get hospitalised," said microbiologist Malik Peiris at the University of Hong Kong.

"People who are at risk are those with underlying chronic disease, pregnant ... we must explain this to the public, that if you are in these high risk groups, it is important to be protected (vaccinated) from the virus," Peiris said.

Here's what the region is doing about H1N1 vaccination:

AUSTRALIA

Australia rolled out a nationwide vaccination drive for H1N1 influenza in late September. Some 5.5 million doses of vaccine have been delivered across the country, enough for 30 percent of the population, and two million doses each month will be made available until January.

The campaign is Australia's biggest mass vaccination and is estimated to cost over A$100 million ($87.95 million). Australia ordered 21 million doses of the flu vaccine from pharmaceutical company CSL Ltd (CSL.AX: Quote, Profile, Research, Stock Buzz).

Vaccinations will start with those most at risk, including health care workers, pregnant women and the chronically ill.

CHINA

China began a mass vaccination programme on September 21, starting with 100,000 students in Beijing.

Its plan is to cover public service providers and vulnerable groups, such as healthcare workers and pregnant women, in densely populated cities and travel hubs such as Beijing, Shanghai and the Pearl River Delta.

The government placed orders with local vaccine makers Hualan Biological Engineering Inc. (002007.SZ: Quote, Profile, Research, Stock Buzz) and Sinovac Biotech Ltd (SVA.A: Quote, Profile, Research, Stock Buzz) and expects 65 million doses to be delivered by year-end -- meaning more than 60 million people would be covered.

HONG KONG

The government has issued a tender to buy three million doses but no decision has been made. Hong Kong's health minister expects the second wave of the pandemic to arrive in January or February, the city's next seasonal flu peak.

However, it is not too worried about vaccine supply because China has pledged to supply Hong Kong with Chinese vaccines in case needed, even though China wouldn't even have enough for its own citizens.

Hong Kong, which returned to Chinese rule in 1997, set aside HK$700 million ($89.7 million) to purchase the vaccines.

Two million doses would be reserved for people in four high-risk groups: health workers, children between 6 months and 6 years of age, people over 65 and those with underlying medical conditions, such as obesity, respiratory illnesses and diabetes. An additional one million doses would be reserved for those who want to pay for them themselves.

INDIA

The Indian government has given three companies approval to produce a H1N1 vaccine, said V.M. Katoch, director general of the Indian Council of Medical Research. They are Bharat Biotech, Serum Institute of India and Panacea Biotech (PNCA.BO: Quote, Profile, Research, Stock Buzz).

The vaccines are being tested on animals and will be tested on humans by the end of 2009. The companies aim to put the vaccine on the market by April 2010, Katoch said.

The federal government wants to test vaccines imported from abroad from four pharmaceutical companies by November.

Katoch did not give a figure on how much the government has spent on vaccines or how many doses would be produced. He said India's four million medical staff and security forces would get priority. India has stockpiled 40 million to 50 million doses of Tamiflu.

JAPAN

Japan will buy $1.26 billion worth of vaccines from GlaxoSmithKline (GSK.L: Quote, Profile, Research, Stock Buzz) (GSK) and Novartis (NOVN.VX: Quote, Profile, Research, Stock Buzz) for 50 million people. It will also secure doses from four local vaccine makers for another 27 million citizens.

It hopes to get 77 million people, 60 percent of its population, vaccinated by end March.

Mass immunisation will begin on Oct. 19 with medical staff who treat flu patients, in November with pregnant women and people with underlying chronic illnesses, and in December with small children.

Parents of babies under a year old, students in junior and high school and above 4th grade in elementary school, and the elderly will be vaccinated from January.

Japanese are generally keen to get vaccinated but worry about possible side effects.

SINGAPORE

The government has secured one million doses from GSK and delivery is expected by end 2009. However, large scale vaccination will only begin after the government is "satisfied with the safety and efficacy reviews of this vaccine", according to the country's Ministry of Health.

About 20 percent of the vaccine will be reserved for essential workers and the rest go to the public on a voluntary basis.

The vaccines will be made available to family doctors at cost price. The cost of the H1N1 vaccine is comparable to the cost of seasonal influenza vaccines, the ministry added.

The ministry also has a deal with Australia's CSL to supply more vaccines when they are ready and when necessary.

SOUTH KOREA

Mass vaccination of about 13.7 million people, or 27 percent of the population, is expected to begin in mid-November. It will cover all medical staff, pregnant women, students and soldiers and is expected to end in February 2010.

Local vaccine maker Green Cross (006280.KS: Quote, Profile, Research, Stock Buzz) will supply 12 million doses in total -- seven million within the year and five million in February. Green Cross has agreed to provide 1.1 million doses for 9.1 billion won ($7.8 million).

The country is also buying three million doses from GSK and negotiations are underway to buy the doses at 14,000 won each.

There were concerns earlier that the government might be charging more than the original cost for the vaccines, but the ministry has since explained that the local supplier set initial prices much higher than planned.

THAILAND

Thailand hopes to take delivery of the first batch of vaccines by year-end. They would be for one percent of its population: healthcare workers, pregnant women, people with respiratory illnesses and other high risk groups.

It is negotiating with two or three companies, which will provide the vaccine at about 5 euros (($7.39) per dose.

Witit Akaravejakun, managing director of the Thai government's pharmaceutical organisation, said the delay was due to negotiations on costs, number of doses required for each person and concerns about side effects.

It is also waiting for results of domestic trials.

"We want to wait for the result of our research. If we can produce our own vaccine domestically, it will save us a lot of our budget," Akaravejakun said.

($1=1,166.8 won) (Reporting by Tan Ee Lyn; Additional reporting by Nopporn Wong-Anan in SINGAPORE, Matthias Williams in NEW DELHI, Christine Kim in SEOUL, Yoko Nishikawa in TOKYO, Fayen Wong in PERTH, Martin Petty in BANGKOK, and BEIJING bureau; Editing by Jerry Norton)