Governments in Western Europe are selling off surplus stocks of the H1N1 flu vaccine and cancelling orders for additional supplies amid low public demand. But the World Health Organisation is warning that flu transmission is still on the rise in Central and Eastern Europe.
France is looking to sell large volumes of surplus vaccine after ordering millions more doses than it needed. Germany hopes to row back on a large order of drugs placed during the early phase of the pandemic, while Spain wants drug companies to buy back its excess vaccine stocks.
A similar picture is emerging in the Netherlands and the UK, where demand has fallen well short of expectations, partly due to the relatively mild impact of the virus and partly due to public unease over mass vaccination.
Switzerland and Canada have also acknowledged that they have more vaccine available than necessary.
Experts say the winter peak has not brought the much-feared wave of infections and the response to national vaccination programmes has been sluggish.
Critics say authorities ‘overreacted’
News that health ministers had vastly overestimated the demand for vaccines has prompted accusations that governments overreacted to the threat posed by the novel flu virus.
The French Health Ministry said it had originally bought 94 million individual vaccinations against the H1N1 virus from Sanofi-Pasteur, GlaxoSmithKline (GSK), Novartis and Baxter International at a cost of €870 million, on the basis that it would need to provide two doses of the vaccine for most of its population.
However, it emerged during the autumn that a single jab would be sufficient to provide immunity, leaving France with a massive oversupply of vaccines.
Some five million people in France have so far been vaccinated against H1N1, health officials say. The flu virus has killed an estimated 198 people on mainland France, according to data released on 29 December, but doctors have said new infections have fallen sharply in recent weeks.
Around 300,000 shots have already been sold by France to Qatar, while a further two million could be sold to Egypt later this month.
“We are in contact with other countries, notably Ukraine and Mexico,” the health ministry in Paris said in a statement, without providing any financial details of the deal.
Vaccine oversupply creates buyer’s market
When the first batch of vaccines arrived in Germany in November, news media reported that patients had to be turned away from clinics due to limited supplies.
The position had changed dramatically by the end of last month, however, when Germany announced that it wanted to sell millions of doses of vaccine, even though its order of 50 million vaccines will not be delivered in full until March.
Afghanistan and Central European countries are among those interested in snapping up the excess supplies – if the price is right.
Last week Bloomberg reported that Germany hoped to cancel 50% of the swine flu shots it ordered from GSK. The order of 50 million doses was based on the expectation that two shots per person would be required, which proved excessive, Deputy Health Minister Hartmut Schubert said. Germany will start negotiations with suppliers this week.
Spain is seeking to return unused vaccines to the manufacturers due to slow uptake. The Spanish government says its contracts with GSK, Novartis and Sanofi-Pasteur include clauses that allow it to return surplus vaccines if they prove to be unnecessary.
Ireland too has renegotiated a deal with Baxter pharmaceuticals in a bid to save up to €35 million. The Irish government had originally ordered 7.7 million doses of vaccine – enough to give double doses to each of the population. This order was split between GSK and Baxter at a total cost of €88 million.
This means Ireland will not take delivery of 3.7 million doses of Baxter’s Celvapan vaccine under a new deal which came into effect at the end of 2009.
The Netherlands has also announced plans to sell 19 million of the 34 million doses that it ordered now that single doses are considered to be sufficient. In Britain, a health ministry spokesman told press agency AFP on Sunday (3 January) that sales of the vaccine were also being considered.
Switzerland, whose total population is 7.7 million, ordered 13 million doses of the vaccine from GlaxoSmithKline and Novartis, while Canada is currently debating whether to sell excess stocks or to keep millions of doses in reserve. Canada expects to have around 20 million unused doses in April unless demand picks up significantly.
Virus spreading in parts of Europe
While the number of new cases of flu appears to have peaked in several Western European countries, neighbouring nations in Central and Eastern Europe are still grappling with the worst of the pandemic.
The most active areas of flu transmission include Greece, Poland, Bulgaria, Serbia, Ukraine and the Urals region of the Russian Federation, the WHO said in its weekly pandemic update.
According to the European Centre for Disease Prevention and Control (ECDC), just over 1,700 fatal cases of H1N1 influenza had been recorded in the EU and European Free Trade Association (EFTA) countries to date.
The European Medicines Agency (EMEA) said that while most deaths have been in Western Europe, there are increasing numbers of deaths being reported from Central and Eastern Europe.
“However, because of lack of laboratory confirmation and underreporting, among other factors, this is likely to be a gross underestimation of the true number of fatalities associated with the pandemic,” it said.
At least 28 million people – including at least 218,000 pregnant women – have been vaccinated to date in Europe with one of the three centrally-authorised vaccines. The most frequent adverse reactions that have been reported are not serious, according to the EMEA.
(EURACTIV with Reuters.)