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Commentary


Low UK Vaccine Uptake Raises Pandemic Concerns
Recombinomics Commentary 20:05
December 24, 2010

366 are adults aged 16-65
51 are aged over 65
26 are young children under five
17 are school age children aged between five and 15
 
Vaccine uptake rates (%) under 65 in risk groups*   43.0 

The above data is from the December 24 update by the UK Department of Health.  The age breakdown of the 460 confirmed or suspected influenza cases in critical care beds is heavily weighted towards the 16-64 age group.  Almost 90% of cases are under 65 reflecting the dominance of pandemic H1N1 over seasonal H3N2 or influenza B, which largely target the over 65 age group and represents 90% of the seasonal flu deaths.
 
The report also cites a vaccine uptake of 43.0% in under 65 risk groups.  The uptake in those under 65 who are not in an at risk group is not given, but is almost certainly markedly lower.  This low vaccination rate likely contributes to the high fatality rate in previously healthy young adults, who now represent more than half of the deaths in that age group.

The increase in deaths in previously healthy young adults is under-reported in the media and largely discounted in agency announcements, which target at risk populations.  Consequently, vaccine uptake in this age group would have been low last season because the vaccine was largely unavailable when infections were highest in late 2009, and the uptake would be low in 2010 because of emphasis on vaccinations in at risk groups.

The current H1N1 in circulation is markedly more virulent than the strain circulating last season.  In the peak period in 2009, the maximum number of critical cases was 180.  This, year when the flu season is just beginning and overall levels of H1N1 are lower than last season, the critical care number has jumped to 460 on December 23 from 302 on December 20, and 182 on December 15.

This spike in critical cases has significantly limited ECMO treatments which threatens appropriate health care delivery, which leads to unnecessary deaths.

The failure to adequately vaccinate the UK population or acknowledge the high frequency of severe and fatal cases involving previously healthy young adults, continues to raise pandemic concerns.

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