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H1N1 WHO update and vaccines

The H1N1 vaccine on a table before use at the Mollen Immunization Clinics set up at Bashas grocery store Saturday, Oct. 24, 2009, in Phoenix. (AP Photo/Ross D. Franklin)

According to the latest report by WHO (the World Health Organization), the H1N1 pandemic continues to spread and the virus has been confirmed in Mongolia, Rwanda, Sao Tome, and Principe. New fatalities have been reported in Iceland, Sudan, Trinidad, and Tobago; these fatalities marked the first loss of life to the H1N1 virus in these regions.

As many regions have stopped submitting reports of verified H1N1 cases to authorities, the current estimates, based upon submitted data are 414,000 confirmed laboratory cases and 5,000 deaths worldwide. It’s important to realize that mild cases of H1N1 often go unverified and unreported, making the actual cases of H1N1 worldwide much higher than the 414,000 figure.

The United States reports higher than average cases of flu like illness or ILI (Influenza Like Illness) and the past week saw a rise in respiratory illness, associated with the H1N1 virus. Joining the United States is Canada who also saw an increase in H1N1 cases.

For those in the United States, the FDA approved four H1N1 vaccines last month. The H1N1 vaccine is referred to as monovalent, due to the fact that it contains one antigen. As the vaccines were recently made available, it has become apparent that there are fewer vaccines for high risk groups than were previously anticipated. It is expected that more vaccines will be available in November.

The four H1N1 vaccines are made by CSL Limited, MedImmune LLC, Novartis Vaccines and Diagnostics Limited, and Sanofi Pasteur Inc. The four vaccines were approved on September 15, 2009 and vary by manufacturer, however, each vaccine was produced using the same methods. The vaccines consist of live and inactivated influenza A and are derived from the H1N1 A A/California/7/2009(H1N1)pdm strain.

Here is a chart that lists the type of vaccine, its manufacturer, and how the vaccine is administered.  The chart is from the CDC here.
 

TABLE. Influenza A (H1N1) 2009 monovalent vaccines approved for use in the United States, October 6, 2009
Vaccine type	Manufacturer	Presentation	Mercury content (μg Hg/0.5 mL dose)	Age group	No. of doses	Route
Inactivated*	Sanofi Pasteur	0.25 mL prefilled syringe	0	6--35 mos	2†	Intramuscular§
		0.5 mL prefilled syringe	0	≥36 mos	1 or 2†	Intramuscular
		5.0 mL multidose vial	25.0	≥6 mos	1 or 2†	Intramuscular
Inactivated*	Novartis Vaccines and Diagnostics Limited	5.0 mL multidose vial	25.0	≥4 yrs	1 or 2†	Intramuscular
		0.5 mL pre-filled syringe	<1.0	≥4 yrs	1 or 2†	Intramuscular
Inactivated*	CSL Limited	0.5 mL prefilled syringe	0	≥18 yrs	1	Intramuscular
		5.0 mL multidose vial	24.5	≥18 yrs	1	Intramuscular
LAIV¶	MedImmune LLC	0.2--mL sprayer**	0	2--49 yrs	1 or 2††	Intranasal

Sources: WHO, CDC

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