PORTUGAL H1N1 UPDATE - JAN 21

UNCLAS SECTION 01 OF 02 LISBON 000035 SIPDIS HHS FOR CDC E.O. 12958: N/A TAGS: CASC AMED KFLU ETRD EAGR ECON EC PGOV PO SUBJECT: PORTUGAL H1N1 UPDATE - JAN 21 REF: 09 LISBON 625 09 LISBON 579 09 LISBON 558 LISBON 00000035 001.6 OF 002 SUMMARY -------------- ¶1. (SBU) The Portuguese Health Ministry has been slow to reach its goal of vaccinating 3 million Portuguese against the H1N1 virus, primarily due to lack of public confidence in the vaccine and media speculation surrounding the deaths of four newborn infants. While many adults, including health care professionals, have been reluctant to get vaccinated, the vaccination program for children under 12 years old has been a success, according to health officials. The first wave of the influenza has passed and H1N1 cases no longer dominate the headlines; nevertheless, the Health Ministry will continue its vaccination campaign in anticipation of a second wave this spring. End Summary. H1N1 VACCINATION CAMPAIGN BESET BY PUBLIC FEAR -------------- - ¶2. (U) Since last spring, when the first H1N1 case was confirmed, the Portuguese have grown accustomed to living with the constant threat of the H1N1 virus and news of additional confirmed cases. With the spread of the virus, public demand for the H1N1 vaccine grew. But when the long-awaited H1N1 vaccine finally became available in October, many expressed apprehension, perceiving it as riskier than the virus itself. The government goal to vaccinate 3 million Portuguese (out of a population of 10.7 million) has been hampered, mainly due to lack of public confidence in the vaccine, even among some health care professionals, which has resulted in lower-than-anticipated vaccinations. ¶3. (U) As of January 5, health officials estimated that a total of 320,000 people had been vaccinated, of whom 73,750 were children under 12 years old. (Note that some patients required two doses.) The Portuguese National Authority of Medicines and Health Products received 151 notifications of adverse reactions to the H1N1 vaccine, of which 62 were considered serious, but no fatalities. ¶4. (SBU) Deputy Director General of Health Graca Freitas told us that many Portuguese have not been vaccinated because of the reduced aggressiveness of the virus and consequently a perceived lower risk of being infected. Freitas attributed the failure of the vaccination program for pregnant women primarily to media speculation linking the H1N1 vaccine to the deaths of four newborn infants. She noted, however, the success of the vaccination program for children under 12 years old, and the increase in the number of vaccinated doctors. ¶5. (SBU) Freitas believes that a national public awareness campaign could increase public confidence but the vaccination program is ultimately dependent on timely delivery of vaccine doses by GlaxoSmithKline Pharmaceuticals, which has been unable to deliver at the desired pace due to limited production capacity. As of January, Portugal had received 470,000 doses but should have received 1 million of the 6 million doses ordered. According to Freitas, Portugal will not consider reducing its order or donating doses to needier countries, as other EU countries have done. END OF FIRST WAVE -------------- ¶6. (U) To date, there has been a total of 94 fatalities, most of them at-risk male patients averaging 47.1 years. The virus peaked during the last two weeks of November with 297 people hospitalized and 54,290 new cases. The number of cases has been decreasing since then, but December registered 47 fatalities, the highest number of the year. ¶7. (U) Minister of Health Ana Jorge declared on December 30 that the H1N1 peak had passed. Despite the reduction in influenza activity, the vaccination campaign will continue, aiming to vaccinate as many people as possible in the shortest amount of time, especially pregnant women, recent mothers, children under 12 years old, the chronically ill, young adults and convicts. A second H1N1 wave is expected before the end of spring. H1N1 COSTS 90 MILLION EUROS -------------- ¶8. (SBU) The H1N1 virus has been costly to the Portuguese National Health Service. According to Freitas, between June and December 2009, the Health Service spent more than 90 million euros, of which 45 million were used to pay for the 6 million doses of the H1N1 vaccine. The remainder was spent on overtime of health professionals, additional hospital staff, a dial-in help line, patient transportation, initial diagnosis of the virus, medicine, and equipment. COMMENT -------------- LISBON 00000035 002.6 OF 002 ¶9. (SBU) Portugal undertook great efforts to educate the public about the H1N1 pandemic upon initial outbreak and quickly adopted preventive measures. Its preparedness in early dissemination of information and diagnosis delayed spread of the virus. Portuguese health authorities, however, did not anticipate the high level of public apprehension over the vaccine, fueled by media speculation over the deaths of newborn infants and lack of clear information on the vaccine itself. The Health Ministry is now preparing for a second wave of the influenza with a renewed campaign to reach its goal of vaccinating 3 million people. With lessons learned from the first wave, a more effective awareness-raising campaign to assuage apprehension over the vaccine, and availability of additional vaccine doses, Portugal should be better positioned to meet the challenges of a second wave.