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Cablegate: Portugal H1n1 Update - Jan 21

Published: Thu 21 Jan 2010 12:59 PM
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R 211259Z JAN 10
FM AMEMBASSY LISBON
TO RUEHC/SECSTATE WASHDC 8078
INFO RUEHZL/EUROPEAN POLITICAL COLLECTIVE
RUEHPD/AMCONSUL PONTA DELGADA 0662
RUEAUSA/DEPT OF HHS WASHDC
UNCLAS SECTION 01 OF 02 LISBON 000035
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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
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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
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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.
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