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Secretary for Food and Health York Chow (left) and Influenza Research Response Group member Yuen Kwok-yung speak at a press conference about Hong Kong's preparations for A (H1N1) influenza yesterday. Edmond Tang

HONG KONG: Those considered at highest risk to the A (H1N1) influenza will be able to receive free anti-flu vaccinations before November at the earliest. The Executive Council (ExCo) approved a HK$700 million procurement bill yesterday to fund the measure.

Despite the relatively mild effects of the virus during the present outbreak, Chief Executive Donald Tsang Yam-kuen warned the strain could turn virulent as it adapts and mutates during the autumn flu season. When that happens, he said, local transmission will become imminent and inevitable.

"The consequences could be dire, and we should try our best to avert this," he told reporters after meeting the ExCo.

Injections will be available for four high risk groups, including medical workers in private and public sectors, children from six months to six years old, senior citizens aged 65 and above, and patients suffering from chronic diseases. Pregnant women are also eligible. The program is to be offered on a voluntary base.

Secretary for Food and Health York Chow explained that among the groups listed are those most likely to experience the most severe complications if infected by human swine flu.

There are about two million people in the target groups. Each will be given two injections of vaccine.

The administration plans to order an additional one million doses for about 500,000 citizens who do not belong to any of the listed categories but who may receive the anti-flu vaccine for a fee.

Chow said he believed there is enough stock to provide for the non-high-risk group. "In fact our supply is more than other regions," he said.

He added that vaccinations for the entire population are unnecessary and that a universal vaccination program would also increase the risk of side effects such as the autoimmune condition Guillain-Barre Syndrome (GBS).

"Our principle is to protect the most vulnerable group first," added Thomas Tsang, controller of the Centre for Health Protection.

GBS, a response to foreign antigens, can affect the nervous system to varying degrees, from tingling sensations in the limbs, to breathing difficulties and paralysis.

Influenza Research Response Group spokesman Yuen Kwok-yung offered the reassurance that there are only about one to two GBS cases per million vaccinations. The mortality rate of human swine flu in the US was 0.1 percent. "If we do not buy vaccines, we will be in big trouble," Yuen added. "We will do it (vaccination program) in a safe way."

The government will prepare tenders for procurement after gathering facts from vaccine manufacturers.

Chow said efficacy and safety are the top criteria for choosing vaccines. Delivery is expected by early November, about three months ahead of the peak season for influenza.

Meanwhile, the government will spend HK$300 million to provide free pneumococcal and seasonal influenza vaccines for the elderly aged 65 and above. This amounts to about 880,000 people.

Chow explained the two vaccines complement the human swine flu vaccine in preventing seasonal viruses and reducing hospitalization and death among elderly patients who become infected.

The administration will seek funding approval of HK$1 billion from the finance committee of the Legislative Council next Friday.

Health panel chairman Joseph Lee Kok-long supported the plan and agreed that there is no pressing need to provide vaccination to non-high-risk group.

"Even if the injection is made free for the entire population, not everyone will be willing to accept it. There will be wastage," he said.

In view of the previous drug scandals, Lee cautioned that expiry dates on vaccine packages should be checked before use.

Infectious disease expert Lo Wing-lok also welcomed the program, yet cautioned against the selection of vaccines to minimize undesirable effect.

"There could be unknown risks associated in the vaccines so the government should choose those adapted to traditional manufacturing process, that means 'egg-based', to reduce uncertainty," he said.

To assure public safety, Lo suggested clinical trials be conducted before use.

Four new cases of A (H1N1) flu were confirmed yesterday, bringing up the total number of cases to 45. All of the cases so far were imported.

They came from the United States, Canada, Phuket and Melbourne. They are all listed in stable condition.

(HK Edition 06/10/2009 page1)