F(L)UTILE

Prevention is better than cure,they say. But shortage of swine flu vaccines is making it a tough advice tofollow. Flu season has hit Gujarat hard, with experts predicting it to growworse. As death toll rises to 108 in the state this season, shortage ofvaccines is stoking people's fears. "I recently learned that we could vaccinate ourselves against swine flu. I visited four big pharmacies and several small ones across the city but was unable to find anyone stocking the vaccine.

Why is it not available to the common man?" asks Viren Patel, a 34-year-old Bodakdev resident working with a private firm. Monica Raval, a 28-year-old homemaker from Prahladnagar, says, "There are two types of vaccines available: shots and nasal spray. I am pregnant and cannot take the nasal spray which is unsafe for children. I have put my entire family on vaccine watch. They have been to many pharmacies across the city but were unable to find even one that stocked flu shots.'

INCREASED DEMAND

Major medical stores like Planet Health, Apollo Pharmacy, Hardik Medical Stores, and SAL Institute of Pharmacy confirmed reports of shortage. "We received 500 inquiries for vaccines in the past 40 days. I exhausted my stock of vaccines by the beginning of February," said vaccinologist Hemant Patel. An employee of Planet Health, refusing to be named, said, "People have been asking us for the vaccine but we have not received any stock. When we forwarded the queries to our higher-ups we were told that stock has been affected due to low production."

A supplier of swine flu from Sanofi Pasteur — a multinational pharmaceutical company headquartered in Paris — said on request of anonymity that there no supply of Vaxigrip vaccine. "We usually have these vaccines on hand. But increased demand has led to a crisis. Pharmaceutical firms were not ready for such a spike, sparking off shortage," the supplier said. Other vaccines being sold include Agripal by Chiron Panacea, Fluarix by GSK Pharma, Influgen by Lupin Laboratories, and Influvac by Solva Pharma. These come in the form of injections which usually cost around Rs 600-Rs 700 per shot. Serum Institute of India in Pune has also introduced Nasovac, a vaccine that can be administered in the form of a nasal spray.

HIGH-RISK PATIENTS

"People suffering from diabetes, children below 5 years and the elderly above 60 years, post-transplant patients, chronic kidney patients, pregnant and post-partum women have been identified as high risk. They are vulnerable to H1N1 virus. Patients who have low immunity due to HIV, tuberculosis and cancer as well as those with respiratory problems should also take this vaccine as a precautionary measure. This should be done in September or October when the flu season begins. Each year, vaccines are modified according to change in strain of the virus," said Dr Vishal Mehta, a consultant physician.

"It is not a universal vaccine so doctors do not recommend it for everyone," he added. Dr Prasad Kulkarni, medical director at Serum Institute of India, said, "People should be made more aware about the flu. They should take the vaccine during monsoon season. Also, swine flu virus changes its composition every year depending on the climate. So there is no permanent vaccine, only sea-sonal ones. These need to be taken every year as prevention is better than cure." Medical experts believe awareness has increased which has led to four-fold surge in demand for the vaccine compared to the number predicted by the government. "Every year, the government makes an estimate of the doses that is likely to be required that entire year.

No one expected swine flu to reach epidemic proportions this time. The demand for vaccine crossed the estimated mark in just three months. That's why the city is reeling under shortage," experts explained. Confirming the shortage, Dr Patel said, "Vaccine is effective in controlling a flu epidemic. Shortage means more people are vulnerable to catching this deadly virus." Vijay Sharma, a 40-year-old professional who is also keeping an eye out for the vaccines, said, "Since people are dying due to swine flu in large numbers, there is a scare. The government should intensify its efforts to deal with the situation. It is high time they did something about the supply considering that the first swine flu death was reported early January and the death toll has shot up since."

SUPPLY LOW

In such a situation, indigenous swine flu vaccine, which has limited demand, can fill up the gap. "Dependence on indigenous vaccines will certainly help in closing the gap between demand and supply," said Dr Kulkarni. In 2010, Zydus Cadila had captured international attention when they created the first indigenous swine flu vaccine named VaxiFlu-S. It has been approved by the Drug Controller General. But sadly, even indigenous vaccines are not available in the market. In reply to an email sent by Mirror, a Zydus spokesperson said, "Not many cases were reported since 2010 and there has been lack of demand. We do have buffer stock for emergency situations, and can scale up production if required.

If the situation demands, we can ramp up production within a short span of time." Acknowledging there is a shortage, Health Commissioner J P Gupta denied knowledge of why this was so. "It is usually not mass-produced due to low demand. International companies supply vaccines. We have not stopped Indian firms from manufacturing these drugs. I do not know the reason for shortage in the market," he said. While hospitals like Apollo, HCG and SAL have admitted to being hit by the shortage, Civil Hospital denied there is a deficit. Medical Superintendent M M Prabhakar said, "We have the necessary supply of vaccines. There is no crisis at all."

INDIGENOUS VACCINE

VAXIFLU-S

Firm: Zydus Cadila, Ahmedabad

Form: Injection

Eligibility: 18 years and above

Effectiveness: 1 year

NASOVAC

Firm: Serum Institute of India,

Pune

Form: intranasal spray

Eligibility: Above 2 years of age

Effectiveness: 1 year

PANDYFLU

Firm: Panacea Biotech, Delhi

Form: Injection

Eligibility: Above 3 years of age

Effectiveness: 1 year