1. H1N1 Pandemic Facts and Fiction Professor Salman Rawaf MD PhD FRCP FFPHM Bahrain 18 th October 2009 WHO Centre, IC London

4. Epidemic may peak in late October Vaccination Starts on 21 st Oct 2-4 weeks Robust Immune Response

5. WHO Centre, IC London Today’s Issues: H1N1: Is it a serious Infection? Is it preventable? The Vaccine: Is it safe? H1N1 Flu Vaccine Vs Seasonal Flu Vaccine The Theory of Conspiracy Who should receive it and when? What is happening in Europe?

6. 215 Patients: H1N1 critically illness mostly affects young adults and is often fatal JAMA 12 October 2009

7. Conclusion: ”Our data suggest that severe disease & mortality in the current outbreak is concentrated in relatively healthy adolescents and adults between the age of 10 and 60 years, a pattern reminiscent of the W-shaped curve seen only during the 1918 H1N1 Pandemic” JAMA 12 October 2009

8. WHO Centre, IC London The Vaccine “The A H1N1 Vaccine is made exactly by the same manufacturers with the same processing, the same materials, as we make seasonal flu vaccine which have extraordinarily good safety record”.

9. WHO Centre, IC London The Vaccine "The risks associated with not getting the H1N1 vaccine are far greater than the sore arm that may result from getting the shot" "This virus has the potential to cause serious illness and death. Receiving a vaccination is an effective way to help fight the spread of the virus."

10. WHO Centre, IC London The Vaccine China: 39,000 injections 4 complications (headache, muscular cramp)

11. WHO Centre, IC London The Vaccine Pregnant Women: Risks is 6 folds Adjuvant vs Non-Adjuvant ?Nasal Spray Swine and Seasonal = 4 weeks interval

12. WHO Centre, IC London Seasonal Flu Effectiveness 60 Patients 120 Control = Effectiveness 73% (8 cases infected non died)

13. WHO Centre, IC London Seasonal Flu Effectiveness Conclusion: Seasonal flu vaccine boosts existing antibodies elicited by previous exposure

14. WHO Centre, IC London Source: DH Oct 2009 VACCINATION TIMETABLE Hospitals - Vaccination of at-risk patients and frontline health workers to start on 21 October and expected to take between two to three days GPs - Will start inviting patients to come and get the jab from 26 October, could take more than a month to get everyone in the priority groups vaccinated Others - Mental health trusts will also receive jabs from 26 October, while local health managers will coordinate the immunisation of health and social care staff working in the community UK Swine Flu Vaccination Time Table

15. The Mask: Surgical vs N95