Operation Keep Pigs from Flying

Prime Minister Benjamin Netanyahu on Monday kicked off the national swine flu immunization campaign, the first such in Israel. It is intended gradually to reach the entire population. The swine flu shots will be given for free.

Netanyahu called upon Israelis to get immunized in the order determined by the Health Ministry. In the first phase: medical personnel, the chronically ill over the age of 65 and parents and relatives of premature babies and infants in the high-risk group up to the age of six months, who cannot themselves be immunized.

At the launch press conference, Netanyahu said that "the goal is that Israel's citizens will enjoy the protection given by the immunization. It is the government's role to budget resources, and we have decided to fund the injections and give up other expenditures. Now it is the citizen's role to get immunized and observe the rules of hygiene. I believe we will get through this winter successfully.

The Health Ministry says people in a high-risk group who have been diagnosed in a lab test as definitely ill with swine flu need no immunization - they are considered immunized.

On Monday, immunizations began at general hospitals around the country, and today the distribution will be expanded to the four health maintenance organizations alongside the seasonal flu campaign that began in October.

Netanyahu held dozens of meetings before purchasing the swine flu immunizations and also led the government in an across-the-board budget cut of NIS 2 billion, about a quarter of which has been allocated to cover the costs of the seasonal and swine flu immunizations. Netanyahu said he worked his personal connections with Novartis CEO Daniel Vasella and phoned him personally to accelerate the delivery of the company's vaccine to Israel.

"Our aim is to purchase immunizations as quickly as possible for the entire population," said Netanyahu. "We have worked with a variety of manufacturers."

A gradual process

The Health Ministry estimates there are about 1 million Israelis in the group now being called upon to get the immunization. Thus far, Israel has taken delivery of only 300,000 doses of the vaccine, which go through testing procedures at the ministry's standards institute and are repackaged, but the experts do not expect long queues. In the United States long lines stretched out from clinics during the first days of the immunization campaign.

Dr. Eitan Hai-Am, the ministry's director general, says: "The working assumption is that not everyone will show up for the shots on a single day but rather people will come gradually, and we have obtained the necessary stock of immunizations."

In parallel, the Health Ministry has initiated a survey to assess the side effects of the immunizations. As of now, the hospitals and HMOs are dispensing the Focetria vaccine manufactured by Swiss Novartis and the Pandemrix vaccine made by the British GSK company. "There is no difference between the immunizations," notes Prof. Dan Engelhard, who heads the epidemic team that advises the ministry.

Within two weeks, says the ministry, the second stage of the campaign will begin. Pregnant women and chronically ill children between the ages of six months and three years will be called upon to get the immunization. This will happen after the arrival of a shipment of vaccine from the French company Sanofi-Pasteur, without the adjuvant present in the two vaccines now being administered. The adjuvant, an additive that boosts the efficacy of a dose, has been approved for use in the immunizations in Europe but has not been approved by the U.S. Food and Drug Administration in the swine flu vaccines marketed in the United States. Engelhard made it clear on Monday that "the FDA has not approved the vaccine with the adjuvant because it had not been asked to do so. We see no problem with this vaccine."

The Health Ministry estimate is that by December 31, some 2.3 million doses of vaccine will have arrived in Israel and during the course of December the national immunization campaign will be expanded - all Israelis will be called upon to be immunized against swine flu.

At Monday's press conference, Deputy Health Minister Yaakov Litzman hastened to make it clear that the swine flu immunization campaign had not been delayed for a few days because of public relations considerations, and that immunizations had been given in recent days as needed.

On Monday Haaretz reported an outbreak of swine flu at the Alyn Pediatric and Adolescent Rehabilitation Center in Jerusalem, following which the ministry decided to go ahead and immunize about 200 hospitalized children and teens as well as the medical staff there on Sunday, before the official launch.

In the coming days, the Health Ministry's swine flu and seasonal flu immunization policy will be discussed in the Knesset Health Committee, in the wake of the Haaretz report that parents here are not immunizing their children against seasonal flu.