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Swedish-English translation
Mass Vaccination saved six lives
Sweden vaccinated 60 percent of the population against swine flu, Germany only eighth Despite the reports of both countries the same mortality. The costly mass vaccination of over five million people in Sweden is expected to only have saved six lives, according to Svenska Dagbladet's review.
Two years after swine flu range is most important and sensitive issues surrounding the Swedish vaccine campaign did not receive their responses. And they are not easy to find. Few or none of the managers want to give a clear message:
What did it mean that Sweden vaccinated most and best in the world - 60 percent of the population? Did we are better than those that only vaccinated high-risk groups, or even fewer?
-The most important thing we must do now is to compare the outcome of different vaccination strategies in different countries, for instance explained Goran Stiernstedt, Medical Director at SKL (Swedish Association) when pandemic effort was called off.
He, like other put his greatest hopes on the EU's disease control agency ECDC is located in Stockholm, set up by bird flu, with the stated task is to engage in precisely the pandemic in the EU.
When swine flu appeared in 2009, it turned out that the EU countries came to run a very diverse vaccine policy. From no vaccinations at all to 60 percent in Sweden. At the top were four Nordic countries by 45 percent or more. Sweden, Finland, Iceland and Norway had a stated mission to mass vaccinate the entire population.
The average number of vaccinees in all EU countries was significantly lower. Several large countries such as Germany, France and Italy were below 10 percent. The causes were an explicit focus on risk groups and a lack of interest from people to set up.
Most attention was perhaps Poland. There, angry country's then minister of health infection doctor Ewa Kopacz to, primarily over vaccine companies' strict requirements, and decided not to buy any vaccine at all. She also rated swine flu milder than regular flu.
-I took the responsibility of non-vaccination as a politician and as a doctor, she explained at a meeting of the EU Parliament.
-ECDC can provide excellent basis for comparison and thus useful knowledge for the next pandemic, thought George Stiernstedt and others.
But is not that simple. ECDC has still not published a single report on this and can not tell when someone is coming.
To get an idea of vaccination effects needed figures on the number of deaths in each country. They exist because they would be reported continuously during the pandemic to ECDC and also to WHO.
Today, they are not quite easy to find, but the figures are, and in constant numbers, and divided the number of cases per 100,000 inhabitants (a common practice to compare countries with different sized populations).
The most remarkable feature is the strong similarity between the two countries despite the difference in vaccination. No country stands out very much. Sweden has the same number, 0.31 per 100,000, with our 60 percent vaccinated by Germany with 8 percent. Poland not vaccinated at all, a mortality rate of 0.47, also in the bottom of the table and not so far from Sweden.
How should now be explained? Those responsible would be nothing to say:
-ECDC is still investigating and we have no answers yet, says Johan Giesecke, Head of Research at ECDC.
He says he wants to get issues on the email. Svenska Dagbladet asks in writing to know the differences or lack of differences in mortality rates can be explained. We promised to answer - ECDC has time and do not forget it. Still, after two weeks, we have not heard anything from the ECDC.
Anders Tegnell on the National Board for its part, points out that Sweden is doing its own investigation and it is not yet clear.
-Sure, says Lars-Olof Kallings, AIDS expert and former director general of the then-SMI, one explanation could be that the disease was so mild that vaccination is less important.
In one of the emails from 10 October 2010 as Svenska Dagbladet has called out and examined from SMI Communications Aase Stone to senior managers discussed pandemic-up for an interview with TV4.
She suggests: "any message that may be useful to develop: the best strategy for Sweden was to vaccinate the entire population. We saved the most lives that way. Well that was the strategy we have chosen prior to the investigations indicated that it was the most effective management method, we know little about the lives saved. "
She also points out that "Sweden has the lowest number of deaths compared with Norway and Finland" and writes: "unnecessary comparison with Poland, had less than ours, difficult comparison."
The other important question is how many lives were saved by the giant operation when more than five million Swedes were vaccinated. Nor it is easy to answer.
-Do not say like that thirty, wondering Maria Larsson, who was then public health minister, responsible for mass vaccination gently.
-Annika Linde told that 50-100 would die without vaccination. 30 died. Then we might have saved between 20 and 70, said John Carlson at the Infectious Diseases Institute.
Now it has actually made calculations on this, such as the official government evaluation of the Swedish pandemic campaign.
-We found that six deaths were avoided with mass vaccination program, says Lisa Brouwers for Disease Control.
Thus rescued six people.
Now a new study to see if maybe some vaccinees were protected during the regular outbreaks of seasonal influenza in 2010 and 2011.
Pandemic campaign was one of the most expensive operations in the Swedish health care ever. When deciding on new drugs or treatments should be introduced in health care is expected such a thing as QALYs (quality adjusted life year), that is the cost related to recovered health.
A QALY at 500000-600000 crowns represents a threshold, above this level is considered the operation not be economically efficient, reasonably priced in other words.
Mass Vaccine ring QALY was 1.3 million, double that considered socially acceptable. And that is not the soaring cost of narcolepsy kids included.