European countries are starting to raise questions about the swine flu pandemic, such as whether it is a false pandemic, and whether pharmaceutical companies put pressure on health ministers to order more vaccine than their countries were likely to need. They are also looking to cut back on orders of vaccine or sell a large part of their stockpile.

Although more than 12,700 people worldwide have died from H1N1 swine flu, the virus does not appear to be as deadly as many people expected. News of this may have influenced people’s decision whether to have the vaccine or not, and while at first when they placed the orders countries thought each vaccination would require two doses, it appears now that one dose is enough.

France is looking to cancel 50 of the 94 million doses it ordered from four pharmaceutical companies, Germany said it had cancelled nearly one third of the 50 million it ordered from GlaxoSmithKline (GSK), while the UK, Switzerland, Spain and The Netherlands said they were also looking to cut back their orders or sell doses they did not need to other countries, according to a report in the Wall Street Journal (WSJ).

French President Nicolas Sarkozy of France said on Tuesday that the government had made the right decision, and that he would always “prefer to be too prudent” on matters relating to people’s health than not prudent enough.

France’s initial plan was to focus on getting high risk groups vaccinated, but then opened it out to everyone in the country, but so far, less than 10 per cent of the population has received the jab, health officials said earlier this week.

A spokesman for the German Health Ministry, Roland Jopp, told the media that the main reason for cutting back on supplies is that only shot is needed per person, whereas this was not clear at first. However, he also said that in Germany, people are “not running to get the vaccination”.

The swine flu vaccine situation has been up and down in Germany. At first, the Pandermix vaccine selected by federal and state authorities came under fire because of possible health risks, then as the numbers of cases of swine flu increased, and more people sought vaccination, GSK couldn’t deliver fast enough and the supply fell short of demand, reported Frankfurter Rundschau. And now, supply outstrips demand and there is too much vaccine in the stockpile.

According to estimates from Paul-Ehrlich-Institute, a Langen-based agency of the German Federal Ministry of Health, only five to seven million Germans have been vaccinated, while 50 million doses were ordered from GSK.

In the US, the picture seems quite different. Like much of Europe, at first vaccine supply looked to fall short of demand, but now supplies are boosted again and a top health official told the WSJ that the US is focused on vaccinating as many people as possible and has no plans to cancel orders or sell its supplies.

Some European politicians have accused the WHO of exaggerating the dangers of swine flu, according to the BBC who also reported that a WHO spokeswoman in Geneva acknowledged there were questions that needed answers and that a review of how the WHO handled the pandemic would be done with independent experts and would be made public. However, they will wait until the pandemic is declared over, so it could be months yet before any report emerges.

The Council of Europe is planning for its Parliamentary Assembly to debate “False pandemics, a threat to health” later this month, when it will also start investigating whether pharmaceutical companies influenced public health officials to spend money unnecessarily, reported the BBC.

The Council’s head of health, Dr Wolfgang Wodarg, said that the makers of flu drugs and vaccines had influenced the WHO decision to declare a public pandemic of swine flu. According to a report in the UK’s Daily Mail, Wodarg said the H1N1 outbreak was “one of the greatest medical scandals of the century”, and that “we have had a mild flu – and a false pandemic”.

Wodarg argued that an atmosphere of panic about pandemic flu started five years ago when fears were raised that lethal bird flu would mutate into a human form and cause a global pandemic of deadly proportions.

He said the vaccine producers had sealed contracts with governments that secured orders in advance, and assured them of “enormous gains without having any financial risks”; they just had to wait for the WHO to declare “pandemic” and “activate the contracts”.

According to the Daily Mail, a spokesman for one of the companies, GSK said that:

“Allegations of undue influence are misguided and unfounded. The WHO declared that H1N1 swine flu met the criteria for a pandemic.”

In a press statement on Tuesday, GSK confirmed that Germany had amended its contract to receive only 70 per cent of the initial order, and that the company was also in discussions with a number of other governments about their “specific pandemic planning needs”, including “governments who are changing their planned immunisation programme”.

The company emphasized the point that at first it was thought that two doses would be needed to ensure immunity, but as data from clinical trials emerged, it was clear one dose would produce a strong enough immune response, and this has “resulted in some public health authorities adapting their recommendations for immunisation”.

President of GSK Biologicals, Jean Stephenn, told the media that:

“Pandemics by their nature are unpredictable and we recognise that governments’ needs are changing. We are committed to finding solutions for governments changing their immunisation programmes and to fulfilling recent new orders.”

The company also stressed that the WHO reports that the swine flu is still active and geographically widespread, with more than “200 countries and overseas territories or communities worldwide with laboratory confirmed cases”.

Other experts, such as those at the UK’s Department of Health, have said that although the outbreak appears to be waning, they also suggested that there could a third wave of the pandemic, and urged everyone entitled to have the swine flu vaccine to take it.

Sources: BBC, Wall Street Journal, Frankfurter Rundschau, Council of Europe, GSK, WHO.

Written by: Catharine Paddock, PhD