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The first trials of swine flu — influenza A(H1N1) — vaccines are expected to begin over the next few weeks and the first vaccine should be available in the United States by September.

Anthony Fauci, director of the National Institute of Allergy and Infectious Diseases (NIAID) confirmed the plans for US trials with Nature yesterday (30 July). In an earlier statement (22 July) he said vaccine trials were imminent.

Five trials testing two vaccines from Sanofi Pasteur and CSL Biotherapies will be run on thousands of healthy people at centres across the country. Two additional trials will test vaccines with adjuvants — additions to vaccine formulations intended to boost immune response.

Initial studies will look at the amount of active ingredient and number of doses needed. Researchers will also investigate co-administration of A(H1N1) vaccine with seasonal flu vaccine.

Europe will begin its first vaccine tests in Belgium next week (3 August) with production scheduled for November.

Pierre van Damme, director of the Centre for the Evaluation of Vaccination at the University of Antwerp, told SciDev.Net that four manufacturers had sent vaccine for testing. He said the university will test two unnamed vaccines on 300–400 people, with each given two doses of vaccine.

The University of Ghent in Belgium and some centres in Finland, France and Germany are also involved in the testing of vaccines.
Europe is bypassing large-scale human trials so that swine flu vaccinations can be made available as fast as possible — leading to concerns from the WHO, UK newspaper The Guardian reported this week (26 July).
The European Medicines Agency has a protocol allowing a vaccine to be fast-tracked in the case of a pandemic.

"There are certain areas where you can make economies, perhaps, but certain areas where you simply do not," Keiji Fukuda, the WHO's flu chief, told the Associated Press.

But many believe Europe is doing the right thing.

"If [regulatory authorities] took all the time that was necessary to make sure there are no side effects, ironically, in the effort to save a few lives, many lives could be lost," said Leonard Marcus, a public health expert at Harvard University.

Elsewhere, the WHO is buckling under the weight of an A(H1N1) information overload* and has been accused of failing to provide enough information to direct policy on how to fight the virus, the Financial Times reported last week (21 July). This is particularly affecting poorer countries, reliant on the WHO for information.

Countries looking to save lives in the influenza A(H1N1) pandemic should give young people antivirals ahead of the elderly, according to Italian research published in the journal BMC Infectious Diseases. The researchers from the Bruno Kessler Foundation in Trento, Italy, used a mathematical model to deduce how to save the most lives using limited drugs supply.

A six-month-old Mexican girl is now thought to be the first person to have contracted influenza A(H1N1), ScienceInsider reported this week (28 July).

Celia Alpuche, head of the Institute of Epidemiological Diagnosis and Reference in Mexico City, said the baby from San Luis Potosí, north-central Mexico, was probably infected on 24 February, making her the earliest case yet detected.

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