Taiwan prepared for H1N1 with domestic vaccine

Since December 15, Taiwan has vaccinated close to 18 percent of its total population against H1N1. With a National Health Plan and the central government buying the vaccine and coordinating the different phases, the island was able to begin innoculating the general public three months ahead of scheudle. Taiwan’s overall H1N1 vaccination plan went far smoother than in the United States, which left many priority patients in the Bay Area still to receive the vaccine by the end of the December.

Taiwan’s vaccination campaign

Taiwan began vaccinating the most vulnerable on November 1st. The population was segmented into twelve groups, with those with weaker immune systems given the vaccination first. Included in that group were typhoon-affected victims, medical personnel in charge of disease control and prevention, and pregnant women. In subsequent phases, the vaccine was offered to infants, younger children and seriously ill patients. Older school children in elementary, junior and senior high were also innoculate at their schools.

The last to be vaccinated were healthy people from 25-49 and healthy adults between 50-64.The government had planned to vaccinate the last group in March, but realized they were ahead of schedule and could vaccinate everyone much sooner than expected.

Thus on December 12th, Taiwan had a “1212 vaccination campaign” which allowed anyone working or living in Taipei to get vaccinated at designated public places, local clinics and hospitals. In the United States, the distribution of the vaccination was somewhat more complicated, with a mix of federal, state, county and the private sector participating to innoculate patients. Although some states and counties were making it availiable to the general population at year’s end, other regions were still trying to take care of their priority groups.

Taiwan’s government ordered 15 million doses of H1N1 vaccination, five million from Novartis, a multinational pharmaceutical factory and another 10 million from Taichung-based Adimmune Corp., Taiwan’s own human vaccine manufacturing company. The Department of Health had set a goal of vaccinating at least 12 million before Chinese Lunar New Year in mid-February. Although not everyone would be vaccinated, vaccinating half of Taiwan’s population would be enough to prevent a crippling pandemic.

Schools given guidance on closure

Vaccinations were conducted on a school by school basis, so the schools had records of when vaccinations were administered and the percentage of students given the vaccine. This was important information since the antibodies develop about 14 days after the vaccination is received. In Taiwan, elementary school children began getting their vaccinations on November 16th, followed by junior high and senior high school students on November 23rd and November 30th, respectively.

In order to prevent a pandemic, Taiwan also used the “325” guidelines for closing schools. If two students in the same class were diagnosed with H1N1 within three days, then the school was closed for five days. However, if an individual student had flu-like symptoms, but 80 percent of the student population had been vaccinated more than 14 days previously, then the school would not close, but the sick students would be sent home instead.

By the end of November, Tawain estimated that 602 H1N1 patients had been hospitalized with the infection and 29 have died.

Adimmune Corp.: Taiwan’s new vaccine superstar

Adimmune’s ability to supply ten million vaccines was a big success for the whole island. In the United States, one of the problems with the shortage and delay of the vaccine supply was the lack of US vaccine producers. GlaxoSmithKline, a Canadian company, faced pressure to supply domestically before fulfilling US needs. Having a locally produced vaccine company like Adimmune Corp. was very important to meeting and exceeding the expectation of Taiwan’s H1N1 vaccine needs. It also made it possible for Taiwan to help other countries by donating 500,000 doses of H1N1 vaccine to the World Health Organization

In producing the vacinnes in six months, the company started from scratch, passed all the regulatory tests and succeeded in developing a world-class product. It was a big gamble for Adimmune that paid off. After being in debt to build its NT$3 billion (US$93 million) vaccine factory, Adimmune was able to win the government contract to produce the H1N1 vaccine for Taiwan. With the factory now in production, Adimmune has the capacity to produce 30 million doses annually. And given the shortages in the United States, it looks like they are in the right place to fill a niche market.