VZCZCXRO6571
RR RUEHIK
DE RUEHLI #0035/01 0211259
ZNR UUUUU ZZH
R 211259Z JAN 10
FM AMEMBASSY LISBON
TO RUEHC/SECSTATE WASHDC 8078
INFO RUEHZL/EUROPEAN POLITICAL COLLECTIVE
RUEHPD/AMCONSUL PONTA DELGADA 0662
RUEAUSA/DEPT OF HHS WASHDC

UNCLAS SECTION 01 OF 02 LISBON 000035 
 
SIPDIS 
 
HHS FOR CDC 
 
E.O. 12958: N/A 
TAGS: CASC AMED KFLU ETRD EAGR ECON EC PGOV PO
SUBJECT:  PORTUGAL H1N1 UPDATE - JAN 21 
 
REF: 09 LISBON 625 
      09 LISBON 579 
      09 LISBON 558 
 
LISBON 00000035  001.6 OF 002 
 
 
SUMMARY 
------- 
¶1. (SBU) The Portuguese Health Ministry has been slow to reach its 
goal of vaccinating 3 million Portuguese against the H1N1 virus, 
primarily due to lack of public confidence in the vaccine and media 
speculation surrounding the deaths of four newborn infants.  While 
many adults, including health care professionals, have been 
reluctant to get vaccinated, the vaccination program for children 
under 12 years old has been a success, according to health 
officials.  The first wave of the influenza has passed and H1N1 
cases no longer dominate the headlines; nevertheless, the Health 
Ministry will continue its vaccination campaign in anticipation of a 
second wave this spring.  End Summary. 
 
H1N1 VACCINATION CAMPAIGN BESET BY PUBLIC FEAR 
--------------------------------------------- - 
¶2. (U) Since last spring, when the first H1N1 case was confirmed, 
the Portuguese have grown accustomed to living with the constant 
threat of the H1N1 virus and news of additional confirmed cases. 
With the spread of the virus, public demand for the H1N1 vaccine 
grew.  But when the long-awaited H1N1 vaccine finally became 
available in October, many expressed apprehension, perceiving it as 
riskier than the virus itself.  The government goal to vaccinate 3 
million Portuguese (out of a population of 10.7 million) has been 
hampered, mainly due to lack of public confidence in the vaccine, 
even among some health care professionals, which has resulted in 
lower-than-anticipated vaccinations. 
 
¶3. (U) As of January 5, health officials estimated that a total of 
320,000 people had been vaccinated, of whom 73,750 were children 
under 12 years old.  (Note that some patients required two doses.) 
The Portuguese National Authority of Medicines and Health Products 
received 151 notifications of adverse reactions to the H1N1 vaccine, 
of which 62 were considered serious, but no fatalities. 
 
¶4. (SBU) Deputy Director General of Health Graca Freitas told us 
that many Portuguese have not been vaccinated because of the reduced 
aggressiveness of the virus and consequently a perceived lower risk 
of being infected.  Freitas attributed the failure of the 
vaccination program for pregnant women primarily to media 
speculation linking the H1N1 vaccine to the deaths of four newborn 
infants.  She noted, however, the success of the vaccination program 
for children under 12 years old, and the increase in the number of 
vaccinated doctors. 
 
¶5. (SBU) Freitas believes that a national public awareness campaign 
could increase public confidence but the vaccination program is 
ultimately dependent on timely delivery of vaccine doses by 
GlaxoSmithKline Pharmaceuticals, which has been unable to deliver at 
the desired pace due to limited production capacity.  As of January, 
Portugal had received 470,000 doses but should have received 1 
million of the 6 million doses ordered.  According to Freitas, 
Portugal will not consider reducing its order or donating doses to 
needier countries, as other EU countries have done. 
 
END OF FIRST WAVE 
----------------- 
¶6. (U) To date, there has been a total of 94 fatalities, most of 
them at-risk male patients averaging 47.1 years.  The virus peaked 
during the last two weeks of November with 297 people hospitalized 
and 54,290 new cases.  The number of cases has been decreasing since 
then, but December registered 47 fatalities, the highest number of 
the year. 
 
¶7. (U) Minister of Health Ana Jorge declared on December 30 that the 
H1N1 peak had passed.  Despite the reduction in influenza activity, 
the vaccination campaign will continue, aiming to vaccinate as many 
people as possible in the shortest amount of time, especially 
pregnant women, recent mothers, children under 12 years old, the 
chronically ill, young adults and convicts.  A second H1N1 wave is 
expected before the end of spring. 
 
H1N1 COSTS 90 MILLION EUROS 
--------------------------- 
¶8. (SBU) The H1N1 virus has been costly to the Portuguese National 
Health Service.  According to Freitas, between June and December 
2009, the Health Service spent more than 90 million euros, of which 
45 million were used to pay for the 6 million doses of the H1N1 
vaccine.  The remainder was spent on overtime of health 
professionals, additional hospital staff, a dial-in help line, 
patient transportation, initial diagnosis of the virus, medicine, 
and equipment. 
 
COMMENT 
------- 
 
LISBON 00000035  002.6 OF 002 
 
 
¶9. (SBU) Portugal undertook great efforts to educate the public 
about the H1N1 pandemic upon initial outbreak and quickly adopted 
preventive measures.  Its preparedness in early dissemination of 
information and diagnosis delayed spread of the virus.  Portuguese 
health authorities, however, did not anticipate the high level of 
public apprehension over the vaccine, fueled by media speculation 
over the deaths of newborn infants and lack of clear information on 
the vaccine itself.  The Health Ministry is now preparing for a 
second wave of the influenza with a renewed campaign to reach its 
goal of vaccinating 3 million people.     With lessons learned from 
the first wave, a more effective awareness-raising campaign to 
assuage apprehension over the vaccine, and availability of 
additional vaccine doses, Portugal should be better positioned to 
meet the challenges of a second wave.