Doctors, confused patients and state health authorities are discovering major differences in local townships’ organization of vaccination programs set up to combat swine flu. A shortage of vaccine and decentralized distribution of what’s available mean the programs vary widely around the country.
Like many other countries, Norway hasn’t received nearly enough swine flu vaccine to meet demand.
State health authorities had hoped that all Norwegians deemed to be at high-risk for the disease would be vaccinated by the end of this week. Now they’re likely not to be offered vaccine for another week or two, while the rest of the population must wait even longer.
Meanwhile, health officials report that the outbreak of swine flu in Norway already has hit epidemic proportions, with thousands of people ill. The death rate in Norway also is proving to be much higher than in other countries.
While state officials are working hard to stem the rate of infection and get vaccine out to the public, it’s the local townships in Norway that ultimately are responsible for primary health care and, now, the vaccination programs. It’s up to each township, and even districts with townships (called bydeler ) to decide how the vaccination programs will be organized.
As a result they vary widely and Norwegians are being treated differently depending on where they live. That’s not always popular in an egalitarian country and some doctors are crying foul. Norwegian Broadcasting (NRK) reported Friday that in Larvik, doctors have only been given 10 doses of vaccine each, leaving them to make the hard choices of who should get them first. “It’s not easy being a doctor here right now,” one physician told NRK.
Others defend the decentralized system, saying local officials know what’s best for their local communities. “I don’t feel the state authorities have pawned off responsibility on us,” Dr Øystein Lappgard in Ål in Hallingdal told newspaper Aftenposten . “We’re simply taking the consequences of how Norway is organized.”
Still lots of uncertainity
The various townships have at least one challenge in common: No one knows how much vaccine they’re being allotted or when it’s arriving. Drug companies weren’t able to develop the vaccine quickly enough and frustration is growing over shortages now.
Norwegian health officials are buying the vaccine from GlaxoSmithKline, which also had problems growing the vaccine. Local boss Åge Nærdal claims production has since met expectations but concedes that no country in Europe has received enough vaccine to meet demands of their high-risk citizens.
In Oslo, those in the high-risk group (pregnant women and people with chronic diseases) are being told to contact their primary doctors (fastleger) for appointments. Vaccination programs for school children and pre-schoolers in the high-risk group vary by district, with some schools offering the vaccine.
All otherwise healthy residents are being asked to wait “until there is enough vaccine for everyone,” wrote city officials in a newspaper ad on Friday. “There is no reason to contact neighborhood officials yet. More information will be released later when vaccinations of persons outside the high-risk group can begin, probably in mid-November.”
More information was available atwww.pandemi.no.