Flu experts try to ensure record vaccine doses get used

first_imgMay 13, 2008 – ATLANTA (CIDRAP News) – Manufacturers of influenza vaccine are poised to deliver record quantities of flu shots for the coming season. But unless medicine and public health officials find new methods and venues for getting those shots into the arms of Americans, another record may also fall: the number of influenza-vaccine doses that go unused.The need to expand flu-vaccine use—to protect Americans’ health, and also to preserve vaccine manufacturing capacity that would be needed during an influenza pandemic—topped the agenda yesterday at the start of the National Influenza Vaccine Summit.The little-known 2-day meeting, which is sponsored each year by the American Medical Association and the Centers for Disease Control and Prevention (CDC), has drawn record attendance of 230 this year. It comes on the heels of a microbiological double-whammy: midseason strain changes that created one of the harshest flu seasons in recent memory, coupled with a vaccine that, because of those viral changes, protected only 44% of recipients against the flu.The possibility that the vaccine mismatch impaired public trust in the flu shot is much on the minds of summit participants. In the just-concluded season, manufacturers made a record 140 million doses, but only 113 million were used, leaving 27 million—also a record—unbought or returned to manufacturers.Representatives of the five companies now selling flu vaccine in the United States said Monday evening that they collectively expect to deliver from 143 million to 146 million doses next flu season, the largest amount ever brought to market here. But health authorities are concerned that consumer distrust might cause a largest-ever amount to go unused as well.The quandary of unused vaccineThat flu vaccine goes unused is not news; it has happened in most years for which public health has records, including years when midseason shortages caused long lines and public unrest.Research unveiled at the summit explains why: The timing of flu-vaccine use and delivery do not match up. Flu-shot use peaks around Oct 1 and falls off to almost zero by Thanksgiving, but by October, manufacturers have delivered only two thirds of what they have made.”If this distribution pattern prevails, and all indications are that it will, we will continue to receive 30% of our vaccine in the period after which people seek to use it,” said Dr. William Schaffner, chair of the Department of Preventive Medicine at Vanderbilt University School of Medicine. “This is a discontinuity.”The pattern makes even less sense when it is graphed against influenza incidence. In most years, flu cases do not appear until the end of January, meaning that influenza vaccination virtually ends before the disease it is meant to prevent begins.Americans have seemed to have no interest in end-of-year flu shots. Last year, for instance, the CDC and a number of other health organizations conducted public-information campaigns, including a post-Thanksgiving “National Influenza Vaccination Week,” that urged late-season vaccination but did not affect shot use.Part of the problem may be simply that no one is asking patients about flu vaccination. That is what manufacturer Sanofi-Pasteur Inc. discovered after analyzing insurance-claims data from approximately 25% of US physician practices during the second half of the flu season.Over “about a 16-week period . . . about 25 million individuals come into their physicians’ offices for about 55 million visits and are not immunized against influenza,” said Dr. David Greenberg, Sanofi’s director of medical and scientific affairs.The patients were not offered vaccination, he said, because their doctors had nothing to vaccinate them with: They had ordered a certain amount of flu vaccine, administered it early in the season, and then had not ordered more for fear it would not be used.But several summit participants said that self-fulfilling situation is unlikely to change until physicians can be persuaded that placing larger vaccine orders at the start of the season will not cause them a financial loss at the end.”Family physicians are trying to stay on the conservative side, because no one wants to get stuck with too much vaccine,” said Dr. Herbert Young, director of scientific activities with the American Academy of Family Physicians.Covering more of the populationPart of the problem, according to some attendees, is the now-lengthy list of groups for whom the vaccine is recommended because the federal government judges them to be at “high risk” of life-threatening flu complications. Currently they include children from 6 to 59 months old, all people 50 and older, younger people with some chronic medical conditions, nursing home residents, pregnant women, healthcare workers, and households and caregivers of all of those groups as well.”That list is long,” said Dr. Andrew Eisenberg, a family physician attending the conference who works in Sarasota, Fla., and rural Texas. “It has 20 items on it, it takes a while to go through it, and that is time the doctor is not being paid for.”In his own office, Eisenberg said, he focuses instead on the much shorter list of people for whom the shot is not advised, and strongly recommends the vaccine for everyone else: “When the patient signs in, the lady who is taking their information asks, ‘Have you had the flu vaccine this year?,’ and if the answer is ‘No,” we say, ‘Well, today you are getting it.'”The question of reaching and vaccinating the recommended groups is about to become more complicated: This fall, a new recommendation that covers all school-aged children will go into effect. (The change, voted in by a federal panel last February, becomes mandatory in the 2009-2010 season but is optional this year.) Up to 30 million children could be covered by that recommendation, though few experts expect them all to step up.Health authorities are just beginning to grapple with the practicalities of getting even a fraction of those children into healthcare offices in the narrow window during which most Americans take flu shots. The task is compounded by the fact that these children need two shots administered 2 months apart to establish immunity.Some of these complexities are being explored as the summit continues today.See also:Apr 17 CIDRAP News story “CDC: Imperfect flu vaccine was of help in tough season”last_img read more

Mandate roundup: Scottish LGPS adds £100m multi asset credit fund

first_imgThe £3.2bn (€4.1bn) North-East Scotland Pension Fund (NESPF) has awarded a £100m multi asset credit mandate to Russell Investments.The investment was completed through a pooled fund.Graham Buntain, investment manager at NESPF, said adding the fund to its portfolio had enabled the local government pension scheme to diversify its fixed income allocations into higher yielding parts of the market and to reduce its exposure to equities.“We recognise the limitations of a single manager accessing the full spectrum of the opportunity set, and feel the multi-manager approach provides a better platform for success,” he added. “The [multi asset credit fund] has allowed us access to an all-encompassing strategy at a competitive price, and with a low governance burden.” Russell’s multi asset credit fund invests in a range of credit strategies by utilising multiple specialist managers. It offers exposure “across the full spectrum of personal, corporate and sovereign balance sheets”.Russell already provided NESPF with implementation, transition management, liquidity management overlay, and foreign exchange trading services. NESPF is the pension fund for the city of Aberdeen, Aberdeenshire, and Moray.German private debt searchA pension fund based in Germany is seeking ideas for a private debt allocation via IPE Quest Discovery.According to search DS-2339 on the pre-RFP service, the pension fund wants to invest in global developed markets. It is after active management and the style should be diversified. It has specified a segregated mandate.LD hunting for fund manager, depository Danish pension fund Lønmodtagernes Dyrtidsfond (LD) is looking for providers for fund management and depositary services via an EU-tender.The tender is being done on behalf of Kapitalforeningen LD (KLD), which is an alternative investment fund that holds all of LD’s listed assets.KLD is searching for a fund management firm, which will be responsible for several administrative tasks, including NAV calculations, accounting, compliance and reporting.The depository will be responsible for oversight of the operation of the fund, cash monitoring, safekeeping of assets and other tasks.KLD’s current fund manager is Nykredit Portefølje Administration, and its depositary is Nykredit Bank with BNY Mellon as global custodian.The deadline for bids is 4 September 2017. Dutch find replacement providersIn the Netherlands, the €781m pension fund for hairdressers (Kappers) and the €2.3bn sector scheme for the meat-processing industry (VLEP) have found a new pensions provider.In its annual report, Kappers said that it had decided to transfer its administration to Rijswijk-based AGH.Elsewhere, John Klijn, VLEP workers’ chairman, made clear that his scheme would join AZL in Heerlen, part of NN Group. VLEP has 77,000 participants and pensioners.Kappers and VLEP were among fifteen mandatory sector pension funds that had to leave pensions administrator Syntrus Achmea Pensioenbeheer, after it announced last year it would cease servicing them because their pension plans were “too complicated”.Because of their specific pension arrangements, the two pension funds did not qualify either for a collective transfer to IT firm Centric, which Syntrus Achmea had offered to most of the mandatory sector schemes involved.Kappers, which has 65,000 participants and pensioners, said that consultancy Mastermind, a transition specialist, had assisted its search for a new provider.Before the transition – scheduled as of 1 January – the pension fund is to check the quality of its data at Syntrus Achmea. It would also test AGH’s system to ensure a smooth transition process.In the meantime, Kappers has found Actor as its new advisor on board support, which had also been provided by Syntrus Achmea. It said two of Syntrus Achmea’s staff have joined the Woerden-based consultancy to guarantee continuity for the scheme.The pension fund for hairdressers is still looking for new advisors on legal and actuarial matters.The IPE news team is unable to answer any further questions about IPE Quest, Discovery, or Innovation tender notices to protect the interests of clients conducting the search. To obtain information directly from IPE Quest, please contact Jayna Vishram on +44 (0) 20 3465 9330 or email [email protected]last_img read more

Lakers get wink from lady luck with NBA Draft Lottery

first_imgNevertheless, it ends an unbroken string of disasters going back to their last title in 2010: the Dallas sweep, Dwight Howard passing through, Steve Nash’s 62 games, Kobe Bryant going down, coming back for eight games in 2013-14, signing a two-year, $48.5 million extension and lasting 35 games in last season’s comeback.• Related: Could next season be Kobe Byrant’s last?A catastrophe just as great seemed to beckon, with a 17-percent chance of falling out of the top five and having to convey their top pick to complete the Nash trade.For once, it seemed after years of worst-case scenarios, they lucked out, as they used to all the time.Overmatched Boston Coach Rick Pitino once famously announced, “Larry Bird is not walking through that door, fans. Kevin McHale is not walking through that door, and Robert Parish is not walking through that door. And if you expect them to walk through that door, they’re going to be gray and old.”Kareem Abdul-Jabbar and Shaquille O’Neal aren’t walking through the Lakers’ door, either. All-time greats are made, not hyped, but they’ll get a major prospect and who knows where he goes from there?Which major prospect remains to be seen. Happily for the Lakers, this draft, once considered so humble, looks to far surpass the celebrated Class of 2014.• Related: Who will Lakers end up with in NBA Draft?With the first pick, Minnesota will almost certainly choose between centers Karl-Anthony Towns and Jahlil Okafor.Towns is taller, faster, a much better defender, a major comer on offense and almost everyone’s favorite.Minnesota, however, likes Okafor, too. We’re not likely to have a clue who the T-Wolves will pick until Adam Silver reads the name June. 27.At No. 2, the Lakers are expected to take whichever big man falls.If it’s Towns, they bag him, no questions asked, feeling like they got the top pick, after all.If it’s Okafor, the Lakers figure to take him, but I don’t think that one is the same kind of lock.Both players ducked the combine where we find out true sizes. In previous measurements in stocking feet, Okafor was 6-9 1/2 to Towns 6-10 3/4.Worse, for all his Tim Duncan-like skill level, Okafor looked like he was nailed to the floor at Duke.It’s actually a good sign that Okafor was overweight and in bad condition, often coming out after 10-minute bursts and coasting on defense.He has since lost 12 pounds and can be expected to move around better — as Duke’s Jabari Parker did a year ago.The Lakers have to be thinking, “If we don’t get a good big man here, how and when would we ever get one?Nevertheless, they’re aware there are two more major prospects at the other key position, point guard — Ohio State’s D’Angelo Russell and Emmanuel Mudiay, who played in China.Russell is more of a known quantity, a shooting guard who converted brilliantly to the point. He has good size, athleticism, is a great passer and is a great shooter in an age in which that’s all-important.Mudiay, the Congo native raised in Texas, is the more athletic, exciting one with the greater upside, if not the established shooting stroke.Both are capable of blowing the Lakers’ doors off. Everyone loves Russell but two of the sharpest NBA people I know insist Mudiay’s better.One way or another, the Lakers will get a major prospect. With their Nos. 27 and 34 picks, Jordan Clarkson and Julius Randle, they’ll finally put some young, exciting vision of their future on the floor with whatever Bryant has left.If the good old days aren’t back, better ones soon will be.With their spoiled fans having been un-spoiled with a vengeance, there’s joy in Lakerdom that’s not based on denial. Since 1980, the other local major league teams won five combined.• Related: Behind the scenes look at how Lakers got No. 2 pickNot that we’re talking dynastic restoration quite yet.If drawing the No. 2 pick in Tuesday’s lottery was their best, or only good, moment in five years, GM Mitch Kupchak reminded fans it won’t lead them into the 2016 Finals.Of course, he was being diplomatic. It’s not likely to lead them into the 2016 playoffs, either. The Lakers are back. … OK, part way.All right, it’s a small part in a tradition that’s not just the usual huckstering.Winning 10 NBA titles since 1980 is why they still eclipsed the Dodgers, Clippers, Kings and Ducks — who were going deep in the playoffs through the Laker dark years when their feats existed only in memory.The closest anyone in the NBA came to the Lakers since 1980 are the Bulls with six titles.center_img Newsroom GuidelinesNews TipsContact UsReport an Errorlast_img read more