Small size, national plans help Europe's H1N1 fight

Dynamo Kiev's fans wear face masks as a preventive measure against the H1N1 flu during their Champions League soccer match against Inter Milan in Kiev November 4, 2009.

LONDON (Reuters) - Compared to the problems dogging health departments in the United States, Europe's battle to vaccinate the vulnerable against pandemic H1N1 swine flu appears to be going relatively smoothly -- so far.

H1N1 vaccination programs in Britain and other European countries are off to a slow start, but experts say the infrastructure of their national health systems allows officials to coordinate and manage them better than in the United States.

Dr. Steve Field, president of Britain's Royal College of General Physicians, has just returned from the United States where he described "lines of people waiting for their flu jabs."

"The thing here is that we are a smaller country, and our health system is more homogenous, and primary care is very strong -- that allows us to prioritize people and to call and recall them when we need to," he said in a telephone interview.

In most countries in western Europe swine flu vaccines made by drugmakers GlaxoSmithKline, Roche AG, Sanofi, Novartis and others are being offered by invitation to those at highest risk of complications.

In Britain, the rollout of vaccines started on October 21 and it is likely to be several weeks before all doctors have supplies at the ready, but because of the invitation-only approach, there are no queues of angry patients demanding shots.

A spokeswoman for the Department of Health said British doctors were being advised to "wait to receive the vaccine before inviting patients in" and added: "This can in many cases be done by telephone, text, or email."

Field said he expected an equally orderly picture to emerge in Denmark and the Netherlands -- which started vaccinations of risk groups Monday -- where family doctors have similarly good contacts and data on their patients.

More than 4OO deaths from H1N1 swine flu have been recorded in Europe and the European Center for Disease Prevention and Control's latest data puts the global death toll at 6,508.

An international survey of primary care doctors last week showed that while the United States spends more than twice as much as other developed nations on healthcare, it lags behind in key measures of quality and has a weak primary care system.

It also showed that electronic medical records are nearly universal in the Netherlands, Britain, Italy, Norway and Sweden.

"There is lots of evidence to suggest that if you have strong primary care, you have much better preventative care, because you have lists of patients to work with and you can ring them or email them if they don't turn up," Field said.

In the United States the slow supply of H1N1 vaccines has piled pressure on state and city health departments trying to get immunizations to those who need and want them.

Children, pregnant women, healthcare workers and those with health problems are supposed to get the vaccine first, but New York City health officials came under fire last week for distributing vaccines to employers such as banks, creating the perception that healthy people were jumping the queue.

"In the United States it's sort of a first come, first served, and there's a little bit of panic going on," Field said. "Here, we can control the panic, because we can prioritize."

(Editing by Sonya Hepinstall)