indigopete
27th July 2020, 12:31
#dyor It's no use following Youtube rumours on a "faith" or "dismissal" basis.
1. Go to the OECD coverage statistics (https://data.oecd.org/healthcare/influenza-vaccination-rates.htm) for over-65's and a reasonable sample of countries. Get a spreadsheet and enter the coverage rates in 1 column
2. Go to the Covid-19 realtime statistics (https://www.worldometers.info/coronavirus/) and cross-reference each country's "Deaths/1M pop" figure. This is the most reliable since deaths per case is all over the place due to wide differences in testing. (Tip: click on the column header for that column to sort in descending order. That brings all the "problem" countries to the top. Notice the significant difference between the top 10-15 and the rest). Populate column 2 of your spreadsheet with these figures
3. You need to distinctly account for the adjuvanted/non-adjuvanted status. It is a distinct medicating component that's added to the vaccine in order to generate a more powerful immune response. The reason this is important is because:
it's only given to over-65's and certain immuno-comprimised groups (the OECD data above applies to over-65's, so compatible)
its use is delineated by health jurisdiction. Some health ministries have an over-65 adjuvanted policy, some don't (so compatible with the death rate data which is also grouped by country)
while the vaccine changes from year to year, the adjuvant doesn't and recipients are re-medicated with it each year. The adjuvant is squaline (shark oil) in an oil-in-water emulsion which is stabilised with an additive called Polysorbate 80
4. In column 3 of your spreadsheet, identify the health juristictions which have non-adjuvanted vaccination policies for over-65 and immunocompromised. Set their coverage rates to zero while copying the other coverage rates across from column 1.
You'll end up with 2 graphs: 1 with death rate against influenza vaccine coverage in general and 1 against adjuvant coverage. Step 3 is slightly non-trivial and requires a bit of work. Even at that, definitive figures are quite opaque. See below.
****** SIDE NOTE: *****
This is an extremely important public health consciousness exercise whatever side of the "vaccine debate" people find themselves on since the public are the consumers of these medication products yet the statistical data is quite opaque beyond generalised coverage rates.
Everyone must participate. If people are not numerate then get someone who is to assist and help each other validate information resources. Otherwise we are sitting on our hands with our thumbs in our mouths listening to random Youtubers mouth off. The work is supposed to be done by an activity called "pharma covigilance (https://en.wikipedia.org/wiki/Pharmacovigilance)" but if this institutionalised process ever comes up with "uncomfortable results" it's unlikely that they'd be instantly made available. For example, having spoken to healthcare professionals in the UK I'm fairly certain that Covid-19 deaths are not being cross referenced to medication history and primary care records, at least not officially that I'm aware of and certainly not openly. Also, there are simply a myriad of conflicts of interests involved and the more the public are familiar with what they are consuming, the less they'll be manipulable by scare stories (in either direction). I'm sorry but there really is no other way than to do the research YOURSELF or in well informed groups in order to arrive at a more informed perspective than is provided by random Youtube comments, albeit assisted by professionals that you trust if necessary. (Though this being a simple statistical exercise should not require anything other than counting skills).
Regarding step 3 above, the OECD statistics make no distinction between adjuvanted and non-adjuvanted coverage even though the vaccine and adjuvant are distinct medications. (So distinct in fact that the adjuvant can be contracted for manufacture (https://english.alarabiya.net/en/coronavirus/2020/05/28/Coronavirus-UK-pharma-giant-GlaxoSmithKline-to-make-1-billion-vaccine-booster-shots) even when the vaccine doesn't yet exist).
To determine this information it's necessary to go to each country's health ministry websites or other indirect sources. In the abscence of officially stated policy, some guesswork may be required via recourse to indirect resources such as news items covering vaccine contracts placed by health authorities with vaccine manufacturers or teaching resources created by local healthcare professionals. (More publicly available & accurate information on this would be helpful in terms of supporting confidence in vaccine performance).
3 general categories emerge with specific regard to adjuvant use:
A: Current, unambiguous adopters (Health juristictions that unambiguously recommend the adjuvanted version to over-65's, care homes & immuno-compromised)
B: Historical adopters (May be currently licensed or unlicensed, may have had a previous swine flu - Pandemrix- campaign)
C: Non-adopters
Here's some links to start you off. Don't be lazy now ;)
Europe: Background to Adjuvanted Influenza Vaccine Licensing
The adjuvanted flu vaccine has a history of use in most European countries, however is only licensed in some of them at the present time according to EU licensing tables.
In general, the adjuvanted vaccine is licensed for over 65’s in:
Some European Union countries (Spain + Italy have the longest continuous use reportedly) + UK
United States
Canada
See:
https://www.arznei-telegramm.de/html/2000_09/0009075_01.html
https://www.ecdc.europa.eu/en/seasonal-influenza/prevention-and-control/vaccines/types-of-seasonal-influenza-vaccine
Country by country table:
https://www.ecdc.europa.eu/en/publications-data/availability-influenza-vaccines-country-eueea-201920-season
And background to the MF59 adverse event in Italy and subsequent suspension by some EU countries:
https://www.tandfonline.com/doi/pdf/10.1080/21645515.2017.1420448
USA: Background:
Quadrivalent version trials carried out in Boston and North Carolina (Dukes University Medical Centre)
https://clinicaltrials.gov/ct2/show/NCT03183908
Chile
Statistics on types of vaccine, composition (with particular regard to adjuvants) and coverage for Chile are not very easy to acquire. However this document produced by the Chilean ministry of health (Ministereo de Salud) does specifically state the Vaccine brands being deployed for the year 2017.
https://www.minsal.cl/wp-content/uploads/2015/09/VC-Programa-Adulto-mayor-Vacunas-en-adultos-Influenza-y-Neumococcica.pdf
The Spanish association of Vaccinology has a useful table with which to cross-reference brand names in the Hispanic world to vaccine content, in particular whether or not they are adjuvanted.
https://www.vacunas.org/vacunacion-7/
New Zealand
This document has been published by the New Zealand Immunisation Advisory Centre:
https://www.influenza.org.nz/2020-funded-influenza-vaccines
It indicates the vaccine brands being deployed for the 2020 flu season.
https://immunisationhandbook.health.gov.au/vaccines/afluria-quad
https://immunisationhandbook.health.gov.au/vaccines/influvac-tetra
Israel
The Health Ministry of Israel does not appear to publish specific guidance as to vaccine brand or type recommendations on its publicly accessible pages. However one of the largest of its state-mandated health organisations (Clalit) appears to use a quadrivalent nasal-spray vaccine.
https://www.clalit.co.il/he/medical/pharmacy/Pages/medicines.aspx?idd=8007
https://web.archive.org/web/20180119123539/http://www.clalit-global.co.il/en/a_million_flu_vaccinations.html
https://www.health.gov.il/English/Topics/SeniorHealth/HealthPromo/Pages/Vaccines_In_Elderly.aspx
https://www.businesswire.com/news/home/20180925005100/en/AstraZeneca-Ships-FLUMIST%C2%AE-QUADRIVALENT-Vaccine-2018-2019-Flu
Belgium
https://www.ema.europa.eu/en/news/no-evidence-fluad-vaccine-caused-deaths-italy
Note also that the Belgian government’s scientific committee for coronavirus has stated that Belgian death rates “should be halved” to obtain a comparable statistic with other countries due to their reporting protocol.
https://www.politico.eu/article/why-is-belgiums-death-toll-so-high/
https://www.bostonglobe.com/2020/04/25/nation/why-worlds-highest-coronavirus-death-rate-is-europes-capital/
See also:
https://archpublichealth.biomedcentral.com/articles/10.1186/0778-7367-68-3-109
https://www.lemonde.fr/planete/article/2009/10/19/en-belgique-la-vaccination-contre-la-grippe-a-h1n1-est-vivement-critiquee_1255770_3244.html
https://medicalxpress.com/news/2014-12-european-drug-novartis-flu-vaccine.html
https://www.vaccination-info.be/maladie/grippe/
https://www.gsk.com/en-gb/media/press-releases/glaxosmithkline-update-a-h1n1-influenza-vaccine-development/
Singapore
https://www.parkwayshenton.com/healthplus/article/fight-flu-get-vaccinated
http://activeage.co/new-four-strain-influenza-vaccine-now-available-in-singapore/
https://www.raffleshealth.com/flu-vaccination-with-consultation.html
https://www.moh.gov.sg/news-highlights/details/moh-establishes-national-adult-immunisation-schedule-extends-use-of-medisave-for-vaccines-under-the-schedule
Vaccine coverage in Singapore:
https://www.todayonline.com/singapore/moh-introduces-new-list-recommended-vaccine-jabs-adults
https://trialsjournal.biomedcentral.com/articles/10.1186/s13063-017-1808-8#ref-CR18
The Netherlands
https://www.rivm.nl/bibliotheek/rapporten/2019-0002.pdf
Also:
https://www.rivm.nl/griep-griepprik/zorg/vaccineren/griepvaccin
Brazil
Historically there were substantial emergency vaccination programs deployed in 2015 and 2016 in response to the Zika and H1N1 (swine flu) viruses.
https://pubmed.ncbi.nlm.nih.gov/22609010/
http://rsaude.com.br/florianopolis/materia/vacinas-em-situacoes-especiais-influenza-2017/12355
https://www.bbc.co.uk/news/world-latin-america-36145181
https://saude.abril.com.br/medicina/as-vacinas-aprovadas-contra-a-gripe-para-2019-campanha-comeca-em-abril/
Iceland
https://www.landlaeknir.is/servlet/file/store93/item35741/Skr%C3%A1ning%20fyrri%20bs%20%C3%AD%20s%C3%B6gu.pdf
https://www.heilsugaeslan.is/um-hh/frettasafn/stok-frett/2019/09/24/Bolusetning-gegn-arlegri-influensu-/
https://www.landlaeknir.is/gaedi-og-eftirlit/heilbrigdisstarfsfolk/dreifibref/nanar/item29921/Dreifibref-nr--1/2016--Bolusetning-gegn-influensu
https://www.serlyfjaskra.is/FileRepos/7a333746-5073-ea11-80fc-00155d15460a/Vaxigrip_Tetra_Fylgise%C3%B0ill.pdf
Australia:
https://www.abc.net.au/news/2018-02-19/fluad-fluzone-flu-vaccines-for-over-65s-what-you-need-to-know/9461766
https://www.ebs.tga.gov.au/ebs/picmi/picmirepository.nsf/pdf?OpenAgent&id=CP-2020-CMI-01074-1&d=202006111016933
https://www.eurosurveillance.org/content/10.2807/1560-7917.ES.2017.22.43.17-00707#html_fulltext
https://www.health.gov.au/health-topics/immunisation/immunisation-services/flu-influenza-immunisation-service-0
https://theconversation.com/heres-why-the-2017-flu-season-was-so-bad-86605
Czech Republic
https://www.ockovacicentrum.cz/cz/vaxigrip-tetra
https://vakciny.avenier.cz/cz/chripkova-sezona-20192020
Germany
https://www.pei.de/DE/arzneimittel/impfstoffe/influenza-grippe/influenza-node.html
Portugal
https://www.dgs.pt/directrizes-da-dgs/normas-e-circulares-normativas/norma-n-0062019-de-07102019-atualizada-a-14102019.aspx
Japan
https://www.nibiohn.go.jp/CVAR/adjuvant.html
Sweden
https://www.snih.org/tales-of-the-past-pandemrix-and-narcolepsy-in-sweden/
https://www.janusinfo.se/nyheter/nyheter/2019/dagsforvaccinationavriskgrupper.5.7231e45916df3792b301d37a.html
https://medikament.se/l%C3%A4kemedel/fluad-2018-2019-injektion-
https://www.folkhalsomyndigheten.se/contentassets/4975c907ea244c2e8bdb1b5f6e385f74/influensavaccination-riskgrupper-15100.pdf
Northern Ireland
https://www.publichealth.hscni.net/news/joint-statement-regarding-availability-seasonal-flu-vaccine
Republic of Ireland
https://www.hse.ie/eng/health/immunisation/hcpinfo/guidelines/chapter11.pdf
France
https://pubmed.ncbi.nlm.nih.gov/15599987/
https://www.has-sante.fr/upload/docs/application/pdf/2018-08/recommandation_vaccinale__extension_des_competences_des_professionnels_de_sante_en_matiere_de_vaccin _2018-08-08_14-46-16_310.pdf
Korea
https://www.ncbi.nlm.nih.gov/pmc/articles/PMC6312896/#B15
See:
https://koreauniv.pure.elsevier.com/en/publications/cost-effectiveness-of-influenza-vaccine-strategies-for-the-elderl
https://synapse.koreamed.org/DOIx.php?id=10.3947/ic.2017.49.4.247
Norway
https://www.seqirus.com/news/fluad-tetra-chmp
Currently available flu vaccine brands in Norway:
https://vaksinebestilling.fhi.no/produkter/influensavaksiner
Estonia
https://www.virtuaalkliinik.ee/uudised/2019/09/03/tanavu-jouab-eestisse-kolm-neljavalentset-gripivaktsiini
Slovenia
https://www.adm.si/Nasveti?n/9HND3SWV
Turkey
http://www.medikalteknik.com.tr/gskdan-gribe-karsi-dort-dortluk-koruma/
https://istanbulalerjimerkezi.com.tr/grip-asisi/
Hungary
https://www.webbeteg.hu/gyogyszerkereso/vaxigrip-tetra-szuszpenzios/903055/betegtajekoztato
Finland
https://perusterveys.fi/influenssarokotus/
https://thl.fi/fi/web/infektiotaudit-ja-rokotukset/rokotteet-a-o/influenssarokote
https://www.keski-uudenmaansote.fi/asiakasryhmien_palvelut/terveys-ja-sairaanhoito/laakari--ja-hoitajavastaanotot/rokotukset/influenssarokotukset/
Denmark
https://www.ssi.dk/produkter-og-ydelser/bestilling/influenzavaccination-2019-2020
http://xnet.dkma.dk/indlaegsseddel/PdfFileServlet?formulationid=16307&lang=da
http://xnet.dkma.dk/indlaegsseddel/PdfFileServlet?formulationid=926&lang=da
8. Brand Names
https://www.drugs.com/ppa/influenza-virus-vaccine-inactivated.html
https://vk.ovg.ox.ac.uk/vk/vaccine-ingredients#MF59
1. Go to the OECD coverage statistics (https://data.oecd.org/healthcare/influenza-vaccination-rates.htm) for over-65's and a reasonable sample of countries. Get a spreadsheet and enter the coverage rates in 1 column
2. Go to the Covid-19 realtime statistics (https://www.worldometers.info/coronavirus/) and cross-reference each country's "Deaths/1M pop" figure. This is the most reliable since deaths per case is all over the place due to wide differences in testing. (Tip: click on the column header for that column to sort in descending order. That brings all the "problem" countries to the top. Notice the significant difference between the top 10-15 and the rest). Populate column 2 of your spreadsheet with these figures
3. You need to distinctly account for the adjuvanted/non-adjuvanted status. It is a distinct medicating component that's added to the vaccine in order to generate a more powerful immune response. The reason this is important is because:
it's only given to over-65's and certain immuno-comprimised groups (the OECD data above applies to over-65's, so compatible)
its use is delineated by health jurisdiction. Some health ministries have an over-65 adjuvanted policy, some don't (so compatible with the death rate data which is also grouped by country)
while the vaccine changes from year to year, the adjuvant doesn't and recipients are re-medicated with it each year. The adjuvant is squaline (shark oil) in an oil-in-water emulsion which is stabilised with an additive called Polysorbate 80
4. In column 3 of your spreadsheet, identify the health juristictions which have non-adjuvanted vaccination policies for over-65 and immunocompromised. Set their coverage rates to zero while copying the other coverage rates across from column 1.
You'll end up with 2 graphs: 1 with death rate against influenza vaccine coverage in general and 1 against adjuvant coverage. Step 3 is slightly non-trivial and requires a bit of work. Even at that, definitive figures are quite opaque. See below.
****** SIDE NOTE: *****
This is an extremely important public health consciousness exercise whatever side of the "vaccine debate" people find themselves on since the public are the consumers of these medication products yet the statistical data is quite opaque beyond generalised coverage rates.
Everyone must participate. If people are not numerate then get someone who is to assist and help each other validate information resources. Otherwise we are sitting on our hands with our thumbs in our mouths listening to random Youtubers mouth off. The work is supposed to be done by an activity called "pharma covigilance (https://en.wikipedia.org/wiki/Pharmacovigilance)" but if this institutionalised process ever comes up with "uncomfortable results" it's unlikely that they'd be instantly made available. For example, having spoken to healthcare professionals in the UK I'm fairly certain that Covid-19 deaths are not being cross referenced to medication history and primary care records, at least not officially that I'm aware of and certainly not openly. Also, there are simply a myriad of conflicts of interests involved and the more the public are familiar with what they are consuming, the less they'll be manipulable by scare stories (in either direction). I'm sorry but there really is no other way than to do the research YOURSELF or in well informed groups in order to arrive at a more informed perspective than is provided by random Youtube comments, albeit assisted by professionals that you trust if necessary. (Though this being a simple statistical exercise should not require anything other than counting skills).
Regarding step 3 above, the OECD statistics make no distinction between adjuvanted and non-adjuvanted coverage even though the vaccine and adjuvant are distinct medications. (So distinct in fact that the adjuvant can be contracted for manufacture (https://english.alarabiya.net/en/coronavirus/2020/05/28/Coronavirus-UK-pharma-giant-GlaxoSmithKline-to-make-1-billion-vaccine-booster-shots) even when the vaccine doesn't yet exist).
To determine this information it's necessary to go to each country's health ministry websites or other indirect sources. In the abscence of officially stated policy, some guesswork may be required via recourse to indirect resources such as news items covering vaccine contracts placed by health authorities with vaccine manufacturers or teaching resources created by local healthcare professionals. (More publicly available & accurate information on this would be helpful in terms of supporting confidence in vaccine performance).
3 general categories emerge with specific regard to adjuvant use:
A: Current, unambiguous adopters (Health juristictions that unambiguously recommend the adjuvanted version to over-65's, care homes & immuno-compromised)
B: Historical adopters (May be currently licensed or unlicensed, may have had a previous swine flu - Pandemrix- campaign)
C: Non-adopters
Here's some links to start you off. Don't be lazy now ;)
Europe: Background to Adjuvanted Influenza Vaccine Licensing
The adjuvanted flu vaccine has a history of use in most European countries, however is only licensed in some of them at the present time according to EU licensing tables.
In general, the adjuvanted vaccine is licensed for over 65’s in:
Some European Union countries (Spain + Italy have the longest continuous use reportedly) + UK
United States
Canada
See:
https://www.arznei-telegramm.de/html/2000_09/0009075_01.html
https://www.ecdc.europa.eu/en/seasonal-influenza/prevention-and-control/vaccines/types-of-seasonal-influenza-vaccine
Country by country table:
https://www.ecdc.europa.eu/en/publications-data/availability-influenza-vaccines-country-eueea-201920-season
And background to the MF59 adverse event in Italy and subsequent suspension by some EU countries:
https://www.tandfonline.com/doi/pdf/10.1080/21645515.2017.1420448
USA: Background:
Quadrivalent version trials carried out in Boston and North Carolina (Dukes University Medical Centre)
https://clinicaltrials.gov/ct2/show/NCT03183908
Chile
Statistics on types of vaccine, composition (with particular regard to adjuvants) and coverage for Chile are not very easy to acquire. However this document produced by the Chilean ministry of health (Ministereo de Salud) does specifically state the Vaccine brands being deployed for the year 2017.
https://www.minsal.cl/wp-content/uploads/2015/09/VC-Programa-Adulto-mayor-Vacunas-en-adultos-Influenza-y-Neumococcica.pdf
The Spanish association of Vaccinology has a useful table with which to cross-reference brand names in the Hispanic world to vaccine content, in particular whether or not they are adjuvanted.
https://www.vacunas.org/vacunacion-7/
New Zealand
This document has been published by the New Zealand Immunisation Advisory Centre:
https://www.influenza.org.nz/2020-funded-influenza-vaccines
It indicates the vaccine brands being deployed for the 2020 flu season.
https://immunisationhandbook.health.gov.au/vaccines/afluria-quad
https://immunisationhandbook.health.gov.au/vaccines/influvac-tetra
Israel
The Health Ministry of Israel does not appear to publish specific guidance as to vaccine brand or type recommendations on its publicly accessible pages. However one of the largest of its state-mandated health organisations (Clalit) appears to use a quadrivalent nasal-spray vaccine.
https://www.clalit.co.il/he/medical/pharmacy/Pages/medicines.aspx?idd=8007
https://web.archive.org/web/20180119123539/http://www.clalit-global.co.il/en/a_million_flu_vaccinations.html
https://www.health.gov.il/English/Topics/SeniorHealth/HealthPromo/Pages/Vaccines_In_Elderly.aspx
https://www.businesswire.com/news/home/20180925005100/en/AstraZeneca-Ships-FLUMIST%C2%AE-QUADRIVALENT-Vaccine-2018-2019-Flu
Belgium
https://www.ema.europa.eu/en/news/no-evidence-fluad-vaccine-caused-deaths-italy
Note also that the Belgian government’s scientific committee for coronavirus has stated that Belgian death rates “should be halved” to obtain a comparable statistic with other countries due to their reporting protocol.
https://www.politico.eu/article/why-is-belgiums-death-toll-so-high/
https://www.bostonglobe.com/2020/04/25/nation/why-worlds-highest-coronavirus-death-rate-is-europes-capital/
See also:
https://archpublichealth.biomedcentral.com/articles/10.1186/0778-7367-68-3-109
https://www.lemonde.fr/planete/article/2009/10/19/en-belgique-la-vaccination-contre-la-grippe-a-h1n1-est-vivement-critiquee_1255770_3244.html
https://medicalxpress.com/news/2014-12-european-drug-novartis-flu-vaccine.html
https://www.vaccination-info.be/maladie/grippe/
https://www.gsk.com/en-gb/media/press-releases/glaxosmithkline-update-a-h1n1-influenza-vaccine-development/
Singapore
https://www.parkwayshenton.com/healthplus/article/fight-flu-get-vaccinated
http://activeage.co/new-four-strain-influenza-vaccine-now-available-in-singapore/
https://www.raffleshealth.com/flu-vaccination-with-consultation.html
https://www.moh.gov.sg/news-highlights/details/moh-establishes-national-adult-immunisation-schedule-extends-use-of-medisave-for-vaccines-under-the-schedule
Vaccine coverage in Singapore:
https://www.todayonline.com/singapore/moh-introduces-new-list-recommended-vaccine-jabs-adults
https://trialsjournal.biomedcentral.com/articles/10.1186/s13063-017-1808-8#ref-CR18
The Netherlands
https://www.rivm.nl/bibliotheek/rapporten/2019-0002.pdf
Also:
https://www.rivm.nl/griep-griepprik/zorg/vaccineren/griepvaccin
Brazil
Historically there were substantial emergency vaccination programs deployed in 2015 and 2016 in response to the Zika and H1N1 (swine flu) viruses.
https://pubmed.ncbi.nlm.nih.gov/22609010/
http://rsaude.com.br/florianopolis/materia/vacinas-em-situacoes-especiais-influenza-2017/12355
https://www.bbc.co.uk/news/world-latin-america-36145181
https://saude.abril.com.br/medicina/as-vacinas-aprovadas-contra-a-gripe-para-2019-campanha-comeca-em-abril/
Iceland
https://www.landlaeknir.is/servlet/file/store93/item35741/Skr%C3%A1ning%20fyrri%20bs%20%C3%AD%20s%C3%B6gu.pdf
https://www.heilsugaeslan.is/um-hh/frettasafn/stok-frett/2019/09/24/Bolusetning-gegn-arlegri-influensu-/
https://www.landlaeknir.is/gaedi-og-eftirlit/heilbrigdisstarfsfolk/dreifibref/nanar/item29921/Dreifibref-nr--1/2016--Bolusetning-gegn-influensu
https://www.serlyfjaskra.is/FileRepos/7a333746-5073-ea11-80fc-00155d15460a/Vaxigrip_Tetra_Fylgise%C3%B0ill.pdf
Australia:
https://www.abc.net.au/news/2018-02-19/fluad-fluzone-flu-vaccines-for-over-65s-what-you-need-to-know/9461766
https://www.ebs.tga.gov.au/ebs/picmi/picmirepository.nsf/pdf?OpenAgent&id=CP-2020-CMI-01074-1&d=202006111016933
https://www.eurosurveillance.org/content/10.2807/1560-7917.ES.2017.22.43.17-00707#html_fulltext
https://www.health.gov.au/health-topics/immunisation/immunisation-services/flu-influenza-immunisation-service-0
https://theconversation.com/heres-why-the-2017-flu-season-was-so-bad-86605
Czech Republic
https://www.ockovacicentrum.cz/cz/vaxigrip-tetra
https://vakciny.avenier.cz/cz/chripkova-sezona-20192020
Germany
https://www.pei.de/DE/arzneimittel/impfstoffe/influenza-grippe/influenza-node.html
Portugal
https://www.dgs.pt/directrizes-da-dgs/normas-e-circulares-normativas/norma-n-0062019-de-07102019-atualizada-a-14102019.aspx
Japan
https://www.nibiohn.go.jp/CVAR/adjuvant.html
Sweden
https://www.snih.org/tales-of-the-past-pandemrix-and-narcolepsy-in-sweden/
https://www.janusinfo.se/nyheter/nyheter/2019/dagsforvaccinationavriskgrupper.5.7231e45916df3792b301d37a.html
https://medikament.se/l%C3%A4kemedel/fluad-2018-2019-injektion-
https://www.folkhalsomyndigheten.se/contentassets/4975c907ea244c2e8bdb1b5f6e385f74/influensavaccination-riskgrupper-15100.pdf
Northern Ireland
https://www.publichealth.hscni.net/news/joint-statement-regarding-availability-seasonal-flu-vaccine
Republic of Ireland
https://www.hse.ie/eng/health/immunisation/hcpinfo/guidelines/chapter11.pdf
France
https://pubmed.ncbi.nlm.nih.gov/15599987/
https://www.has-sante.fr/upload/docs/application/pdf/2018-08/recommandation_vaccinale__extension_des_competences_des_professionnels_de_sante_en_matiere_de_vaccin _2018-08-08_14-46-16_310.pdf
Korea
https://www.ncbi.nlm.nih.gov/pmc/articles/PMC6312896/#B15
See:
https://koreauniv.pure.elsevier.com/en/publications/cost-effectiveness-of-influenza-vaccine-strategies-for-the-elderl
https://synapse.koreamed.org/DOIx.php?id=10.3947/ic.2017.49.4.247
Norway
https://www.seqirus.com/news/fluad-tetra-chmp
Currently available flu vaccine brands in Norway:
https://vaksinebestilling.fhi.no/produkter/influensavaksiner
Estonia
https://www.virtuaalkliinik.ee/uudised/2019/09/03/tanavu-jouab-eestisse-kolm-neljavalentset-gripivaktsiini
Slovenia
https://www.adm.si/Nasveti?n/9HND3SWV
Turkey
http://www.medikalteknik.com.tr/gskdan-gribe-karsi-dort-dortluk-koruma/
https://istanbulalerjimerkezi.com.tr/grip-asisi/
Hungary
https://www.webbeteg.hu/gyogyszerkereso/vaxigrip-tetra-szuszpenzios/903055/betegtajekoztato
Finland
https://perusterveys.fi/influenssarokotus/
https://thl.fi/fi/web/infektiotaudit-ja-rokotukset/rokotteet-a-o/influenssarokote
https://www.keski-uudenmaansote.fi/asiakasryhmien_palvelut/terveys-ja-sairaanhoito/laakari--ja-hoitajavastaanotot/rokotukset/influenssarokotukset/
Denmark
https://www.ssi.dk/produkter-og-ydelser/bestilling/influenzavaccination-2019-2020
http://xnet.dkma.dk/indlaegsseddel/PdfFileServlet?formulationid=16307&lang=da
http://xnet.dkma.dk/indlaegsseddel/PdfFileServlet?formulationid=926&lang=da
8. Brand Names
https://www.drugs.com/ppa/influenza-virus-vaccine-inactivated.html
https://vk.ovg.ox.ac.uk/vk/vaccine-ingredients#MF59