Exclusive interview with MOLDPRES by head of Strategic Center for Health Policy

Exclusive interview with MOLDPRES by Inga Pasecinic, head of the Strategic Center for Health Policy.

MOLDPRES: Mrs Pasecinic, the pandemic has greatly changed our way of life and even our perception of concepts and attitudes towards health. The new coronavirus is on the rise. Is there a possibility, if not prevention, then at least minimize the impact of this phenomenon on the health system and citizens?

Inga Pasecinic: Even in normal times, the flu season has the potential to strain health systems. The Center for Disease Control and Prevention (CDC) estimates that between 9 million and 45 million people worldwide are infected with the flu each year, and between 140,000 and 810,000 are hospitalized. At the same time, the impact for hospitals is about 10 million flu-related hospitalizations.

This year's flu season will be a very difficult one, even the most difficult in modern history. Both influenza and Covid-19 are manifested by respiratory symptoms, and a severe case of any of these can lead directly to complications and hospitalization. Given how Covid-19 has already depleted the health system's resources, affecting the capacity of many hospitals, health experts say it will be crucial to carry out a large-scale vaccination against the flu to reduce the added strain. Preventing hospitalizations from the flu could help the health system, which is already overloaded due to the COVID-19 pandemic.

MOLDPRES: We know from the statements of several officials that flu vaccines will traditionally be available in our country in November. Do you think that in the created situation we should act more energetically, faster and more efficiently to prevent an unprecedented exacerbation of the crisis?

IP: Influenza vaccines are designed to provide protection against three to four strains of the virus that scientists predict could circulate in the autumn and winter, which means that the effectiveness of this vaccine may vary from year to year.  Even if it does not always prevent an infection, a flu vaccine can protect against severe complications.

There are already some efforts to launch tests that detect both COVID-19 and influenza, as the ability to quickly distinguish between the two will have important implications for isolation and contact tracking efforts.

According to the CDC, the population is preferable to be vaccinated in early autumn, ideally by late October to provide protection for most of the flu season. The CDC says vaccination too soon - in July or August, for example - is associated with less protection in the flu season.

MOLDPRES: I partially agree on the deadlines. But don't you think that fear will create a demand for vaccines far beyond the traditional one?

I.P .: With the rapid approach of the flu season and under pandemic COVID-19, hospitals and pharmacies in many countries around the world have formed much larger stocks of flu vaccines than usual, anticipating an increase in demand.

Colleagues from Romania informed me about a shortage of influenza vaccine, although vaccine volumes for the current season were estimated based on private market deliveries from the previous season, and to help increase the vaccination rate, a 33% higher dose volume was purchased compared to last season, delivered in pharmacies in early October.

MOLDPRES: Do you think it would be good to take over the experience of European countries and especially Romania in terms of immunization?

I.P .: All European countries, including Romania, implement annual free influenza vaccination campaigns. As part of these free vaccination campaigns, people aged over 65 are immunized as priority, with chronic diseases, especially respiratory and cardiovascular diseases, metabolic diseases, institutionalized children and the elderly, medical staff, and pregnant women, according to WHO recommendations.

Speaking about Romania, for 2020-2021 season, the Ministry of Health purchased 3 million doses of flu vaccine, a double the amount compared to last year (with a potential increase to 14 million), in order to immunize as many people as possible.

In most countries, anyone who wants to get vaccinated against the flu can get the vaccine, which is widely available to all pharmacies. For example, in Romania, given the epidemiological situation, the Ministry of Health came up with a recommendation to the population that does not fall into the category of high risk of disease to purchase the vaccine for immunization. The Ministry of Health also requires pharmaceutical units to stock up on flu vaccine in advance.

MOLDPRES: Why don't we have vaccines in pharmacies and why isn't there a more competitive market that would make vaccines more affordable and cheaper?

I.P .: In the Republic of Moldova, the annual influenza vaccination is mostly covered by the National Immunization Program developed by the Ministry of Health, Labor and Social Protection, carried out largely through Primary Health Care, for at-risk population categories. So far, free influenza vaccination campaigns have been implemented in the Republic of Moldova.

In Moldova we face several significant challenges in this regard, starting with the limited accessibility of influenza vaccines, low social responsibility and controversial opinions of the population on viral infections, prevention and vaccination.

Vaccination remains the best way to prevent the flu and the risk of complications from the disease.

Maybe we should take the positive experience of other countries. The pandemic is an opportunity to explain to people about infections and to promote the importance of vaccination.

MOLDPRES: Is there any idea for the National Health Insurance Company to cover some of the costs of immunization?

I.P .: There are few examples, which belong exclusively to developed countries, with sustainable health systems, where a universal coverage with influenza vaccine from social insurance is guaranteed.

Within the Compulsory Health Insurance there is the fund of prophylaxis measures, which could be mobilized for this purpose, to cover a wider layer of the population.

I think it would be good to have at least the opportunity to get the flu vaccine on our own.

MOLDPRES: What are your predictions about the evolution of the pandemic in Moldova and what is the forecast on deadlines of appearance of anti-COVID-19 vaccine?

I.P .: There is a tight global race to develop a COVID vaccine. 150 such projects are being worked on worldwide. Only after successfully completing three stages of testing, the vaccine is approved and can reach the market.

I hope we will have access to the widespread flu vaccine in the Republic of Moldova as well, and people will take responsibility for protecting not only themselves but also their friends, family and colleagues this season.

It is true that existing steps to reduce the spread of Covid-19 - including social distancing, masks and increased hand washing - can also help keep the flu transmission lower. But flu vaccination is the key to this effort.

MOLDPRES: Thank you very much.