Dear Dr Bharti You raise a very interesting point about the potential to increase the availability of H1N1 vaccines by delivering a reduced dose by the intradermal (ID) route. Certainly, any approaches that could improve access to H1N1 vaccines would be extremely valuable. However, whether or not dose sparing is going to be possible with H1N1 vaccines by using the ID route still needs to be tested in clinical trials. Unfortunately, a review of the literature shows that ID delivery does not always result in the same degree of dose-sparing for all vaccines. For example, Sanofi's ID formulation of flu vaccine which you have kindly brought to everyone's attention still contains 9 ug HA of each strain (only a 40% dose-saving). For more details, please see the report we compiled for PATH and Project Optimize (highlighted by Debra Kristensen in Technet21 Digest, issue 20). The ID route of delivery could have many benefits (in addition to stretching the supply of some vaccines), but further clinical trials are both required and warranted so that we have a better understanding of what is achievable by administering vaccines this way. Kind regards Julian Hickling MBA PhD Working in Tandem Ltd

Dear Sir, Thanks for the mail. Actually we need to do simultaneous trials for intradermal delivery of H1N1 vaccine to spare the vaccine and save the money as well. There is more to it, please refer to the link below, http://www.ncbi.nlm.nih.gov/pubmed/15525714?ordinalpos=1&itool=EntrezSystem2.PEntrez.Pubmed.Pubmed_ResultsPanel.Pubmed_DiscoveryPanel.Pubmed_Discovery_RA&linkpos=2&log$=relatedarticles&logdbfrom=pubmed Let some one do the trials, but the evidence is supportive the the Intradermal vaccine is not only dose sparing but effective as well,Regards, Dr. Omesh BhartiM.B.B.S.,D.H.M.,M.A.E.(Epidemiology) Directorate of Health Safety and Regulation,Himachal Pradesh+91-9418120302 [[email protected]][email protected][/email]; [email protected] --- On Mon, 28/9/09, julian wrote: