In the 1918 19 H1N1 pandemic, rates of clinical illness were less than 20% in some urbanised communities, but more than 60% in isolated communities such as Western Samoa [1] [4].
Although data on the immunization rate before pandemic season is not available in out cohort, we could postulate that, after the initial fear related to pandemic, the coverage returned to a low pre-pandemic rate progressively moving far from the pandemic year.
Also during a pandemic, vaccination rate did not increase, and, although the rate was higher than for seasonal flu, H1N1 vaccination coverage was totally unsatisfactory.
Figure 1 depicts graphically the association between pandemic mortality rate and public spending on health.
Intention for the pandemic vaccination rate that was 22% in a study from Greece was lower than ours [ 9].
To estimate pandemic mortality rate, we can define a discrete period of pandemic influenza activity and estimate the number of deaths in excess of background deaths that occurred during the pandemic period.
During the 2009 pandemic, the rate of ICU admission for respiratory failure among hospitalized patients with a confirmed diagnosis of influenza A (H1N1v) ranged from 15% to 34% [ 18- 22].
Australian indigenous populations have more respiratory infections than nonindigenous groups (25 ), and the higher pandemic attack rate in this group is also consistent with their overrepresentation in admissions to intensive care units (26 ).
Despite numerous programs to combat the global HIV and AIDS pandemic, infection rate s remain high, especially in sub-Saharan Africa, where two-thirds of all people living with HIV reside.
For example, assuming a pandemic attack rate of 3 times the seasonal average, we simply scale up the seasonal influenza cost by a factor of 3. In addition, there is a cost for the Norwegian government of stockpiling Tamiflu for pandemic influenza (K. Sælensminde, personal communication, 10 November 2009).
