The elderly and chronically ill may be given free vaccinations against pneumonia to reduce deaths if the city is hit by a swine flu pandemic. In anticipation of a swine flu outbreak that could last from a few months to even a year, health officials have decided that vaccination is a key long-term strategy against a flu pandemic. A scientific committee under the Centre for Health Protection will meet soon to study the effectiveness of three vaccines - human swine flu vaccines expected to be available in a few months, ordinary seasonal flu vaccines and pneumococcal vaccines against pneumonia. The committee, formed by medical experts, will hold discussions if all three vaccines are recommended. The government will then decide if the vaccines should be provided free, and to whom. Medical experts said many deaths during a flu pandemic were caused by secondary bacterial infections, which occur when flu attacks patients' immunity. The pneumococcal vaccine can protect against infections of Streptococcus pneumoniae, a common bacteria that causes pneumonia, meningitis, bacteremia - the presence of bacteria in the blood - and ear infections. The University of Hong Kong has completed a study showing that a double vaccination against seasonal flu and streptococcus could significantly reduce hospital admissions and deaths during a flu season. The findings are in line with overseas studies which found that the death and hospital admission rates among chronic lung disease patients during a flu peak was cut by 81 per cent and 64 per cent, respectively, if double vaccinations were used. 'Health officials tend to support a double vaccination programme [against seasonal flu and Streptococcus pneumoniae] and agree that it has to be done before the coming winter flu season,' a senior medical source close to the discussions said. From September, children under two can receive the pneumococcal vaccination free at government clinics. The department estimated that a total of 280,000 doses would be required each year, as there were about 70,000 newborns annually. While infants needed four doses of the pneumococcal vaccine, elderly patients needed only one dose. The cost of the vaccine for the elderly was also cheaper. 'The free pneumococcal vaccination for children can increase protection during a pandemic. The issue is whether this free programme should be expanded to other groups,' the source said. However, the safety issue of the new human swine flu vaccines has been an important concern among health officials. In 1976, swine flu vaccines used in the United States were associated with contracting Guillain-Barre syndrome, a disease in which the body damages its own nerve cells, resulting in muscle weakness and sometimes paralysis. University of Hong Kong microbiologist Ho Pak-leung, who had pushed for pneumococcal vaccination for children, said the vaccine could reduce the risk of pneumonia. He said flu could cause increased mortality of between 30 and 50 per cent if a patient had a co-infection with other bacteria. Another medical source said that the government had also discussed a long-term strategy for suspending Hong Kong school classes, after considering that it was impossible to close all schools indefinitely. Health officials have said that should there be a community case of human swine flu, all classes at kindergartens, nursery schools and primary schools would close. The source said Hong Kong had to be prepared for swine flu being here for a long period, and said that plans should be drawn up now on how schools should reopen after the summer holidays. 'New ideas include a policy to only close schools where swine flu cases are found, or only close the schools in that area,' the source said.