US vaccine supply

I am rather outspoken in my support of the pandemic H1N1-2009 vaccination campaign.  In the space of two weeks my son and then my husband have come down with [presumed] “Swine Flu”, and we had our first infection at my “day job”.

This week we also had a vaccination campaign at work.  Our seasonal vaccine was paid for by the corporation that employs me and the pandemic vaccine [FluMist] was paid for by the government.  I am pleased to say that our vaccine uptake at work was impressive.  Those that were eligible [no contraindications] to receive the FluMist vaccine opted to get it as well if they were getting their seasonal vaccine.

The vaccines can be difficult to come by, depending on which version one wants or needs:

Swine flu vaccines delayed, CDC says

Fri Oct 16, 2009 9:54pm EDT

By Maggie Fox, Health and Science Editor

WASHINGTON (Reuters) – Delivery of some swine flu vaccines has been delayed because companies cannot make it as fast as they had hoped, just as the virus has really started to spread, the U.S. Centers for Disease Control and Prevention said on Friday.

The CDC’s Dr. Anne Schuchat said that while 40 million doses had been anticipated for the end of October, only about 28 to 30 million doses would be available.

“Yields for vaccine are lower than would be hoped,” Schuchat said in a telephone briefing. “We unfortunately won’t have as much at the end of this month as we had hoped to.”

We have over 300 million people in the US. That’s a considerable shortage of vaccines.

She also said deaths from H1N1 swine flu were above the epidemic threshold in some U.S. cities and states. H1N1 flu activity was widespread in 41 states, she said.

It is unprecedented for this time of year to have the whole country having such high levels of activity,” Schuchat said.

An interesting “lesson” from this thankfully mild pandemic is that official assumptions have generally been that infections would “roll” across the country.

US Influenza 2009 Week 40

CDC : US Influenza 2009 Week 40

We now know that the “official assumption” is not supported by the reality of a highly infectious, even if mild, disease.

“There are now a total of 86 children under 18 who have died from the 2009 H1N1 influenza virus,” she added. Many had died in recent weeks and the number was now higher than the usual number of child deaths in an entire flu season.

These are very sobering statistics … 43 deaths in one month is a lot,” Schuchat said. “Some of these children have been totally healthy.”

Older children were hardest hit, she said, with 16 deaths among 5- to 11-year-olds and 19 deaths in 12- to 17-year-olds.

That would leave 8 deaths for children under 5.

I cannot help but remember the furor – and efforts expended – and costs incurred – when salmonella showed up in peanut butter.  Every peanut butter product was cleared from store shelves irrespective of whether they used the contaminated institutional product in their manufacture.  People cleared their pantries and cupboards of everything “peanut butter” in order to protect themselves [and their children] from the salmonella threat.

Not for the first time I find myself wondering why we can be outraged and driven to action [sometimes over reaction] when the perceived threat is caused by “the hand of man” yet many of us blithely ignore the potential assaults on our health from infectious disease – influenza specifically in this case.  Perception being “it’s only the flu” for many.  For most salmonella is no worse than a genuine case of influenza – yet look what we did in the face of that threat.  Mother nature just doesn’t inspire the same factor of outrage as human malfeasance.  Odd but true.

BUMPY DELIVERY

Schuchat said 15 percent to 20 percent of patients with H1N1 who needed to be hospitalized were requiring intensive care. “Influenza is widespread in the country and illnesses, hospitalizations and deaths continue to increase,” she said.

The U.S. government has opted to roll out seasonal flu vaccine and H1N1 vaccines as they become available, which the CDC has said could make for a bumpy vaccination plan.

People need both vaccines to be protected from all the circulating viruses, although Schuchat says virtually all cases of influenza are due to the new H1N1 virus.

I received my seasonal influenza vaccine on Thursday, paid for by my employer. The doctor’s office that was administering the seasonal vaccine was also administering the FluMist version of the pandemic strain vaccine, free of charge thanks to the government.

I turned 50 years old in April of this year and so I am a few months outside the official “2-49″ age range for FluMist.  I attempted to ask the nurse to administer the FluMist vaccine anyway, given I was only a few months outside the official guidance.  She very angrily responded that “It wasn’t safe!” to do so.  My counter was that if it would have been “safe” for me in March it was “safe” for me in October.

Needless to say, I was roundly denied the vaccine irrespective of “me as an individual”.  Not only was I flatly denied, the nurse reacted as if I had asked her to administer poison.  I very much wanted to tell the nurse that I was quite confident that I probably knew a great deal more about the vaccine than she but decided there really are times in life when fact and reality have no meaning outside an arbitrarily drawn line of demarcation.

Yes, the height of irony: I have spent two years expounding on the superiority of FluMist to the traditional injected vaccine, I have spent months exhorting the prudence of vaccination in the face of a pandemic, I… me… denied a vaccine because I am a few months too old.

Although I was angered by the arbitrariness of the “line of demarcation” and angered by someone obviously informed by nothing more than “orders”, I have no anger about being unvaccinated.  With only so many to go around some of us will just have to do without.  At least for the time being.

“This is how influenza vaccine production often goes,” Schuchat said. She said there should be widespread availability by November and advised people who wanted a vaccine but were having trouble finding one to keep trying.

Good advice. Advice I will surely follow. But as sound as the advice is, there will be an awful lot of us who will either become infected before we find a vaccine or this active phase of infection will pass and then we will lose the sense of urgency.  Influenza ain’t peanut butter.

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