Swine flu vaccine first doses are being administered in the United States today, at first targeting health-care workers as the country’s biggest influenza prevention program seeks to slow the pandemic.
Among the first to have AstraZeneca Plc’s nasal spray vaccine are doctors and hospital workers in Marion County, Indiana, and Le Bonheur Children’s Medical Center in Memphis, Tennessee. About 600,000 tubes will be shipped by tomorrow, with shots coming later this week totaling 6 million to 7 million doses, said Bill Hall, spokesman for the Health and Human Services Department.
Swine flu, or H1N1, is spreading widely in most U.S. states. The first H1N1 vaccines will be targeted at health-care workers, children, pregnant women and people with chronic conditions that put them at risk for complications. While the U.S. has ordered doses to cover all Americans, only half of U.S. adults plan to get the vaccine, according to a Harvard University poll.
“This is uncharted territory for an influenza season; we’ve already had many millions of cases, and we will have many millions of cases more,” Thomas Frieden, head of the Atlanta- based Centers for Disease Control and Prevention, told members of Congress on September 29. “Over the next several weeks, there will be some vaccine in the system, but there will also be some roughness as it gets distributed.”
Most adults, including the elderly, should wait until abundant supplies of vaccine arrive, according to CDC recommendations. About 40 to 50 million vaccines will be ready to ship next week, Hall said.
Same Procedure
The H1N1 vaccines are made with the same ingredients, dose and manufacturing process as the seasonal influenza vaccine given to 100 million Americans each year, Frieden said at the hearing in Washington. The H1N1 vaccine is more effective than some seasonal shots because the virus hasn’t mutated and matches the vaccine, he said.
Individual states will decide how initial vaccine doses are distributed, said Anne Schuchat, head of the National Center for Immunization and Respiratory Diseases at the CDC. Many areas will focus on inoculating health- care workers in the initial days when supply is most limited, she said.
Sixty children have died from H1N1 since April in the U.S.. That’s more than die in an entire season in some years, Schuchat said in an interview October 2.
“We went as fast as we could without taking shortcuts,” with vaccine testing and production, said Bruce Gellin, director of the National Vaccine Program Office at the HHS Department. “I have an 11-year-old son, and I would like to have him protected.”
Surging Cases
Hospitals in the Northern Hemisphere are bracing for a surge of cases in coming weeks, spurred by colder weather that promotes spread of the flu. While a majority of people infected with H1N1 have similar symptoms as the seasonal flu – cough, fever, sore throat, aches and fatigue – a small number of otherwise healthy people develop life- threatening disease.
Cases spiked when students returned to classes in September, and U.S. flu rates are currently higher than the February peaks of two of the last three seasons, according to CDC surveillance data. The illness swept through college campuses, with more than 27,000 potential cases reported out of 3.2 million students tracked by the American College Health Association. Last week, 6,527 new cases were reported at colleges, down 19 percent from the previous week.
Swine flu is responsible for more than 600 U.S. deaths since the virus was identified in April, Schuchat said. Cases of severe illness occurred during spring and summer months when flu typically doesn’t spread in the U.S.
Pregnant Women
Pregnant women are especially at risk. More than 100 pregnant women have been hospitalized in intensive care units, and 28 have died, Schuchat said. The H1N1 shot is recommended for pregnant women, though the nasal spray isn’t, she said.
Each year, influenza kills about 36,000 people. The majority of deaths are in people older than age 80, according to the CDC. In contrast, swine flu attacks children hardest, while older people have some immunity, probably from exposure early in life to a virus that was genetically similar to the new H1N1, according to the National Institutes of Health, which conducted the vaccine tests.
The U.S. government took the unusual step of buying all of the H1N1 vaccines and is funneling them through San Francisco- based McKesson Corp., the biggest U.S. distributor of drugs and medical supplies. States, health departments and large cities can order the vaccine through a CDC website, and the U.S. plans to distribute them directly to 90,000 doctors’ offices, pharmacies and school- based vaccination programs.
Poll Results
About 53 percent of adults said they plan to get vaccinated, with 41 percent saying they won’t and 6 percent saying they’re not sure, according to a telephone poll of 1,042 people conducted by Harvard University School of Public Health from September 14 to 20. About 70 percent of parents said they will get the H1N1 vaccine for their children.
New York became the first state this year to require health-care workers to get the swine flu vaccine. Health-care workers are at high risk for getting the flu and passing it to their patients and families, said the CDC’s Frieden, who was formerly New York City health commissioner. Frieden told Congress the CDC may consider a federal mandate for future flu seasons.
“I object to the government telling me what shots I’ve got to take,” said Gail Sloan, a registered nurse in the emergency room at A.O. Fox Memorial Hospital in Oneonta, New York. “The vaccine has been pushed by drug companies and I don’t think it has been fully tested.”
Sloan was one of more than 200 demonstrators Sept. 29 outside the capitol building in Albany carrying signs such as “NYS Health Workers Are Not Lab Rats.”
Dead Virus
Flu shots are made from dead virus samples that trigger the body into producing protective antibodies to fight off future infections. They’re approved for everyone older than 6 months, and enough doses of the swine flu vaccine will be available in the coming months for anyone who wants one, according to the CDC. Possible side effects include soreness where the shot was given, low-grade fever and aches.
The nasal vaccine is made from a genetically weakened form of the virus and is approved for people ages 2 to 49, excluding pregnant women and people with breathing difficulties such as asthma. Side effects are similar and may also include runny nose, wheezing, cough or headache. It’s impossible to contract the flu from either vaccine, the CDC’s Frieden said.
For the seasonal and swine flu vaccines, children under age 10 require two doses to prime and boost their immune systems.
The vaccines are free, though doctors and pharmacies may charge a fee to administer them. Some health departments are setting up free centers to administer the vaccine, and New York is offering shots free to children with consenting parents.
Seasonal Flu Shot
A separate vaccine against the seasonal flu is now available in the U.S., though Paris-based Sanofi-Aventis SA reported delays that are causing shortages in some U.S. areas. Sanofi is “a few weeks” behind schedule, and has distributed more than half of its allocated 50.5 million doses to the U.S., spokeswoman Donna Cary said in an e-mail last week.
About 70 million doses have been shipped across the U.S., more than is typical for this time of year, and any shortages should be temporary, the CDC’s Schuchat said. The seasonal flu shot doesn’t help against swine flu, she said.
Vaccine suppliers Sanofi, London-based AstraZeneca and GlaxoSmithKline Plc; Basel, Switzerland-based Novartis AG and CSL Ltd. of Australia are making 114 million seasonal flu doses, and 251 million swine flu doses for the U.S., according to HHS. About 10 percent of the H1N1 supply will be donated to poor countries, according to the department.
The new H1N1 influenza strain has killed at least 3,917 people worldwide and spread to 191 countries and territories.
