The CDC’s Dr. Terrence Tumpey, staff microbiologist and a member of the National Center for Infectious Diseases, examining reconstructed 1918 Pandemic Influenza Virus inside a specimen vial. Dr. Tumpey recreated the 1918 influenza virus in order to identify the characteristics that made this organism such a deadly pathogen. Work such as this enables researchers to develop new vaccines and treatments for future pandemic influenza viruses. The 1918 Spanish flu epidemic caused by an influenza A (H1N1) virus, killed more than 500,000 people in the US, and up to 50 million worldwide. (Photo by James Gathany/CDC)
With the U.S. Centers for Disease Control and Prevention reporting that there is now “substantial flu in virtually all states” – and a majority is the H1N1 strain – states are finally receiving their first shipments of H1N1 vaccine.
According to the CDC, as of last Friday, Oct. 3, approximately 3 million doses were available to order, and a total of 6-7 million doses were expected to be available to order by the end of this week.
In a CDC press conference held last Thursday, Rear Admiral Dr. Anne Schuchat said that the first courses of the vaccine would be arriving in 23 states by Tuesday, Oct. 6. And that these first shipments would be the nasal inhalant form, because it could be formulated more quickly than the form that is injected.
Dr. Schuchat, who heads the National Center for Immunization and Respiratory Diseases, stressed that “there was no cutting corners” in clinical trials that preceded distribution of these first batches of H1N1 vaccine.
She added that clinical trials are continuing and, “so far, there have been no red flags, in terms of safety.”
Dr. Schuchat also repeated information announced in September, that this vaccine takes effect much faster than expected – in 8 to 10 days – compared to the three weeks initially expected, and that only one dose will be needed instead of two doses separated by four weeks.
The new vaccine has been described as “very robust” and this means people who get the vaccine will be protected much sooner.
Dr. Schuchat also stressed that “you cannot get the flu from the vaccine.”
Vaccine arriving in Connecticut
Photo by James Gathany/CDC.
On Oct. 9, Gov. M. Jodi Rell announced that an initial shipment of more than 20,000 doses of the intranasal H1N1 vaccine has arrived and another 20,000 doses, which will include the injectable form, are due next week. The vaccine is being distributed directly to providers who have placed orders with the state Department of Public Health.
Gov. Rell expects the state to receive more than 500,000 doses of both the injectable and intranasal H1N1 vaccines by mid-October and then several thousand more in weekly shipments thereafter.
28 deaths among pregnant women
Dr. Schuchat also reported that the H1N1 flu is already having an especially serious impact on pregnant women.
As of late August, she said, about 100 pregnant women throughout the US infected with H1N1 had been reported admitted to intensive care, and 28 of them died.
“These are upsetting numbers, I know,” she said. “I want to remind women, doctors and midwives that antiviral medication can be a very important protection.”
Her comments underline the strategy the federal government is recommending for administration of the H1N1 vaccine, and that is to encourage healthcare workers and employees who work with children to get immunized – thereby lowering the risk of infecting those they care for.
Complications of pneumonia
Dr. Schuchat also reported that autopsies performed on 77 people who died after contracting the H1N1 virus revealed that more than one-third also had developed pneumonia. What this means, she said, is that someone with a history of respiratory health issues, or with a weakened immune system might benefit from getting a pneumaccocal vaccination in addition to the H1N1 shot.
Tamiflu also available
In addition to the H1N1 vaccine, 300,000 courses of liquid Tamiflu – which is administered after someone has come down with the flu – is also being made available. “Each state will receive its proportion,” she said.
In addition to the H1N1 vaccine, 300,000 courses of liquid Tamiflu – which is administered after someone has come down with the flu – is also being made available. Pictured here is the capsule form.
In order to provide as much of this medication as possible, tests were run on supplies that have expired to determine if some might still be effective enough to distribute. “The FDA (Food and Drug Administration) has extended the expiration dates of some of the liquid formulation, after careful testing,” Dr. Schuchat said.
She said these supplies were found still to be potent and safe to use. “It’s not just changing the label,” she said.
Like the H1N1 flu vaccine, distribution of Tamiflu will be prioritized, with supplies going first to people with underlying illnesses such as diabetes and asthma, to pregnant women, and to “the very old and the very young,” Dr. Schuchat said.
Warning signs in children
Dr. Schuchat also outlined some warning signs for parents that may indicate the need to ask their doctor if their child might be in need of Tamiflu. These signs include fast breathing, “looking a little blue or gray,’ getting better and then getting much worse, and trouble being woken up.
Updates post on Fridays
Beginning last week, the CDC began posting updates on how much H1N1 vaccine is available and how much was shipped between Wednesday and Friday.
As of last week, there were 6 million doses available, “but more is being produced,” Dr. Schuchat said.
“We’re planning to have enough vaccine so that anybody who wants to be vaccinated can be,” she said.
“It is important to say that we are just in the beginning… but we are starting much earlier than expected,” she said. Last month, the CDC said it expected to receive vaccine in mid-October.
“The first doses will be the nasal spray, live attenuated influenza vaccine [LAIV], which we expect to be for those age 2 to 49, and for those with chronic medical conditions or who are pregnant,” Dr. Schuchat said.
“We are targeting the priority groups… which is more than half the country,” she said.
What Connecticut is doing
The Connecticut Department of Public Health, in accordance with the state’s H1N1 vaccination distribution plan, advises that the first shipments of the intranasal vaccine be used for healthy children 2-4, who are at greater risk for severe illness if they contract the H1N1 flu.
The first round also is being made available to caregivers and household contacts of children younger than 6 months, and hospital healthcare workers and Emergency Medical Services personnel with direct patient contact.
The second round of vaccine will expand the priority groups to include pregnant women and people under the age of 18 with high-risk medical conditions.
Colorized transmission electron micrograph of Avian influenza A H5N1 viruses (seen in gold) grown in MDCK cells (seen in green). The current H1N1 virus includes avian, swine and human flu strains. (Photo by Cynthia Goldsmith/CDC)
DPH Commissioner Dr. J. Robert Galvin says, “People who belong to these priority groups should contact their healthcare provider to find if their provider will be getting the vaccine. If somebody does not have a healthcare provider or if their provider is not getting the vaccine, they should call the H1N1 Hotline at 800-830-9426.”
He adds, “It is important that people understand that the vaccine is just now beginning to arrive in the state and we expect to receive more vaccine every week. People may need to be patient and persistent to get the vaccine in these early rounds of vaccine supply.”
DPH has established outlets where the public and providers can get information on the vaccine:
H1N1 hotline – 1-800-830-9426 or www.ct.gov/ctfluwatch The H1N1 hotline is staffed from 7 a.m. to 7 p.m., Monday through Friday (except Mon. Oct. 12 which is the Columbus Day holiday.)
Doctors and other health care providers interested in registering with the DPH to place orders for the vaccine can get information at:
www.ct.gov/ctfluwatch/providers or 860-509-7929.
Also get the seasonal flu shot
The H1N1 vaccine is only effective against the H1N1 virus and does not protect against seasonal influenza. Public health officials encourage Connecticut residents to get their seasonal flu vaccination, in addition to the H1N1 vaccination. That vaccine is available in a number of locations, including clinics held at pharmacies such as CVS and Walgreen’s, as well as doctor’s offices and some walk-in clinics.
More information is also available at www.flu.gov .
Posted Oct. 10, 2009
[Also see other stories posted here concerning the H1N1 flu, including, “Pregnant women first in line, age 65-and-older last for new H1N1 vaccine,” http://mansfield.htnp.com/?p=4726 and “Good news about the H1N1 vaccine,” published on Sept. 17, 2009 http://mansfield.htnp.com/?p=6025