24 August 2009

Massive Swine Flu Vaccination Campaign This Fall

From the Washington Post:

Swine Flu Campaign Waits on Vaccine

By Rob Stein
Washington Post Staff Writer
Sunday, August 23, 2009

Government health officials are mobilizing to launch a massive swine flu vaccination campaign this fall that is unprecedented in its scope -- and in the potential for complications.

The campaign aims to vaccinate at least half the country's population within months. Although more people have been inoculated against diseases such as smallpox and polio over a period of years, the United States has never tried to immunize so many so quickly.

But even as scientists rush to test the vaccine to ensure it is safe and effective, the campaign is lagging. Officials say only about a third as much vaccine as they had been expecting by mid-October is likely to arrive by then, when a new wave of infections could be peaking.

Among the unknowns: how many shots people will need, what the correct dosage should be, and how to avoid confusing the public with an overlapping effort to combat the regular seasonal flu.

To prepare, more than 2,800 local health departments have begun recruiting pediatricians, obstetricians, nurses, pharmacists, paramedics and even dentists, along with a small army of volunteers from churches and other groups. They are devising strategies to reach children, teenagers, pregnant women and young and middle-aged adults in inner cities, suburban enclaves and the countryside.

"This is potentially the largest mass-vaccination program in human history," said Howard Markel, a professor of medical history at the University of Michigan who is advising the Centers for Disease Control and Prevention as it spearheads the effort.

Public health officials describe the effort as crucial to defend against the second wave of the Northern Hemisphere's first influenza pandemic in 41 years.

As schools reopen, the number of cases could jump sharply within weeks, sparking a second wave potentially far larger than the outbreak last spring. Although the swine flu appears no more dangerous than the typical seasonal flu, the new virus -- known as H1N1 -- is likely to infect many more people because most have no immunity against it.

The vaccine effort carries political risks for the Obama administration. "If the outbreak fizzles, they will be susceptible to being criticized for spending billions of dollars," said Harvey V. Fineberg, president of the National Academy of Sciences' Institute of Medicine, which advises Congress about medical issues. "On the other hand, if this outbreak is early and severe and there isn't enough vaccine, they'll be criticized for under-preparation."

Officials stress that they are proceeding cautiously. A final decision to move forward will not be made until they get the results of clinical trials -- testing to determine safety and dosing -- and assess the virus's threat. But officials are confident the vaccine will pass muster and expect a campaign will be launched as soon as manufacturers deliver the first vials.

"There's little doubt we're going to vaccinate people," said Anthony S. Fauci of the National Institute of Allergy and Infectious Diseases, who is leading the government's testing of the vaccine. "Who and when and exactly how -- we have to figure out."

The campaign is haunted by memories of the government's ill-fated 1976 effort to vaccinate against swine flu. The epidemic fizzled, but the vaccine was given to 40 million people and blamed for causing a rare paralyzing disorder known as Guillain-Barré Syndrome.


"This is an overreaction," said Barbara Loe Fisher of the National Vaccine Information Center, which opposes many vaccine policies. "There is no national security threat here. Why are we operating like this? This is not polio. This is not smallpox."

Fears and misinformation about the vaccine are circulating, including inaccurate claims that it will be mandatory.

"I'm very concerned about the dangers of vaccines," said Janice Smith, 58, of Misawaka, Ind., who attended a public hearing Aug. 15, one of a series of meetings the CDC has sponsored to gauge public sentiment about the vaccine.

Authorities are adamant that vaccination will be voluntary, and they say there is no reason to think the vaccine will be any less safe than the usual flu vaccine. An adjuvant will be used only if necessary and proven safe, they say.

To address concerns of pregnant women and parents with young children, some vaccine is being produced without a mercury additive. And because the short-term studies can identify only common, immediate side effects, the CDC will step up monitoring for rarer, serious complications such as Guillain-Barré.


In the meantime, local officials are drafting plans tailored to their communities. The shots in the arms and squirts up the nose will happen in schools, medical offices, hospitals, public health clinics, workplaces, drug stores and at mass vaccination events, possibly including drive-through clinics in parking lots where people would stick their arms out their car windows for a stab.


Schools considering giving shots to children are making plans to get permission from parents and have to determine how best to line up anxious, rambunctious students.

Everyone who gets a swine flu shot may need a booster several weeks later, potentially causing mix-ups about who got which shot when.

But Frieden and other outside observers expressed confidence that the program would be safe and successful.


The government is prepared to buy enough to vaccinate every person -- 600 million doses all together -- if the pandemic or demand warrants it. That could increase the cost to $5 billion for the vaccine alone. It would cost at least $9 billion to administer the vaccine to the entire population, according to the Association of State and Territorial Health Officials.


Experts are uncertain whether they will face a shortage of vaccine because of high demand or will have plenty of vaccine but little interest.


The CDC is formulating a $4.8 million multimedia campaign to encourage people to get vaccinated and help alleviate concerns and confusion, including radio and television public service announcements, print ads, and messages delivered via Twitter, RSS feeds and video podcasts on YouTube.



Andrew K said...

Why? How many people died from swine flu in the First World?

This is crazy.

Fr. Andrew said...

I'm actually quite scared about this now that I am a chaplain to Catholic students at our state university. Not so much on the flu side but the vaccine- what sort of immoral sources will they use for the vaccine? Will they use embryonic sources that violate human dignity?

Athanasius Magnus said...

Harkening back to what Congressman Ron Paul said about the last time a form of this vaccine was pushed, I would be quite cautious about accepting it. If you don't know what I'm talking about, basically the vaccine itself killed more people than the actual flu did. Check earlier listings on this blog concerning the swine flu for more info.

Anonymous said...

I have a son at MU/Columbia in a dorm = worried mom. KU in Lawrence has had about 40 cases already. They are having the students go home or if not able put in a room by themselves and food will be brought into them.

I did take the swine flu shot in 1977 where I worked. I had a young son and worked in a large bank. I passed out from the shot (they used an airgun thing), then I was sick for about a week.

Here in KC, Children's Mercy Hopsital is running a trial with children. Money will be paid to those who sign up. From what I understand they filled the slots.

So, swine flu shot and regular flu shot will be pushed for the compromised immune system and elderly. I really am not sure I want either shot. But I am sure my dr's office will contact me to come in for my turn.

Martha in KC

John said...

I am actually doing some research on H1N1 for a large university hospital. While H1N1 is only "just the flu", there are several factors to consider.

1. Why are predominately you healthy persons and children who are affected vs. the elderly who typically suffer the most from the seasonal flu.

2. H1N1 has not been circulating in humans for over 50 years so it is a unique virus.

In fact, many virologist suggest that factor 1 and 2 are related since those born before 1957 when the last H1N1 epidemic occurred have been exposed to a similar strain.

3. Personally as a physician, I am expecting lots of phone calls and office visits as flu season kicks into high gear around Nov.

4. In regards to the above comment regarding the etiology of H1N1 vaccine, it my understanding that it has been derived from non-human fetal/embryonic sources like regular seasonal flu. Also remember that if you receive the H1N1 vaccine, that doesn't cover you for other seasonal flu, you would still need a separate vaccine for that.

cmziall said...

We received a letter in the mail inviting us to bring our 7yo in for immunizations to "test" them. We would get $75 for each office visit and $10 for each phone call they made to us. 7yo was freaked out "NO WAY, I don't want to get any shots" then we told him we (he) would get $75/office visit and he said "when do we start"!

Seriously, we would NEVER do anything like this. Our children are not guinea pigs and will never be used, with our permission, to do such a thing.

Anonymous said...

I work at a children's hospital. There are a number of reasons this flu is semi-scary.

1. The last outbreak of a new strain came in 1968 with the Hong Kong flu. Basically every flu since has been a variation of that, adn therefore we have some built-in immunities, despite the small variations. None of us have any sort of immunity built in for the H1N1. None.

2. As John pointed out above, the normal Hong Kong variation of the flu kills the weakest, e.g. the youngest and the oldest in our society. The initial reports about H1N1 was that it was 'killing far healthier people' than in the past. We think that this was overblown, and therefore not really that different than other flus that kill tens of thousands of people every year.

3. BTW, vaccines typically are developed from 'non-human fetal/embryonic sources,' as John said above. The most common source for that - chicken eggs. So if you have severe allergies to eggs, you should request more info before you get your vaccine.

4. Timman, can you revisit this issue in about 4 months. As Martha in KC said, having kids in schools together this fall is the perfect incubator for this serious disease. I happen to agree with the article - Obama is in a no-win situation, i.e. either the strain of the flu won't be as serious as originally thought and therefore they will have huge left-overs, or it will be deadly serious and there simply won't be enough. Sadly, our media will somehow find a way to make this into a political drama - it sells newspapers and air time.

5. I suffer from mild asthma, and therefore will get the vaccine as soon as available. One of the primary complications from flu is pneumonia - I am considered at high risk without the vaccine.

6. Let us all pray Novenas, Rosaries, and special intentions that this flu will not be as devastating as some say, and that God will hold us close during these months ahead.

just wondering said...

the link on this blog - children of God for life - confirms that the flu vaccine is made by ethical means.

Guggie Daly said...

Logic is not following here...

1. How can they claim they will only use an adjuvant if it's deemed safe/necessary? These vaccines are already in production! They can't make a million doses and then add the adjuvant in later. LOL! Vaccines require an adjuvant to stimulate the immune system and 3 weeks of trials is not even into phase I of a normal study.

2. The claim that pregnant women will receive a mercury-free (assumption: safe) vaccine is disingenuous; mercury-free is a positive marketing phrase for "live-attenuated virus." Since there are zero studies on pregnant women and immunisations, they can't claim the live vaccine is safer than one which contains mercury.

3. And I just <3 the warning that some people will need a 2nd booster injection within a few weeks. Way to boost confidence.

Anonymous said...

And yes, I just wanted to confirm that the vaccine is not going to be using aborted feotal tissue. Depending on the company, the growth medium will be caterpillar parts or canine tumour cells.