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Who's on first?

by: Okieman

Sun Aug 23, 2009 at 23:50:46 PM EDT


Which county,..which city,..which school gets the vaccine first?  

What if  your state has 500,000 kids, but initially only enough vaccine to vaccinate 50,000 of them?  And to make matters worse, the spread is increasing, with all the schools having outbreaks simultaneously.  Who gets first shot (excuse the pun) at having their kids vaccinated early?  Is it the big city schools?  Or maybe the schools with the most money/political pull?  Maybe a little bit for every school?  If so, who within that school gets the vaccine?  The school board member's kids, or the at-risk kids?  Maybe a lottery.  (No I'm not serious about a lottery.)
Okieman :: Who's on first?
Even if this virus remains relatively mild, there is the potential for a significant amount of anxiety and angst among parents.  One local death or really serious complication and folks will be on edge in a big way.  Now, under this type of situation throw in the potential for their kid(s) to receive the vaccine, but for what ever reason it goes to someone else.  Never mind that it takes two weeks for the vaccine to take effect, or that two doses may be needed.  All the parents know is that the virus is in their school and their kids have had to take a back seat to someone elses kids.  How do you think that is going to turn out?

Next question, the vaccine did not arrive in time.  The hospitals are being overwhelmed, with medical personnel out sick while the case loads have increased dramatically.  Is there enough antivirals?  What if there is enough on the rich side of the city, but not in the poorer side?  Or enough antibiotics.  How do you think that is going to turn out?

These are very very hard things to contemplate.  Hopefully situations such as this will not occur.  But, if all the cities in every state in the nation now have the virus present due to the summer spread, and all of the schools begin at the same time, what are the chances that the whole country will reach this critical point at the same time?  What are the consequences?  Those of you who work in state and local government or the media...these are issues which you need to consider.  How do you think this type of situation is going to turn out?

Let us hope my bit of questioning is all off track and everything turns out fine.  But what if the question concerning "Who's on first?" turns out to not be funny at all.  
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Who's on first? | 23 comments
Your questioning is not of track at all...
it is in fact right on target.  All of these questions and more may arise.  I have seen no info about how my state (CT) will handle vaccinations under the new guidelines.  Will pediatrician offices be handling or public health officials at schools/elsewhere?  How do PH officials decide who gets it first?  Does an asthmatic child have to come in with a note form his/her doctor?  If parents start panicing, how many of them will call in favors to make sure their kids get a note?  Because if MSM coverage picks up after Labor Day about outbreaks, you can bet parents will start to panic.  Right now they are complacent because schools are just ramping up now.  It will take a few weeks for things to really explode.  

What if a ped's office is only given 100 doses but they happen to have 150 kids who really should get it?  What then?  Will all the docs in a practice sit down in a room and argue for their own patients' needs to get vax'd?  

Add to that the reality that a vax will not be ready for quite some time, maybe even too late, to help kids anyway.  Seriously - by November (which is looking more realistic each day) most kids may have had it already, unless their parents pulled them from school.  Then you have to start prioritizing adults who haven't been ill yet.    

using the 1957-1958 pandemic as a reference
There's a chart published August 21, 2009 at http://www.bbc.co.uk/blogs/the... that shows the crescendo of cases peaking 4 weeks into September 1957 in the UK during that flu pandemic.  Let's see, if schools now still begin around September 1, and the cases begin to go ballistic at the end of the month and into October, and the flu vaccine isn't even distributed until mid to late October, and it takes x weeks to become effective after being given to someone......well, we're soon going to be in for a lot of people who are sick and/or very upset.  However, if it peaks between November and January like the 1968 pandemic did, the effects may be somewhat lessened.  We wait and fretfully wonder what lies ahead.  
Swine Flu Shot Protection? Maybe by Thanksgiving
Swine Flu Shot Protection? Maybe by Thanksgiving
http://www.nytimes.com/aponlin...

Swine Flu Shot Protection? Maybe by Thanksgiving

ATLANTA (AP) -- It will likely be Thanksgiving before a significant number of Americans who get the swine flu vaccine are protected, health officials said Monday.  Roughly 50 million doses of vaccine are expected to be available by mid-October. But for those who get initial doses right away, that will only mark the beginning of a vaccination process that will take five or more weeks. more at link...

By Thanksgiving things will have already exploded.  If it hasn't, holiday travel will insure that it does.

Interesting!!
Many on this blog and other blogs only talk about how they will not take the vaccine.  Moreover, how they will not let their kids have the H1N1 vaccine.

The CDC has already said that Pregnant women and Health Care workers will be first then children/adults 2 - 24 years old.  Then the rest of us.  

However, with as many people who are scared to take the H1N1 vaccine I believe there will be more available than you think.  Many uneducated people will take only one dose of H1N1 vaccine and will not return for the most likely needed second dose.  Or the truth is they will forget or just to lazy to get the second dose.

I live in Colorado and I can guarantee most of Boulder will not be taking any vaccine of any kind!!

I would not get too concerned yet until the vaccine is available.  

We also have the possibility the H1N1 mutates and the vaccine is no good or the side effects, so feared, turn out to be really bad and no one takes the vaccine.

You see there are lots of outcomes we must wait and see and not cause a problem where there is none yet.  

I believe
the "silent majority" will want the vaccine, as long as it has been created in the same manner as the seasonal vaccine.  Begin adding adjuvants and that changes everything.
[ Parent ]
yes, that is THE most important distinction n/t




All 'safety concerns' are hypothetical.  If not, they'd be called side effects...
[ Parent ]
Agreed. nt


ITW(Joel J)
Courage is resistance to fear, mastery of fear - not absence of fear.
- Mark Twain
 
[ Parent ]
Who will get the vaccine.
I think the "who will get the vaccine" question has multiple answers. As the flu remains mild, few will bother. If it mutates into something scary, everyone will want it. Of course, at that point the vaccine may be of little or no use anyway. I feel like we all keep going in circles!
[ Parent ]
FluMom, I'm in the DFW Metroplex...
and I think TX is going to be a lot like Colorado in that more people will NOT want the vaccine than will. Right or wrong, many here are injecting politics into the discussion and as I scan the comments on local H1N1 stories around the state buzz words like "big government, big pharma and scare tactics" are prevalent. I can't think of ONE friend who wants an H1N1 vaccine or is concerned about their children in school, traveling, going to the state/county fairs, etc.  

 



"History never looks like history when you are living through it." ~John W. Gardner
[ Parent ]
Adjuvant What Is an Adjuvant!!
Funny but sad story...90% of people do not know what an adjuvant is or what it does or why it is bad!!

My boss who runs an elementary school did not know what an adjuvant was or why it was a problem.  You know what he told me after I tried to explain what an adjuvant was..."Well if this H1N1 gets bad and we need to get shots because we work with children I will have you explain to the staff what we need to do and what to watch out for."

LOL!  The general public will not care or know if they are getting vaccine with adjuvants.  They only time people will care is if people start dying by large numbers from the flu or there is a major problem like GBS during distribution of H1N1 vaccine.  Then and only then will you see panic to get the vaccine or the on slaut of lawsuits because the vaccine was "bad".

Back to the original question...
Some folks won't like my answer, but here's what I think:

In general, start vaccinating the priority groups in the highest-density population areas first, and continue to lower-density areas from there.  

Virus spreads more quickly within high-density cities, doesn't it?

Does it depend on whether the city or town has cases
(or has many cases) already?  Schools have really high density, so if a rural area has cases, their school would spread it just as fast, wouldn't it?  They might not have a hospital nearby, either, in case serious symptoms developed.  Kids have been mixing somewhat during the summer, and cases have popped up in many areas.  Would the state health departments be able to prioritize their hot spots?

"The truth does not change according to our ability to stomach it."  Flannery O'Connor
[ Parent ]
This article is appropriate for this diary
Where Will You Get Your H1N1 Vaccine? Information Remains Unclear

Friday, August 28, 2009
By Marrecca Fiore

With school about to start next week in many parts of the U.S., and dire warnings sounded about an expected rapid spread of the H1N1 virus, public health officials appear to be struggling to put in place an effective plan to inoculate the nearly 159 million Americans at the greatest risk.

"The CDC has been working with HHS (Health and Human Services) and the states to develop plans for distributing the vaccine, but what works best for a large state or city like New York may not work best for a small state like Wyoming," said CDC spokesman Joe Quimby. "Our first recommendation is that people contact their local health provider and that might be their local doctor's office, or their local county health department."

Other than doctors' offices, where people will be able to get the forthcoming vaccine is still unclear.

[snip]

http://www.foxnews.com/story/0...

On the CDC webcast for pregnant women/H1N1,
they said that ob-gyn offices will give the shots, as will pharmacies (the ones that give other shots now, I presume).  Children will be getting them in their schools, according to other news stories.  Okieman's article says it will vary by state, though.

"The truth does not change according to our ability to stomach it."  Flannery O'Connor
[ Parent ]
I can't seem to get a definitive answer on where they will be given
in Dallas County.

A few weeks ago on TV station reported it would only be available at hospitals and designated clinics throughout Dallas and not at private physicians. Just this week, two pharmacists told me that NO pharmacies will have it - just private physicians and hospitals. So who knows?

In regards who should get it, isn't the CDC working with State Health Departments regarding where breakouts are currently and which areas are most in need? It seems like those areas (and surrounding areas) would be the likliest to vaccinate 1st along with highest density population areas.

It's also being reported that for those with complications, it will be an "honor system". (see link below)  If indeed, physicians are administrating the vaccine then it seems like they would know whether or not their patients would have a complication that would warrant receiving the vaccine or not. It's a crappy place to put our physicians in but it's one way to help ensure that dose goes to someone who really needs it.

http://www.wfaa.com/sharedcont...

Just before I posted, I DID find this at the Texas Department of State Health Services. It's available as a .PDF entitled Novel H1N1 Mass Vaccination Plan. It has to do with who gets the vaccine.

When supplies are limited, DSHS will make decisions
based on the following factors:
o Vaccine availability
o Priority groups
o Population
o Disease trends
o Geographic morbidity/mortality
o Federal guidelines
o Distribution limitations
DSHS Each time
vaccine is
received


 



"History never looks like history when you are living through it." ~John W. Gardner
[ Parent ]
Bump
Because it is now a very pertinent question.
Pharmacies
Our local Minute Clinic (located inside CVS pharmacy) said they WILL have H1N1 vaccines.

When we registered for the seasonal flu shot, it asked if we wanted to be contacted when the H1N1 vaccine arrives.

Our pediatricians office doesn't seem to act like they will have it, but that the "network" will have flu shot clinics.  I think that is probably an attempt to keep from overloading individual offices with people coming in for shots.

Doctor's offices . . .
A doc's office is the last place I want to go to get a flu shot - they tend to be full of sick people, and I think as the weeks go by they will be even more full, and almost a way to guarantee exposure to the virus.

I'd far rather go to a pharmacy to get a shot - there may be some sick people there, but I'd hope not as many.

[ Parent ]
The Clamor For Flu Vaccine
Hat-tip to ChrisC.  And so it begins.  If I'm not mistaken, and hopefully I am, it will get worse before it gets better.

Worry Grows Among Doctors Over Clamor for Flu Vaccine

By ANEMONA HARTOCOLLIS
Published: October 5, 2009

The fear of swine flu is being compounded by new worries, this time among primary care doctors who say that they are already being swamped by calls from patients seeking the new vaccine, and that they are ill-prepared to cope with the nationwide drive to immunize everyone, particularly children and chronically ill adults.

[snip]

"People want it," Ms. Paterno said of the swine flu vaccine. "When they listen to news reports, they pick out bits and pieces - 'swine flu, get it' - but they don't quite comprehend that we don't have it yet, and we're dealing with a quite affluent socioeconomic group here."

[snip]

Kathleen Sebelius, secretary of Health and Human Services, acknowledged the concerns, but said it was up to local health departments to run interference between doctors, hospitals and the federal government.

[snip]

http://www.nytimes.com/2009/10...

Local Health Departments
Not the best news for those of us living where I do - just a week ago, a so-called "expert" on H1N1 from the local health department gave a talk at a college emphasizing that if the patient has no fever, the patient has no flu.

Daughter called the Health Department the next day and spoke to the director, and advised him to check the VA State Health Department website, and the CDC website.

That wasn't the only mistake made - just the most obvious.
And these are the people who will be running interference for our benefit here . . .

Great, just great.

[ Parent ]
Mom Charged With Stealing Swine Flu Vaccine
Mom Charged with Stealing Swine Flu Vaccine

HUNTINGTON, W.Va. (WSAZ) -- The Cabell County Sheriff's Office says a Huntington woman has been arrested for stealing a vial of swine flu vaccine during a vaccination clinic on Thursday.

They say the theft happened at the Health Department's clinic at the New Baptist Church.

Deputies arrested 25-year-old Elizabeth Wilson of Huntington.

Chief Deputy Doug Ferguson, who was at the clinic, tells WSAZ.com that the vial of the swine flu vaccine was found in Wilson's purse.

Ferguson, says he confronted Wilson after a health department employee told him that Wilson was trying to steal several syringes.

Ferguson says Wilson was at the clinic to get her three children vaccinated.

He says Wilson told him she took the vaccine because it wasn't available for her age group at Thursday's clinic.

[snip]

http://www.wsaz.com/home/headl...

Banksters on first
Somebody messed up very badly on this.  But, he who has the gold...gets the vaccine...if you work for Goldman Sachs and their ilk.

Goodness gracious folks...!!

Link
Goldman Sachs, Citigroup got swine flu vaccine

By KAREN MATTHEWS (AP) - 19 minutes ago

NEW YORK - Some of New York's biggest companies, including Wall Street giants Goldman Sachs and Citigroup, received doses of swine flu vaccine for at-risk employees, drawing criticism that the hard-to-find vaccine is going first to the privileged.

[snip]

http://www.google.com/hostedne...

[ Parent ]
Who's on first? | 23 comments
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