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October 08, 2009

CDC Offers Reassurances on H1N1 Vaccine Safety

Robert Lowes
October 6, 2009 ( UPDATED October 7, 2009 ) — On the second day of nationwide vaccination for the influenza A (H1N1) virus, the director of the US Centers for Disease Control and Prevention (CDC) reiterated that the vaccine is safe in an effort to assuage public misgivings.
"The vaccine is the best tool to protect against the flu," CDC Director Thomas Frieden, MD, said today during a press briefing. "My children will get it."
As of Monday, some 2.2 million doses of FluMist, the intranasal formulation of the H1N1 vaccine, had been ordered by all 50 states, the cities of Chicago, New York, Philadelphia, and Washington, DC; and 3 overseas public-health jurisdictions. This figure represents 92% of available stock. Next week, the first doses of the injectable H1N1 vaccine will become available for administration, said Dr. Frieden. The CDC will begin taking orders for this vaccine formulation tomorrow.
Despite many physicians reporting that patients have tied up their phones asking to be vaccinated immediately, one poll suggests that a large swathe of the public is reluctant to get vaccinated, in large measure because of safety concerns. A survey conducted in mid-September by the Harvard School of Public Health found that 53% of adults intended to get the H1N1 vaccine for themselves, but only 40% of adults were "absolutely certain" they would. Of the adults who did not intend to get the vaccine, or who were otherwise uncertain, 30% cited possible adverse effects as the reason, while 20% worried about contracting influenza from the vaccine.
Likewise, only 51% of parents were "absolutely certain" that they will have their children vaccinated, and of the remaining parents, 38% cited adverse effects, and 33% were concerned their child might contract another major illness from the vaccine.
Dr. Frieden repeated earlier CDC assertions that the new vaccine is safe. "It's made in the same way that seasonal vaccine is made each year by the same manufacturers using the same methods in the same facilities." And the safety track record of the seasonal flu vaccine, he said, is excellent.
He also addressed a misconception that H1N1 influenza is a benign illness that does not necessarily require vaccination. "The flu isn't always mild," said Dr. Frieden. "It can kill you."
Other individuals, said Dr. Frieden, have contended that it's too late during the H1N1 pandemic to administer the vaccine. "It's too soon to say it's too late," countered Dr. Frieden, noting that the flu season traditionally extends into May. "We don't know what the rest of the season will bring. And even in places where the flu has been widespread, affecting 5% to 10% of the population, 90% to 95% are still susceptible."
Dr. Frieden acknowledged that public-health messages about the H1N1 virus are hard for Americans to balance, especially when it comes to knowing when to go to the hospital emergency department. Infected patients who become seriously ill or have underlying medical problems need to seek care promptly, he said. Otherwise, patients with a mild infection can see a physician or care for themselves at home.

Update on Supplies of H1N1 and Seasonal Flu Vaccines
The doses of H1N1 vaccine administered Monday and Tuesday are the first of 251 million ordered by the Department of Health and Human Services from 5 manufacturers. "We’re making them available as soon as they come off the production line," Dr. Frieden said.
The number of doses that public-health agencies can order will reach 40 to 50 million by mid- to late October, according to the CDC. Vaccine production eventually should average 20 million doses per week through the end of the year.
Because initial supplies are slim, said Dr. Frieden, state and local authorities will allocate the vaccine on a priority basis. The CDC has recommended that healthcare workers, people who care for infants, children aged 6 months through 4 years, and children aged 5 through 18 years with a chronic illness should be the first to receive the vaccine. Dr. Frieden said that there is no order of priority within this group. "It’s up to the states to determine," he said.
Children younger than 10 years need 2 doses of the new vaccine, ideally 4 weeks apart. Dr. Frieden encouraged school vaccination programs not to hold back some of their initial allocation for the second shot, but instead to use it all for the first shot. "They should vaccinate as many people as possible," he said. "More [doses] will be coming."
According to news accounts, emergency production of the H1N1 vaccine has caused spot shortages of the 2009-2010 seasonal flu vaccine, forcing clinics in several states to cancel such immunizations. However, this supply problem will get resolved, said Dr. Frieden. "There will be plenty of both vaccines for those who want to be vaccinated."
Robert Lowes
Freelance writer, St. Louis, MissouriDisclosure: Robert L. Lowes has disclosed no relevant financial relationships.

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