Weekly Report on Novel H1N1 Influenza as of August 13, 2009.

Weekly Report: Download Weekly Report 8-13-09  (Download PDFWeeklyRept)

This Week's Developments:

Yesterday, the Massachusetts Public Health Council (PHC) approved two sets of emergency regulations that will better protect Bay State health care workers and residents during the upcoming flu season.

The first set of regulations require licensed health care facilities in Massachusetts to offer all employees of those facilities seasonal influenza vaccine, and H1N1 vaccine when it is available.  Vaccinating health care workers against the flu is always important but it is even more critical this year.  As readers of this blog know well by now, we are facing a flu season in which we will likely have different strains of flu circulating; the seasonal flu as well as the novel H1N1 influenza that first started spreading in the U.S. last spring.  H1N1 flu has caused of the first flu pandemic in 40 years, which means its geographic spread is now worldwide.  While most people who became infected with H1N1 recovered after mild to moderate illness, the outlook for the fall and winter flu season is uncertain.  Having different strains of the flu circulating at the same time can increase the number people who get ill and seek care at health care facilities --  and that can increase demands on our health care system as a whole.  Find out more by clicking the link below.

Encouraging health care workers to get vaccinated helps in a couple of important ways.  First, it protects the workers who will be on the frontline caring for people who are ill.  The prospect of providing care for more patients seeking care in emergency rooms that are normally very busy, means that hospitals and other health care facilities will need all of the help they can get.  Keeping health care workers from getting the flu protects those individuals, but it also helps protect our health care system.  Secondly, protecting health care workers from the flu also provides protection to patients.  An infected person can spread flu germs before they start feeling ill, so this is an obvious concern for health care facilities and employees who care for very vulnerable people.  A person whose immunity is low, or who suffers chronic health conditions, like diabetes and asthma, is more likely to suffer severe complications from the flu. 

Similar vaccination requirements have been in place for several years for long term care facilities in Massachusetts licensed by DPH.  These changes would expand the number and type of health care facilities covered by the rules.  There is an opt-out provision for employees, however they must sign a statement declining the vaccination after being informed of the risks and benefits of vaccination.

The second set of regulations approved by the PHC will allow the Commissioner of Public Health, if necessary to protect the public, to authorize an expanded group of health professionals to provide flu vaccinations after being properly trained and supervised.  Health care providers and public health professionals from throughout the state are working with other key partners to prepare for a flu vaccination campaign that is unparalleled in recent times.  Training health professionals like pharmacists, dentists and paramedics to deliver flu shots could provide much needed assistance in vaccinating millions of residents seeking seasonal and H1N1 influenza immunization. 

Given the time line for flu season preparations, the regulations passed today were proposed as emergency amendments and will take effect in the coming weeks.  However, there will be a public hearing on the changes in September, and the PHC will have to formalize its approval of the amendments with a final vote in November.

We'll share information on the public hearing when it is scheduled.  In the meantime, if you want to learn more about the measures passed today, click here.

Comments

[Charles E. Lutton, M.d, Ph.D.]

How do private health care practitioners who are not affilliated with a clinic or hospital obtain the appropriate
vaccinations in a timely manner?
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John Jacob responds: Thank you for your question. Further details on plans for the vaccine distribution process for health care providers, and how to register with DPH as an H1N1 vaccine provider, are available at www.mass.gov/dph/H1N1registration.

[Donna Parten]

H1N1 Public Engagement WebDialogues: Aug 26-27 or Aug 31-Sept 1

The CDC invites the public to discuss, deliberate, and offer input as it considers whether to take a "full-throttle" or a "go-easy" approach to mass vaccination, or a moderate approach somewhere in-between.

Make your voice heard on a decision facing Americans about the H1N1 vaccine: Register to participate in an upcoming WebDialogue at: www.webdialogues.net/H1N1

There are uncertainties which remain and will remain about how widespread and severe H1N1 influenza will be in the US next fall, and about how much public demand there will be at the time for vaccine. Also, because of the complexities and resources required to plan for mass vaccination well in advance of the epidemic, these uncertainties and complexities pose a difficult dilemma---whether to take a “full throttle” or a “go-slow” approach to mass vaccination, or something in-between?

Each option has pros and cons and a difficult choice must be made in advance. Scaling up or scaling down during the epidemic itself will be “too little too late” to avoid cases that might otherwise have been prevented, or “too much too late” to avoid a loss of credibility for overreacting and an unnecessary use of limited resources in a period of economic hardship.

On behalf of the CDC, The Keystone Center and WestEd are engaging the public throughout August about this policy dilemma. To learn more about opportunities to offer your input visit:
www.webdialogues.net/H1N1

Hurry: Space is limited. All engagements are held in August.

[Tara]

Doesn't someome ralize in the Massachusetts Department of Education that all school in Mass. should be forced not to return to school at least until after Labor Day. It would give health care workers more time getting vaccines and administering to students beforehand. We saw what happened last year. We should learn from this. Hopefully, someone will address this and force all MA schools to open after Labor Day in order to get the vacination process underway first.
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Tara, thanks for your comment. The seasonal flu vaccine will be available in the next few weeks, but the H1N1 flu vaccine is still under development and likely won't be available until mid-October -- after most schools start. Until then, we will stress the same prevention measures like washing hands, good cough etiquette, and staying home when sick. Also, getting the seasonal flu vaccine is a good idea while waiting for the H1N1 flu vaccine to arrive.

[C. Whitbeck]

When is the public health service going to tell the public that children are "super spreaders" and so others are most likely to catch the pandemic flu from a child? Especially if the schools are not going to be immediately closed, parents should be told so they can decide--perhaps on the basis of evidence about the virulence of the fall mutation of the virus--if they would rather tutor their children for a few days, rather than have them exposed to the H1N1 (or any other pandemic virus) in the schools.