H1N1 Vaccine and Prisons: Setting the Record Straight

Posted by:
Commissioner John Auerbach, Department of Public Health

You have probably seen the incorrect media reports stating that the Department of Public Health intends to make the H1N1 vaccine available to prison inmates before it is available to members of the general public.  These reports are misleading and factually inaccurate.  

The Department of Public Health has already distributed tens of thousands of H1N1 vaccine doses to hundreds of medical sites around the state to begin the vaccination of children, pregnant women and health care workers, consistent with the federal guidance.  Our ability to share H1N1 vaccines is dependent on the vaccine manufacturers’ ability to produce the vaccine and the federal Centers for Disease Control's (CDC) distribution plan to states.  Unfortunately, the timeline associated with the distribution of the vaccines is quite fluid as production estimates vary week to week due to the unprecedented volume and short timetable for planning. 

Our top priority is and will remain those members of the public who are at greatest risk.  Initially that category includes children, pregnant women and health care workers.  As supplies allow, we will also target young adults below the age of 25, and 25-64 year olds with certain underlying health conditions.  Public clinics will only be held at the point that there is sufficient volume to shift beyond the focus on these target groups.  The CDC states that eventually there will be enough H1N1 vaccine to protect anyone in the population who wishes to be immunized.  

We will not be sending vaccines to prison settings to vaccinate the general prison population before the vaccine has been made available to the general public.  However, health care workers in prison settings will be treated the same as health care workers in other clinical settings and offered the vaccine as supplies allow.  As supplies become available, vaccine will be made available to prisons for the vaccination of those inmates at greatest risk.  For example, female inmates who are pregnant will be offered the vaccine as part of the statewide effort to reduce the likelihood of serious illness among those most vulnerable.  Because of national supply shortages, we have not yet determined the date for the distribution of vaccine to segments of the prison population at highest risk.   

Again, we want to emphasize that plans to vaccinate the general population of prisoners will not begin before there have been opportunities for the general public in the state to be vaccinated. 

Comments

[Maria]

For me as a father of two this is acltaluy a fairly easy decision. There is a very clear and measurable risk associated with not having my kids vaccinated. There is very poorly argued case and no clearly identified risk with MMR. Perhaps the risk is there but the wide use of MMR and so far poor evidence for real problems leads me to suggest that the right choice for my kids and our community is to go ahead with vaccination.

[Michelle]

My children live in Massachusetts, but have a Rhode Island Pediatrician and they are told that they can not get the vaccine from their Pediatrician even though they have the vaccine. However, Massachachusetts Pediatricians have the vaccine and my kids can't get it because they are not patients. Why is that? Where does that leave our children in Massachusetts? Why aren't the schools getting the vaccines yet? What is the hold up?

[Ann]

Why are there clinics set up in Massachusetts for all to receive vaccine vs school age children getting it in school like in Rhode Island???

[Kate]

We have a national emergency with no vaccine - someone sure messed up. We knew about the H!N! last year. And because of it - people will die.

[M Russell]

I have a 3 year old and a 1 year old who has been a regular at Boston Children’s Hospital since he was born. He has a neuromuscular condition which puts him in the high risk category and we cannot get anyone to tell us when it will be available for him. From what I understand the state is vaccinating the health care workers first and not giving it the children whom are at the highest risk. I understand that the health care professional are at a high risk of coming down with it but it's the children whom have the highest mortality rate from it. I am very disappointed in our health care system.

[Matthew Cassarino]

You have some nerve ditching the traditional group of injured and ill from 25 to 64 in favor of soccer moms who will vote. I nearly died thanks to a doctor the state knew about and had on probation. He prescribed a new medicine he shouldn't have for what I actually had if he hadn't been in a cocaine induced stupor. I nearly died from MRSA when I was held like a prisoner by CDC after the state said I was OK to be discharged according to my doctor before any of you ever said a word about HA MRSA. I got it in my leg the year after that with the same near result. I had CHF repeatedly after that. I didn't go to 4 years of college in political science and history, do all that "play by the rules" nonsense that Bill Clinton chanted to be put behind some healthy kid after my bank account was already looted once for what YOU caused in my life. My mother had a stroke and is disabled and my father dropped dead. Who is going to shop for food if I get sick ? Your Governor is doing OK but your President is Nixon with Carter's incompetent shell. If someone with cardiomyopathy, neuropathy, asthma, vasculitis, past repeated CHF, GI bleeds, blood transfusions, hypothyroid disease, and past MRSA can't get that shot, then what is this ? Is it the lie the paranoids say it is or a soft kill the other paranoids say it is ?

[Joan Anderson]

Should your child receive the vaccine if they have already been sick with h1n1?

[D. Murray]

I believe that the press regarding prisoners getting the H1N1 vaccine before other people is generally inflated, and I don't want to sound like chicken little crying about a falling sky, but I have first hand knowledge that we are having a problem getting the vaccine to all of the high risk patients in the general public that are electing to vaccinate. I have a problem with vaccinating any inmates while babies and pregnant women wait for their shots.

While I understand the rationale behind offering the vaccine to prisoners because it is a closed system, I think this should take a back seat until all babies, children and pregnant women receive their doses. I don't want riots in the prisons, or infected ex-inmates infecting the general population. And I'm not a blood thirsty vigilante who wants prisoners to suffer. I just want pregnant women and children to get access to the vaccine first.

As of now, this is NOT the case. I have 2 children under 3 (one is a 9 month old baby), and I am being told that no one has the vaccine right now. When I called about the shot (pediatricians won't call patients because this vaccine is in such great demand that they never get enough for the people on their waiting lists, so you apparently have to get lucky and call on the right day) I was told that they ran out of it in a matter of hours. The women I work with, all highly educated school teachers and nurses, are also having no luck vaccinating their children. My sister in law, a pregnant pharmacist, can't find the vaccine for herself.

I'm glad that "tens of thousands of H1N1 vaccine doses" were sent "to hundreds of medical sites around the state," but it was clearly not enough to cover even the highest priority of the high risk groups. Shouldn't we address this problem before we start discussing who to give this elusive vaccine to next?

[laura]

Given the chaos and the upset over the very irregular distribution of vaccine in our state...where in one town all children under a certain age are vaxed while in another higher risk kids are not...is the MDPH considering changing how vaccine distribution is managed so that NEXt timE this does not occur?

Different states have handled it differently. Perhaps some have been more successful at uniformly targetting the at risk than others. Is what other states are doing and how it is working being shared and learned from?

Again, if this were a severe pandemic, many unnecessary deaths could result from spotty availability of vaccine to those at highest risk. If the state makes a list of risk priorties for vaccine, it seems to me it needs to have some control over that actually happening.

PLEASE, please consider learning from this. Very high risk kids I know (with CP etc) who's risk of death from this according to CDC documents is many many times healthy kids' risks or asthmatic kids' risks...may or may not get it...yet in the next town healthy kids get the vaccine. Or even in the next pediatric practice if the practice was more proactive.

People are angry because their success in getting vaccine seems so random. And it does seem from what I am reading that MA was not totally proactive as some states in ordering vaccine. I hope you can also comment on that posting. thanks

[Colleen Feeney]

Where do we go to find out who has the vaccine available in MA so we can request an appointment?

[e. smith]

Massachusetts was not on the published list of early states that had pre-ordered the vaccine. It did do so, but later. Now Massachusetts seems to be at a disadvantage with the vaccine in such short supply. Children and pregnant women should have it available to them now as their mortality numbers climb. This pandemic was in the news all spring and summer and the federal and state government should have been better prepared. People at highest risk cannot even find the vaccine to get immunized.

[Michael]

"The Department of Public Health has already distributed tens of thousands of H1N1 vaccine doses to hundreds of medical sites around the state to begin the vaccination of children, pregnant women.. "

Really? This conflicts with what other people at DPH are saying . I have been told over and over again that the DPH does not distribute any vaccines and that they have no knowledge of where the vaccines are located. If this is true that the DPH has indeed distributed the vaccine, can you please tell me (an exact address and phone number) where my wife go to get the vaccination today? She is pregnant and has asthma.

Thank you.

[Sally Kloman]

I am a senior citizen and have NEVER been more disappointed in the federal health system than I am now! Totally unprepard for a pandemicd Allowing the U.S. to be almost dependant on off shore vaccine makers and face masks. Continued statements the the vaccine will be available soon but LATER. The whole thing would be funny if thousands of lives were not put at risk because of the government failure to be prepared.

[Kris Cambra]

Can sites such as pharmacies give the seasonal flu vaccine to children under 18? We had an appt for my 7-year-old to receive the vaccine at her pediatrician, but it was canceled today because they ran out of vaccine.

What are the alternatives for children? I did look at http://flu.masspro.org so I know where to go, but not sure if you can do that for children.

[leesa]

What is actually in the Vaccine? Who makes it?

[D Peters]

I would like to know exactly where to get the H1N1. I've called my PCP and rheumatologist without success in getting the vaccine. I am on immunosuppresent drugs and have an underlying medical condition that places me in the CDC's high risk category.

Second, will there be enough supply for children 6 months to 9 years who need 2 doses. The pediatrician gave the first dose, but said he did not know how his supplies would be in a month when the 2nd dose is needed. Isn't this counterproductive to the intent of the vaccine?

[Matt]

I am 16 and i have never hade the flu before. and i have not got the vaccine yet what is my risk of catching the swine flu.
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DPH RESPONDS: Thank you for your question. Because H1N1 is a new kind of flu virus, our bodies have not yet built up any resistance to it. That is why so many people may get sick. In addition, flu spreads very easily from person to person and the virus can also get on things you touch like doorknobs and phones.

Since last spring, the H1N1 virus has been disproportionately affecting younger people which is why the CDC has recommended all people from 6 months through 24 years of age receive the H1N1 vaccine. This is especially important for anyone from 6 months through 18 years of age because many cases of H1N1 have been seen in kids who are in close contact with each other in school settings, which increases the likelihood of the disease spreading.

[Matt]

what cities is the swine flu in in mass
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DPH RESPONDS: Thank you for your question. Currently available rapid influenza diagnostic tests cannot distinguish between H1N1 and “regular” seasonal flu viruses. Most people with flu symptoms this season will not require testing for H1N1 because the test results usually do not change how you are treated. As of September 2009, more than 99% of circulating flu viruses in the United States are H1N1. Therefore, at this time, if your health care provider determines that you have the flu, you most likely have H1N1. You can find specific information on the current flu situation in the state of Massachusetts every week from our weekly flu report posted to this blog. Last weeks report can be found at: http://publichealth.blog.state.ma.us/2009/10/weekly-flu-report-october-15th-a-new-flu-season-begins.html

[Matt]

can you die from the swine flu.do you need the vaccine if you have a good amune system. and how old do you half to be for the nose spray.
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DPH RESPONDS: Thank you for your questions. Illness with the H1N1 virus has ranged from mild to severe. While most people who have been sick have recovered without needing medical treatment, hospitalizations and deaths from infection with this virus have occurred. Secondly, everyone who is able to get the vaccine should be vaccinated. Not only will it protect you from getting the flu but it will also prevent you from spreading it to others. Finally, the LAIV, or nasal spray, is approved for healthy people age 2 to 49 years who are not pregnant.

[Jeff McDermott]

Why has a large group such as Harvard Vanguard received only 500 doses as stated in the Boston Globe this morning. They serve over 400,000 patients in MA, including my 7 moth old twins. How could the state have received 300,000 doses as DPH is quoted in the same article and this group received so few? Where are all these doses going?
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DPH RESPONDS: Thank you for your question. The federal government is working with vaccine manufacturers at the national level to ensure that H1N1 and seasonal flu vaccines are produced and shipped as quickly as possible into Massachusetts and the other states. As these supplies arrive in the state, the DPH immunization program is working with partners across the provider community to ensure that these vaccines are distributed to the highest-risk people as quickly as possible We share your frustration more vaccine is not available to distribute at this time, and appreciate your patience as we work through these complex issues.

[E Smith]

Since children under 10 will require 2 doses...shouldn't pediatricians get first priority in receiving the vaccine so it can get high risk children on a vaccination immunity schedule? ------------------------------------------------------------
DPH RESPONDS: Yes, which is why every effort is being made to ensure that providers who serve high-priority groups, including pediatricians, will receive vaccine as soon as possible.

[E Smith]

Please give us the list of names of the "hundreds of medical sites around the state to begin the vaccination of children". I have called most major medical sites in Boston area to try to get the vaccine for my 2 yr old who was born with medical issues. No one has the vaccine availaable at this date. Children should be top priority. Many are in daycare and preschools which are breeding grounds for viruses. PLEASE let us know where we can get our children vaccinated asap.
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DPH RESPONDS: Thank you for your question and we appreciate your frustration. While DPH is aware of the total number of doses of vaccine that will be distributed overall to locations within Massachusetts each week, we do not have detailed information on whether or when a specific provider location will receive shipments of vaccine. Every effort is being made to ensure that providers who serve high-priority groups, such as children, will receive vaccine as soon as possible. The single most effective way that you can stay informed about the availability of seasonal and H1N1 flu vaccine in your community is by staying in touch with your health care provider, and by visiting http://flu.masspro.org where you'll find a database of locations currently offering flu vaccines, when they are available, searchable by your zip code.

[thomas coyne]

thank you for your comment it is good to know that schoolkids who are in the highest risk (cdc) will have the first priority then prisoners in the high risk next