Weekly Flu Report: October 15, 2009

First, a brief programming note: the Weekly Flu Report that usually appears in this space on Thursdays is slightly delayed this week, and will be posted here tomorrow. In the meantime, we wanted to take a few minutes to talk about how seasonal and H1N1 vaccines make their way from vaccine manufacturers into the community.  

There are five major vaccine manufacturers who are producing flu vaccine this year. They are producing vaccines for both Seasonal and H1N1 flu, in the same time period.  This has never been done before, and there have been some interruptions in the supply chain as a result. Nonetheless, these manufacturers are working day and night to produce and ship the H1N1 and seasonal flu vaccines in ever-increasing quantities to communities across the state and country.

All vaccine supplies are shipped directly from the manufacturer to the community-level provider, such as physician’s offices, hospitals, community health centers, pharmacies, and local public health departments. There are a couple ways to monitor when vaccine is available in your community:

• Visit http://flu.masspro.org, to find out if there are any public flu clinics planned for your area, including vaccination clinics at supermarkets and chain pharmacies such as CVS, Walgreen’s or Rite Aid.
• Keep in close contact with your health care provider to stay updated on when they expect to receive vaccine supplies from the manufacturer, and to schedule an office visit to get vaccinated when they do.

Getting vaccinated is a great way to keep from getting sick – but there are also other vitally important ways we can keep from getting or spreading the flu, including frequent hand washing with soap and warm water, or using an alcohol-based hand sanitizer; covering our cough and sneeze with a disposable tissue or our inner elbow if a tissue isn’t handy; and staying home from work or school if we’re sick.

Comments

[Trisha]

I have a 2 year-old and 1 year-old. I had been getting the runaround from my pedi's office the last couple of weeks (the office is in Braintree). I was told I could call and speak to a nurse about the vaccine today and so I called first thing. I was told my kids aren't considered high priority and they don't know when they can get vaccinated, but she said at least a month. I am confused. Aren't my kids high priority? According to the CDC they are. How can they turn high priority kids away like this and offer them no information on when they may be able to be vaccinated? I spoke with the head of the practice who said they only received 100 doses of injectable and no nasal and chronic patients are first in line. But they don't have any plan on how to get these chronic kids vaccinated. He said they wouldn't be getting anymore vaccine until this batch is used. I find this impossible to believe as other offices get weekly shipments. Most kids we know (healthy kids under age 10) have either received their first dose or have appointments to do so. It's frustrating and I'm angry at this office's complete lack of planning. Is there any way to find out how much vaccine has been shipped to a particular office? The nurses tell me to check their website while the doc says to check with the nurses every couple of weeks. That seems insane and I'm afraid my kids won't get vaccinated for a couple of months and they need two doses. I am angry that they can just give me no explanation about any of this and I'm supposed to just sit back and hope I catch them on a good day when I call? I'm sorry but kids under 3 should be prioritized with chronic patients or right after them and this office isn't doing that.
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DPH RESPONDS: Thank you for your questions and we share 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 and the availability of vaccine at any given provider site at any given time may be sporadic at this point. Every effort is being made to ensure that providers who serve high-priority groups 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 to continue to stay in touch with your health care provider and/or by visiting http://flu.masspro.org where you'll find a database of locations currently offering flu vaccines, searchable by your zip code.

[laura]

hello again,
I found a reference that seems to refute your repeated statement that "all vaccine supplies are shipped directly forn the manufacture to the community level provide" and thus that we need to contact them...ie it is out of your hands and you do not know nor have you any control of the situation...

from your own website
http://www.mass.gov/dph/h1n1registration

"On-Line Registration with the MDPH H1N1 Vaccine Program
(Deadline October 9, 2009)
Register as an H1N1 Vaccine Provider
This fall, to protect the public from the 2009 H1N1 pandemic influenza virus, the federal government will provide states with H1N1 vaccine and supplies (needles, syringes, sharps containers, alcohol swabs, H1N1 immunization cards) at no cost. The Massachusetts Department of Public Health (MDPH) will be responsible for directing the shipment of all H1N1 vaccine in the Commonwealth.

In order to facilitate allocation of H1N1 vaccine to providers in Massachusetts, MDPH has developed an on-line system to register all public and private provider sites interested in receiving and administering novel H1N1 vaccine."

I got the link for this MA page on the CDC website. It is on the page for PROVIDERS not for the public. Your own document, and seemingly the CDC since they have a link there, says that "The Mass Dept of Public Health will be responsible for directing the shipment of all h1n1 vaccine in the Commonwealth".

This DIRECTLY CONTRADICTS as far as I can see what you are saying. it says to me that the Mass dph knows exactly who has h1n1 and where and that they are involved and in fact in charge.

so, I am confused. Please explain then why you then say in multiple responses to the public's queery why this is not so.
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DPH RESPONDS: DPH does play two important roles in the vaccine distribution process: we serve as a registration point for health care providers who wish to receive vaccines for their patients and/or client populations, and we communicate with these providers about the weekly projected total amount of vaccine expected in the state.

[laura]

I have been reading comments on alot of public health flu tracking boards, including published stories in local media. The H1N1 pandemic flu vaccine is being delivered to other states and in some places the STATE department of health (you counterpart) knows when and where. SO, it feels bad that you cannot. You refer me/us to the masspro flu website. Have you been there? there are NO H1N1 clinics listed where I live, which is the city of Boston. I randomly tried a large number of other towns (Brookline, Natick etc) and received the same results. What I conclude is that as of this date NO public health commissions have H1N1 vaccine to use on the public...probably towns are usuing it on their first responders, understandably. Also, NO pharmacies (CVS, Walgreens, Rite Aid) have pandemic flu vacccine seemingly, only seasonal. Thought you would want to know this.

On the other hand, I have found out that private pediatricians have the pandemic vaccine currently. My friend in Natick was able to get her high risk kids taken care of. I asked my OWN doc and called around to many other docs and it seems as if NO ONE has vaccine for adults yet. Even high risk adults (asthma etc) are lower on the preference scale I know than the kids. EXCEPT for one catagory of adult and it seems like no one, YOU, the towns and cities etc, had taken this into account.

I live for example in the city of Boston and am in a high risk catagory..I take care of premature babies as a caregiver. This is a priority catagory. As high as asthmatic kids. The first catagory. Yet I cannot get vaccinated. In any of the places you refer me to. And, I submit, NO PERSON in my shoues, no ADULT seems to have the ability to get vaccinated and protect these littlest ones. A friend is the parent of premie baby twins with lung disease. My God, if she gets it so will they. They are at huge risk.

I want to echo the other writers to comment strongly that the way this is rolling out seems incredibly chaotic and not thought out. Random who is lucky. And no one planned for adults to get it to protect the babies.

I cannot afford not to work. I work with older kids also. If they give it to me and i do not know yet, I can bring it to the baby.

I hope you all are learning from this fiasco. I live in the flagship city in our state and am much more aware of pandemic flu issues than the average person and cannot get the vaccine I am clearly supposed to be in the first tier in getting. This is a problem.

I hope you all are thinking this thru. We are so so lucky this isn't a severe pandemic.

FYI the city of Boston website says nothing about having any pandemic vaccine. No town's website that I checked so far has it.

It feels like you refered people to places to check (masspro etc) for pandemic flu vaccine that do not have it.

Maybe you can give feedback so NEXT time "all vaccine supplies will not be shipped directly from the manufactuer to community level provider" without some central accountability at the state level.

I think people will die because of this. My friend's sick kids would not have the vaccine if she went to masspro to look for it.

if all this or some of it is out of your jurisdiction or control, pass it on above or below you. Ostensibly you have some relationship with town or city depts of public health or publish guidelines for how they are to be...and you obviously have a relationship with those above you.

On the flu sites it;s clear every state is different. And who gets it depends on where you live.
If this was a more severe flu especially, that would be unconsionable.

[K. DelSesto]

Being 6.5 months pregnant I have been diligently checking with my primary care doctor's office since my OB will not be providing the shot. Be pregnant, having a daughter under two and working daily with three school age children I am becoming more impatient with the random disbursement of supply and lack of credible information as to when I can get a vaccine. If we truly are in a high priorty group, then the state should be organizing such a process to see that vaccine is being administered properly to those in the highest priority groups. It is just very frustrating to see it reported that is highly recommended for pregnant women get the shot, yet there is nothing we can do about getting it except wait & make daily phone calls to the doctor's office.

[Cathleen Drinan]

I am the health agent for the Town of Halifax. To say that I have been working hard to organize H1N1 vaccination clinics and stay informed on the topic and keep the public informed, does not come even close to the reality of how encompassing this has been. Wanting to do anything I can to help my town, just yesterday, I applied to be included in a pilot program for an early H1N1 vaccination clinic in November. Today, 10-16-09 a Health Alert Notification (HHAN) just arrived saying, "Within the past 48 hours, however, we have been alerted by the Centers for Disease Control and Prevention (CDC) that adjustments are being made to the amount of vaccine that is expected to be available to states in October and November. Public and school based clinics tentatively scheduled for November should be postponed indefinitely pending the availability of more specific information about vaccine production."
This is not only discouraging news. It concerns me greatly that if a public statement is not made very quickly about this, people will, understandably, draw their own conclusions and when we leave room for that, we open the door to inaccuracies, misunderstandings and cynicism.
Health agents have been taught to deliver accurate information ASAP to the public in order to avoid problems from becoming worse than they already are.
Please urge CDC to come forward with reasons, explanations and plans.

[Jane Smith]

My PCP and OB both tell me to find it somewhere else because they don't know if or when they'll be getting it in - if ever. So you're saying that although I am pregnant, I have to wait until there is a public clinic at some unknown time in the future, probably in November? What happened to vaccinating priority groups first. This seems so unorganized. I know you are doing your absolute best, but what are those of us who are truly at risk supposed to do?
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DPH RESPONDS: Thank you for your questions and we appreciate your frustration. We hear on the news and from experts how important it is to get vaccinated against H1N1, but as of now it’s difficult to find. It’s important to note all vaccine supplies are shipped directly from the manufacturer to the community-level provider (physician’s offices, hospitals, community health centers, pharmacies, local public health departments, etc.) 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 the more detailed information on whether, or when, specific provider locations will receive shipments of vaccine. In addition to looking for public clinics near you, we continue to encourage everyone to keep in close contact with their health care provider(s) to stay updated on when they expect to receive vaccine supplies from the manufacturer, and to schedule an office visit to get vaccinated when they do.

[Kerri Farrington]

What I find disturbing is that pharmacies are involved in distribution of these vaccines. I have a six year-old autistic son and his pediatrician's office has told me they are unsure when or if they will even receive the H1N1 vaccine. I have little confidence that a pharmacy will adhere to the CDC guidlines set forth pertaining to high priority groups, as they will not want to deal with irrate people and will simply administer vaccines to those who show up and wait in line to keep the peace.

I appreciate how difficult it is that the DPH doesn't know when or where the vaccines are going. This is something the CDC should be in charge of and communicating to each state's DPH. No one in my area (local public health departments, doctor's office, school, etc.) seems to know anything, and I have a child who should be on the high priority list and I am worried that he will be left unprotected while others in lower risk groups are innoculated. I will keep watching but I am completely frustrated with the system and the lack of real information, assistance and organization from the CDC on this issue.

[Alanna]

I have been hearing bits and pieces about a mandatory H1N1 Vaccination in MA, with a hefty monetary fine for noncompliance. I have not been able to find any conclusive information on this. Can you please explain this in full?
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DPH RESPONDS: Thank you for your question. Vaccination against seasonal and H1N1 flu is completely voluntary. Commissioner Auerbach further expanded on this false rumor in a letter to members of the general court and local and municipal elected officials which you can find on our website at: http://www.mass.gov/Eeohhs2/docs/dph/cdc/flu/swine_commissioner_memo_%20re_false_rumors_of_mandatory_vaccination.pdf

[Michelle Winn]

An article in the Boston Herald on 10/15 states that swine flu shots will be rolled out to pregnant woman today per the MA DPH, but the MA DPH stated to me the shots will not be until in MA until mid-November when I called on 10/14. With conflicting information from the MA DPH, it is hard to determine when I can receive a shot. This article will be updated today, so hopefully it will tell pregnant women where the shots are in MA because by PCP and Ob Gyn do not have them in.
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DPH RESPONDS: We appreciate your confusion. As you might know, all vaccine supplies are shipped directly from the manufacturer to the community-level provider (physician’s offices, hospitals, community health centers, pharmacies, local public health departments, etc.) 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. In the meantime, there are a couple of ways to monitor when vaccine is available in your community:
• Visit http://flu.masspro.org, to find out if there are any public flu clinics planned for your area, including vaccination clinics at chain pharmacies such as CVS, Walgreen’s or Rite Aid.
• Keep in close contact with your health care provider(s) to stay updated on when they expect to receive vaccine supplies from the manufacturer, and to schedule an office visit to get vaccinated when they do.