Who gets the first flu shots?

It is decided. The Advisory Committee on Immunization Practices has met, ruminated, voted, and now decrees that pregnant women, health care workers, and children over six months old will be vaccinated first. The reason we even need to worry about this is that there will not be nearly enough flu vaccine to go around in the event of a real surge in the novel swine flu.

In the US, according to MSNBC,

The government estimates that about 120 million swine flu vaccine doses will be available to the public by late October. Nearly 160 million people are in the priority groups considered most vulnerable to infection or most at risk for severe disease, Schuchat said.

Since it is expected that two doses will be needed per person, it will be necessary to subdivide the target population and use a finer priority scale. Here is the order of priority:

  1. Pregnant women
  2. Household contacts of children younger than 6 months
  3. Subset of health workers who have direct contact with ill people
  4. Children 6 months through 4 years of age
  5. Children 5 to 18 who have greater risk factors for the flu

I’m a little uhappy that our health care system has not figured out how to produce sufficient supplies of effective vaccines against novel flus. It is almost like the whole medical, pharmaceutical, and scientific world has been hampered by eight years of … oh, never mind..

Comments

  1. #1 Dorid
    July 29, 2009

    I’m watching the report on it now on the news, and they just said that they’ll have more a few months after they start, and they also listed elderly and adults with other medical conditions on the list, and included all kids 6 mos to 18 years. I think there’s going to be a lot of confusion about this as it gets closer to the date they actually start releasing the vaccine for use in the US.

    Of course I think the media has dropped the ball on swine flu since day one, and has published and/or hit the air with the information before they had all the facts.

  2. #2 NewEnglandBob
    July 29, 2009

    I’m OK then, being a pregnant health-care worker under 6 month of age.

    The priority list needs to include:

    Elderly
    People with heart conditions
    People with respiratory conditions

    Otherwise we are throwing them under the bus.

  3. #3 KarinNH
    July 29, 2009

    Okay, this may make me a terrible person but…

    On Huffington Post there is an article about the swine flu, and the author declares he will never allow himself (or his children) to be forced to the shot and implies there is a vast conspiracy, etc.

    When I read it, my first thought was who the hell takes their health advice from “a male model” and my second thought was huh…maybe if enough people do there will be enough vaccine for the rest of us.

  4. #4 KarinNH
    July 29, 2009

    Ah, that should say forced to take the shot.

  5. #5 MadScientist
    July 29, 2009

    Oooo – look out for the big bad swine flu! Let’s see – so far it has a mortality rate about on par with the common flu if not lower (and an actual # of kills which is far lower due to infection of a drastically smaller population) – it’s not whacking as many babies or oldies as the usual flu. The people who are dying have other horrible medical problems; it’s not as Fox news announces that “young healthy adults” drop dead.

    So – if an effective vaccine is created then good, but if not it’s nothing to worry about (unless of course the next round of swine flu is a good killer).

  6. #6 Greg Laden
    July 29, 2009

    It all depends on if this mimics the 1918 flu, which in all respects including morphogy it has.

    In any event, at some point, a killer pandemic is going to come along. If the best we can do is a few tens of millions of doses, then the basic idea that the human population problem is going to be handed this way is something you can bet on.

    But don’t panic.

  7. #7 Dunc
    July 30, 2009

    I’m a little uhappy that our health care system has not figured out how to produce sufficient supplies of effective vaccines against novel flus.

    Why can’t 9 women have a baby in 1 month? Damn biology!

    Personally, I’d find it very useful if I could culture enough brewers yeast for a 22L batch from a slant in less than 5 days, but it’s simply not going to happen. When you’re growing things, you have to accept that they have a maximum growth rate.

  8. #8 MadScientist
    July 30, 2009

    If we get something like the 1918 flu it will be much worse; just about any place is far more crowded now than 100 years ago and ease of travel (fly to anywhere on the planet in under 48 hours, vs take a ship and a few weeks or months) will make it impossible to contain an epidemic. When the swine flu was first identified people were talking about a human vaccine trial in a matter of weeks; one year later the human trials are still being planned.

    How to survive an epidemic? Keep 3 months stock of food and when you hear news of the killer flu in the neighborhood, take 3 months off work and hope you’ve avoided the disease. I doubt many would have the discipline to do that. Another alternative is one that worked during the great plagues; head off into more remote areas far away from people. Of course when 80% of the city wants to get out of that same city you have the stuff that stories are made of.

  9. #9 Nathan Myers
    July 30, 2009

    The 1918 flu killed only a percent or two of the people who contracted it; swine flu will be no worse. What made 1918’s notable was that it killed the (previously) healthiest percent. A flu that kills old and already-sick people is easy not to notice, and, sure enough, we don’t.

  10. #10 Aaron
    July 30, 2009

    With other vaccines herd immunity is a major benefit, is there a reason why they don’t make enough flu vaccines for everyone and try to get there?

    Is it because of the effectiveness (especially if it’s the wrong strain) or the fact that you wouldn’t be able to convince
    enough people to get vaccinated?

    Similarly do they try campaigns targeted at salesmen and frequent travelers to try to cut down the spread? Even personally I’ve wondered how much benefit there is in myself getting vaccinated just to remove myself as a potential carrier.

  11. #11 MadScientist
    July 30, 2009

    @Aaron: Making up a large batch to treat a large fraction of the population is not economical; most of it will simply go to waste. I doubt anyone has large enough facilities to produce a vaccine in large enough quantities in a short enough time either. Unlike many vaccines, any flu vaccine is essentially only useful for that one flu season; fighting the flu is still a huge challenge.

    Government can require immunization records for all travelers, but this is unlikely unless the disease is a big killer. Also, the vaccines are not 100% effective so you’d need quarantine on top of vaccine records and given the number of travelers that just isn’t possible.

  12. #12 Greg Laden
    July 30, 2009

    Dunc: the growth rate varies across flu strains as well, so it is unpredictable. But there is a way to get twice as much flu vaccine at the end of the growth period, and it does not require tricking biology in any way whatsoever!

    And no, not really interested in post hoc economic efficiency arguments. We are making enough vaccine when we are throwing some of it out.

    Regarding the 1918 flu mortality rate, it was actually more like 10-20 percent.

  13. #13 Art
    July 30, 2009

    Okay, we are a little behind the power curve on flu vaccines but, on the up side, we have enough Viagra and Cialis to give every male on earth a hard-on for a month.

Current ye@r *