First Doses of Swine Flu Vaccine Coming Soon
CDC Says 3.4 Million Doses Will Be Ready in Early October
Daniel J. DeNoon
WebMD Health News
Louise Chang, MD
Sept. 18, 2009 -- The first 3.4 million doses of swine flu vaccine -- all the
nasal spray vaccine -- will ship in early October, the CDC said today.
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In addition, some flu shots may be ready to ship by then, too, Jay Butler,
MD, chief of the CDC's H1N1 Vaccine Task Force, said at a news conference.
"Vaccine will be going out and will be distributed to providers by the first
week of October," Butler said. "Additional vaccine may be available as well,
but 3.4 million doses is the hard number that we have right now. And all that
vaccine is the live attenuated vaccine, which is the nasal spray."
H1N1 swine flu vaccine will be distributed to states according to population. Here's how it
- Some 90,000 provider sites -- some of them retail chains with many stores
-- will order vaccine from state health departments.
- State and local health authorities will triage the orders, deciding who
gets how many doses of vaccine.
- State and local authorities will then send the orders to the CDC, which
will collate them and send them to the distributors at about 5 a.m. the next
- Distributors will fill the orders within three business days and then ship
the vaccine by overnight express to providers.
- By mid-October, some 45 million vaccine doses will be available. Every week
after Oct. 15, 20 million more doses of vaccine will become available until the
entire U.S. allotment of 195 million doses is reached.
Unlike the more traditional flu shots, the nasal spray version of swine
flu vaccine is approved only for people age 2 to 49 years. That means that very
young children -- one of the priority groups for swine flu vaccination -- won't
be getting these first doses. Neither will pregnant women.
Instead, these first 3.4 million vaccine doses likely will go to health care
workers with direct patient contact, or to caretakers and household contacts of
infants under 6 months of age.
"It's a decision that really does need to be made locally," Butler said.
Two Flu Shots for Kids
The good news from clinical trials of H1N1 swine flu vaccine is that healthy
adults need only one dose of vaccine for protection.
But the package inserts being readied for the vaccine say that kids under
age 10 years will need two doses of vaccine, given three weeks apart.
"We anticipate that two doses will be required for younger children," Butler
Do You Need Vaccine if You've Already Had a Flu-Like Illness?
Swine flu is, of course, already here and moving like wildfire. It's now
widespread in 21 states, with cases in all 50 states.
"It's a very strange thing for us to see that amount of influenza at this
time of year," Daniel Jernigan, MD, deputy director of the CDC's flu division,
said at the news conference. "In the Southeast right now there's a considerable
amount of influenza disease, very consistent with the earlier opening of
schools in the Southeast. ... We may expect that increases in numbers of cases
will occur in other parts of the country, where kids are now getting back
It's clear that a lot of people will have had the flu by the time the flu
If you've had a flu-like illness since the pandemic began, will you need a
flu shot? Yes, Jernigan says.
It's true that you're immune to swine flu if you've already had it. But H1N1
swine flu isn't the only bug that causes flu-like symptoms.
Unless you've had a laboratory-confirmed case of swine flu -- not just a
rapid flu test in a doctor's office, but a lab test of a
nasal swab sample -- you really can't know that you've had the flu. And such
tests aren't being done on people with mild cases of flu.
"There's no evidence that, even if you have immunity, getting the vaccine
would cause problems or increase the chances of a reaction," Butler said.
"Certainly for myself, if I had been ill in the past six months without a lab
confirmation, I would definitely want to get the vaccine."
It's a Pandemic, but Not a Bad One
When swine flu first appeared, the signs were ominous: Previously healthy
young people were showing up in hospitals with severe disease. Some died.
It looked as though the swine flu pandemic was going to be bad one. But that
no longer seems to be the case.
Early severity estimates were based on cases that came to medical attention,
while milder cases weren't at first noticed. Now it appears that -- at least so
far -- we've been lucky. While lots of people have and will have swine flu,
it's not as bad a pandemic as the terrible pandemic of 1918 or even the
moderate pandemic of 1957.
This week, Harvard researcher Mark Lipsitch, PhD, told an Institute of
Medicine meeting that on a 1 to 5 scale -- with 5 being a 1918-like pandemic --
the swine flu pandemic looks more like a 1.
Jernigan said that the CDC has been collaborating with Lipsitch, but is
doing its own analysis.
"We are likely to have numbers that look very similar to what Dr. Lipsitch
had," Jernigan said. "Our estimates do indicate that the amount of disease is
about what we would expect for a severe influenza season and not at the levels
of the pandemics from 1918 or 1957."
That said, Jernigan noted that flu viruses can change quite quickly, and
that the CDC will continue to monitor the severity of the pandemic in the U.S.
"There's only so much that you can do with forecasting," he said.
SOURCES: Daniel Jernigan, MD, deputy director, Influenza division, CDC. Jay Butler, MD, chief, 2009 H1N1 Vaccine Task Force, CDC.
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