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| No. 21 | 
Nov 14, 2009, 02:15 PM
 Re: 4000 deaths ACIP developed the guidelines for immunizations: CDC’s Advisory Committee on Immunization Practices (ACIP), a panel made up of medical and public health experts, met July 29, 2009, to make recommendations on who should receive the 2009 H1N1 vaccine While some issues are still unknown, such as how severe the flu season, the ACIP considered several factors, including current disease patterns, populations most at-risk for severe illness based on current trends in illness, hospitalizations and deaths, how much vaccine is expected to be available, and the timing of vaccine availability.
The groups recommended to receive the 2009 H1N1 influenza vaccine include:
Pregnant women because they are at higher risk of complications and can potentially provide protection to infants who cannot be vaccinated;
Household contacts and caregivers for children younger than 6 months of age because younger infants are at higher risk of influenza-related complications and cannot be vaccinated. Vaccination of those in close contact with infants younger than 6 months old might help protect infants by “cocooning” them from the virus;
Healthcare and emergency medical services personnel because infections among healthcare workers have been reported and this can be a potential source of infection for vulnerable patients. Also, increased absenteeism in this population could reduce healthcare system capacity;
All people from 6 months through 24 years of age
Children from 6 months through 18 years of age because cases of 2009 H1N1 influenza have been seen in children who are in close contact with each other in school and day care settings, which increases the likelihood of disease spread, and
Young adults 19 through 24 years of age because many cases of 2009 H1N1 influenza have been seen in these healthy young adults and they often live, work, and study in close proximity, and they are a frequently mobile population; and,
Persons aged 25 through 64 years who have health conditions associated with higher risk of medical complications from influenza.
2009 H1N1 vaccination has begun but initial supplies are small. More doses are expected for shipment each week. We ask members of the public who want to receive this vaccine to be patient as this program expands and more vaccine becomes available. While we expect there will be enough vaccine available for anyone who wishes to receive it, the ACIP also made recommendations regarding which people within the groups listed above should receive the first available doses. For more information see the CDC press release CDC Advisors Make Recommendations for Use of Vaccine Against 2009 H1N1. http://www.cdc.gov/h1n1flu/vaccination/acip.htm
It sounds like the priorities were developed from a women and children first approach including those most at risk of a fatal case. Priority groups were expanded yesterday...  | | No. 22 |
Nov 14, 2009, 05:34 PM
Re: 4000 deaths
The entire nation is engaged in collective hand-wringing over what to do to solve the problem of individuals who can't access existing health care because of lack of funds.
Steph cites an example of the inverse situation: a person with the means to pay for services can't access them because they no longer exist, and this is the response we get...
Originally Posted by HM2VikingRN  Occasionally individuals are on the wrong side of the priority definitions...
Seems a little inconsistent, doesn't it?
| | No. 23 |
Nov 14, 2009, 05:43 PM
Re: 4000 deaths Goldman Sachs, Citigroup got swine flu vaccine
By KAREN MATTHEWS (AP) – Nov 5, 2009
NEW YORK — Some of New York's biggest companies, including Wall Street giants Goldman Sachs and Citigroup, received doses of swine flu vaccine for at-risk employees, drawing criticism that the hard-to-find vaccine is going first to the privileged.
Hospitals, universities and the Federal Reserve Bank also got doses of the vaccine for employees who need it the most, such as pregnant women or chronically ill workers, according to the city's health department.
In order to receive the vaccine, companies had to have their own medical staff.
Distributing large doses of the vaccine to such businesses is "a great avenue for vaccinating people at risk," said Jessica Scaperotti, spokeswoman for the city Department of Health and Mental Hygiene.
But critics said Wall Street firms should not have access to the vaccine before less wealthy Americans.... http://www.google.com/hostednews/ap/...9HwkwD9BPM93G0 | | No. 24 |
Nov 14, 2009, 11:11 PM
Updated
Nov 14, 2009 at 11:43 PM by NRSKarenRN
Re: 4000 deaths
In my area, Philadelphia school district school children are receiving vaccine along with OB clinics in the city. Not a drop in my county yet.
Healthy system was gracious to kick in scarce regular Flu vaccine so my 15 staffers finally received last week as homecare agency didn't get full shipment. I guess I should just drive to Pocono's and camp out at Sanofi Pasteur's office as I pass it on the way to my parents vacation cabin. When my parents bought their cabin in 1982, there was ONE building on property---now there is 50 
Part of the problem is that new flu manufacturing plant section (pictured above) completed in 2007, didn't receive FDA license approval until May 2009: http://www.pharmaceutical-technology...asteurvaccine/ H1N1 vaccine availability « Supply Chain Matters
Many companies/hospitals were unaware they had to sign up for the new vaccine through the state health department, instead of ordering from their regular flu distributor (ours was McKesson who also supplies our homecare supplies). This is so state could target priority health groups.
Large employers with savy occupational health departments were ones that signed up. Pennsylvania Department of Health Updates H1N1 Vaccine ...
Wisconsin: H1N1 Vaccine Distribution Update | | No. 25 |
Nov 15, 2009, 11:32 AM
Updated
Nov 15, 2009 at 11:57 AM by HM2VikingRN
Re: 4000 deaths Originally Posted by Jolie The entire nation is engaged in collective hand-wringing over what to do to solve the problem of individuals who can't access existing health care because of lack of funds.
Steph cites an example of the inverse situation: a person with the means to pay for services can't access them because they no longer exist, and this is the response we get...
Seems a little inconsistent, doesn't it?
The question that was previously asked by you about how priorities for vaccination were developed was addressed in this post.
If you are asking me whether I think individuals with chronic debilitating illnesses should have access to vaccination. I do think that.
But I also understand that priorities for vaccination were developed on the basis of who was at the greatest risk for a fatal case of the flu. Its a problem of the commons. Vaccinate those at the greatest risk first and then move outwards. CDC identified the populations at greatest risk and those are the top priorities.
Ability to financially access care really isn't the issue nor should any individual be able to jump the queue in public health issues...
Health care equity is the issue that I think we all struggle with: Its definition varies widely. The basic concept often includes: Egality, or equalising individual net benefits or opportunities for such benefits;
Providing for distribution (of goods or services) according to entitlement;
Providing a decent minimum standard or level (of goods and services);
Utilitarianism, or maximizing aggregate gain with resources;
The Rawlsian maximum, or maximizing the position of the least well-off;
Providing for envy-free allocations. Berman et al, 1989:
“A common definition of equity in the public health literature is that the primary determinant in the use of services should be the need for them. Other factors such as income, race, location of residence and so forth should not play an important role in selecting who receives care and who does not.” http://www.idrc.ca/geh/ev-29060-201-1-DO_TOPIC.html | | No. 26 |
Nov 15, 2009, 02:34 PM
Re: 4000 deaths
Viking,
You've either missed my point entirely, or are trying to ignore it. Nowhere did I ask how priorities were set for distributing the seasonal or H1N1 vaccines. I don't live under a rock and I don't need to be "informed" of the CDC's priority lists. I live them every day at work.
I am trying to point out the incredible inconsistency among individuals who profess to be so concerned about equal access to health care for all, yet focus only on one politically expedient aspect of that "equal access," while totally ignoring others that pose just as much, if not more of a barrier to receiving healthcare. If a simple, basic measure such as a vaccine is not available to everyone who needs it, then there is unequal access to healthcare. Unfortunately, the regrettable position of Steph's patient isn't garnering anywhere near the attention or action that is being spent trying to figure out a solution to another healthcare barier. One that is more appealing to the evening news than a single ALS patient who is at risk for complications from both seasonal and H1N1 flu, and can't seem to get protected from either.
One could easily argue that the lack of vaccine is a far greater public health problem than the lack of individual health coverage. Those who lack individual health funding can still get care, even if they face financial problems later. Steph's patient can't get needed care because it doesn't exist in her area. That is indeed a bigger problem than funding, and one that deserves equal time and attention.
| | No. 27 |
Nov 15, 2009, 03:05 PM
Re: 4000 deaths http://www.medscape.com/viewarticle/711245
"Even If You Yell at Them, They Don't Grow Faster"
The CDC originally estimated that vaccine manufacturers would have produced roughly 40 million doses of H1N1 vaccine by the end of October. However, the agency has revised that figure downward to 28 million doses. As of today, 16.1 million doses were available for states to order, according to Dr. Frieden, and as of October 21, some 11.3 million doses had been shipped. Echoing what other CDC officials have said previously, Dr. Frieden urged patience.
"In the coming weeks," he said, "we will see steady increases in the amount of vaccine available."
Dr. Frieden defended the egg-based method for producing vaccine as reliable but "antiquated," and not well-suited to responding to a pandemic. "The tools we have aren't as modern as we would like, or as rapid," he said. "Even if you yell at [the vaccine strains], they don't grow faster."
"We have to remember that the enemy here is the virus," Dr. Frieden pointed out.
Detailed information about snags in the manufacturing process emerged yesterday during a meeting of the Advisory Committee on Immunization Practices, an expert panel that makes recommendations to the CDC. Bruce Gellin, MD, MPH, director of the National Vaccine Program Office of the Department of Health and Human Services, told the committee that summer production of H1N1 vaccine lagged behind schedule because yields of vaccine immunogen from chicken eggs fell short of those gained in initial experiments. "For some manufacturers, it was 3- to 4-fold less than expected," said Dr. Gellin.
Manufacturers tweaked their production methods to boost immunogen yield, so that it equals or even surpasses the initial projections, but this increased efficiency will not make a difference in H1N1 vaccine supplies for at least several weeks, Dr. Gellin said. Delays in producing seasonal flu vaccine also have been a factor because the same set of manufacturers makes both types of vaccine. In addition, facilities that package both vaccines have experienced interruptions."
Earlier in this article, published Oct. 23 of this year, the author describes a CDC decision to go with the chick-embryo method of manufacture rather than tissue-culture. Don't know why that decision was made ... was it political to benefit certain drug manufacturers ... economic to keep costs down ... or a judgement call to go with a known as opposed to an relatively unknown method.
Might be good questions to have answered before we start carrying on about incompetence, etc.
And those don't even address the distribution system and whose responsible for that ...
| | No. 28 |
Nov 17, 2009, 10:22 AM
Re: 4000 deaths Georges Benjamin, Exec Director of the American Public Health Association, has this to say: The U.S. response to the H1N1 flu pandemic has come under fire recently, however, much of the criticism fails to capture the extraordinary achievements we’ve seen thus far.
Since March when H1N1, also known as swine flu, first emerged, U.S. health officials have acted quickly and effectively to keep the public informed, learn about the virus, and minimize its spread and negative outcomes. This transparency and coordination between agencies has been a hallmark of the flu response since the beginning of the outbreak and has led to an honest conversation with the American people about the risks of and preparation for H1N1.
During this same time, we witnessed the rapid identification of this novel organism and its genetic sequencing, and the creation of a safe, effective vaccine to protect against its infection.
http://www.dailykos.com/
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