Slowly But Surely, U.S. Swine Flu Vaccination Begins

As predicted, the U.S. government has started to deliver a small amount of swine flu vaccines to states this week, and states are wrestling with how to decide who should receive the limited supply first. But plans to have large amounts of vaccine available by mid-October remain on track, and public health officials have begun to address another dilemma: how to encourage a somewhat reluctant public to take advantage of the product once it is widely available.

At a press conference held today, Thomas Frieden, head of the U.S. Centers for Disease Control and Prevention, said that 2.4 million doses of vaccine against the novel H1N1 virus are now available. Although states have only ordered 2.2 million of them. Frieden dismissed the slight under demand this week as simply the difficult process of launching a complicated national campaign that makes vaccine available to states each day as soon as it comes off the production line. “It’s a little bit of a messy process and we do expect it to be a little bit bumpy in the first few weeks,” he said. CDC plans to report each Friday how many doses of vaccines are available.

But Frieden said CDC expects supplies will outstrip demand “fairly soon,” and he addressed “three major concerns” that the people have raised “despite the clear message from all of us in public health and doctors throughout the health care field that vaccine is our best tool to protect against the flu.”

One is that the pandemic swine flu virus is perceived as mild. Even an average case, he stressed, “is no picnic,” and the virus has sent many to the hospital and killed some.

Second, he addressed fears that the vaccine is unsafe, stressing that no corners were cut to make the product, and that it’s the same process as the one used for many years to make seasonal vaccine. Finally, Frieden addressed fears that the vaccine would not arrive in time to help. “It’s too soon to say it’s too late,” said Frieden

The last point has worried many epidemiologists and epidemic modelers, who suspect the pandemic may peak in the United States just as the vaccine become plentiful. Given that it takes vaccinated people a few weeks to develop a robust immune response, protection might not occur in most of the population until well into November. Flu is now widespread in the country, and indeed some states already have seen decreases, Frieden noted. Yet he stressed that even in widespread states, maybe 5% to 10% of the population has been infected by the novel H1N1 virus. “That leaves 90% to 95% of the population that's still susceptible,” Frieden said.

Frieden noted that flu season often lasts through May. “We’re very confident that there will be plenty of vaccine for everyone who wants to be vaccinated,” he said. “Unfortunately, it will not be available when everyone would like to be vaccinated. We’re getting it out as rapidly as possible.”