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 Shortages, Confusion and Rumors in a Fight Against Flu 
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Post Shortages, Confusion and Rumors in a Fight Against Flu
Shortages, Confusion and Rumors in a Fight Against Flu
http://www.nytimes.com/2009/10/24/health/24flu.html
By DONALD G. McNEIL Jr., October 23, 2009

A month ago, Dr. Thomas R. Frieden, the director of the Centers for Disease Control and Prevention, warned that the flu vaccination drive soon to begin would be “a little bumpy.”

That was an understatement.

Good and bad news have alternated in the twice-weekly briefings from Dr. Frieden’s agency, and confusion has reigned across the country. Vaccinations started earlier than planned, then supplies began running short. The only flu circulating now is swine flu — seasonal flu is not expected to emerge for another month — but most of the vaccine available is against seasonal flu, because it was ready first; vaccine companies started making it in February, and swine flu emerged in April.

Many doctors complain that they cannot get either vaccine at the same time, while supermarkets offer 10 percent off groceries to customers buying seasonal shots. Average Americans seem baffled by the choices: Nasal spray or needle? Thimerosal-free or not? No shot for my toddler, or just one, or two?

Adding to the confusion is the decision by New York State to require hospital workers to get both types of flu shots. Many employees have accepted it as part of their duty to protect patients, but some have been furious. (Gov. David A. Paterson’s administration suspended the regulation Thursday because supplies ran short.)

All sorts of false rumors appear on the Internet — that the swine flu vaccine is untested, or that it is made from African green monkeys or aborted fetuses. The conservative commentators Glenn Beck and Rush Limbaugh and the liberal commentator Bill Maher have advised their listeners not to get the new vaccine, suggesting it could be deadly or part of a plot by the Obama administration to dictate Americans’ health.

“If somebody had the swine flu right now, I would have them cough on me,” Mr. Beck said last month. “I’d do the exact opposite of what the homeland security says.”

Planners at the C.D.C., the National Institutes of Health and the Food and Drug Administration are caught in a no-win situation. Having pushed private companies and themselves to make and approve a new swine flu vaccine as soon as possible, they now stand simultaneously accused of rushing an “untested” product to market and of not rushing enough of it.

Despite the current confusion, top flu experts say they ultimately expect a different outcome: So much vaccine is being made that by January or February, there will be a lake of surplus, not a nationwide shortage.

The shortfalls, they argue, are temporary. The problem recalls the fad for Beanie Babies, in that perceived shortages create a mad rush and exacerbate the shortages.

As soon as the flu fades from the headlines (as some experts predict it will, because the pandemic’s fall wave may be peaking right now), so will the demand for shots. That means the government will eventually be able to donate tens of millions of doses of swine flu vaccine to poor countries.

When the world’s richest countries wrote contracts with the big vaccine makers last spring, the poorest were promised enough to cover 2 percent to 3 percent of their populations. After it became clear that the new vaccine would protect a person with just one shot, the United States offered 10 percent more of its contracted purchases to the World Health Organization. But those doses presumably will not be available until mid-winter.

In the meantime, unhappy vaccine-seeking Americans are everywhere.

In Des Moines, the first “vaccine day” on the State Fairgrounds ran out of seasonal shots at lunchtime.

In Franklin County, Pa., some stores ran out of vaccine. A local TV station reported that others still had some but warned viewers to “call ahead and be ready to stand in line.”

And in Massachusetts, a furor arose when The Boston Herald had this report: “Thousands of state inmates will get coveted swine flu vaccinations weeks before law-abiding Bay Staters, who foot the bill for prisons, have a shot at protecting themselves, state public health officials have decided.”

The confusion has put high-ranking medical officials on the defensive.

Dr. Anne Schuchat, who has led many of the C.D.C.’s briefings, said this week that getting 13 million doses of swine flu vaccine out by late October “probably feels like a slow start for a lot of people.”

But, Dr. Schuchat added, “I think this is a significant achievement.”

It normally takes up to nine months to get a seasonal vaccine out each year. Each February, experts pick the most common strains circulating, and a vaccine ships in November. (Much of that time is spent growing the vaccine in millions of eggs; each has to be injected by hand and later cracked by hand.) By contrast, the development of a vaccine for swine flu took less than six months.

At a recent conference, several top flu researchers praised the effort. “The government should really be commended for buying the vaccine doses and distributing them early,” said Peter Palese, a virologist at Mount Sinai School of Medicine.

Other problems are local. Although the federal government ordered the vaccine and established which groups should receive it first, decisions on how to inject it were left to state and city officials. Their public health budgets have been cut deeply in recent years.

“We’ve got a new vaccine pipeline starting to flow, but at the end of it are a lot of rusty faucets,” said Michael T. Osterholm, director of the Center for Infectious Disease Research and Policy at the University of Minnesota.

And some logistical problems are daunting. It is easy to vaccinate health care workers on the job and children at school, but hard to get pregnant women, many with toddlers in tow, to line up in stadiums for shots — to say nothing of people with serious heart and lung disease.

Further confusion stems from arguments over whether the epidemic will peak before people get shots. By some estimates, a wave passes through a community in about seven weeks.

Ira M. Longini Jr., an epidemiologist at the Fred Hutchinson Cancer Research Center, in Seattle, predicted that the national peak would be in late October. Indeed, cases have already started to decline in the Southeastern States, where they spiked in August when schools opened.

Federal officials conceded months ago that many people would be infected and some would die before the vaccine was ready. But Dr. Schuchat pointed to the 1957 flu as an example of why lives could still be saved.

In that year, Dr. Schuchat said, “there was early disease around September-October like we’re seeing here.”

“Then, she added, “they had another big wave after the first of the year.”

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Post Re: Shortages, Confusion and Rumors in a Fight Against Flu
HHS' Sebelius: Ample flu vaccine will be available

(AP) – 29 minutes ago
http://www.google.com/hostednews/ap/art ... AD9BIOLG00

WASHINGTON — Health and Human Services Secretary Kathleen Sebelius said Monday the swine flu vaccine "is coming out the door as fast as it comes off the production line."

But at the same time, she acknowledged delays in getting a sufficient supply for all those demanding it.

"We were relying on the manufacturers to give us their numbers and as soon as we got numbers we put them out to the public. It does appear now that those numbers were overly rosy," Sebelius said in one interview. "We do have a vaccine that works," she said. Sebelius said the immune response is working faster than officials anticipated.

Appearing Monday morning on nationally broadcast news shows, she said officials now have a supply of about 16.5 million doses of the vaccine, while conceding that's millions of doses below the amount needed.

Sebelius said she couldn't predict just how widespread the virus will be. Roughly a thousand people have died from it so far in the United States. But she also said officials do not believe there is yet any cause to close down schools and cease other daily activities.
President Barack Obama declared a health emergency over the weekend to give hospitals and health professionals more leeway from federal regulations to respond to the illness. And on Sunday, Senate Republican Leader Mitch McConnell of Kentucky said Congress would be happy to provide additional support and money on a bipartisan basis, if the need arises.

Said Sebelius: "If we had found the virus a little earlier we could have started a little earlier."

Asked what advice she would give to people who have waited futilely in line for shots, the secretary replied, "I want them to come back."

"I hope that people aren't discouraged," she said. "I know it's frustrating to wait in line and particularly if you end up with no vaccine. We wish this could have been smoother, that we had a larger supply. We knew it would come in waves."

Sebelius sought to assure people that eventually there will be enough supplies "for everyone."

Dr. Anne Schuchat, who heads the Immunization and Respiratory Diseases Division of the Centers for Disease Control and Prevention, said it's hard to predict how long the H1N1 wave will continue, so even getting vaccinated a few months from now — when vaccine supplies are more plentiful — won't be too late.

"It wouldn't be too late," she said. "We don't know how long this increase will go on. ... We might see another wave after the first of the year. I think it's important for people to take steps to protect themselves."

Sebelius appeared on ABC's "Good Morning America," CBS's "The Early Show" and NBC's "Today" show. Schuchat was interviewed on CNN.

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