H1N1 vaccine shortage, distribution criticized
A huge shortage of vaccine is leaving most local residents unprotected against the H1N1 virus and is making local physicians and health officials increasingly critical of distribution problems.
Dr. Steven J. Lana, a Buffalo pediatrician and part-time medical director of the Buffalo Public Schools, said he gets “multiple, multiple calls a day” for the vaccine but still doesn’t have any injectable vaccine to offer patients.
Lana quickly exhausted 500 doses of a mist vaccine and estimates he would have given several thousand H1N1 injections by now if it were readily available.
Lana called the rapid development of the H1N1 vaccine “a triumph of medical science,” but he said the distribution has been a bust.
“We can’t seem to deliver it to the front lines where it’s needed,” he said. “There’s no rhyme, reason or order to the distribution. It’s chaotic. It’s a major public health failure.”
If anything, demand and public concern are expected to grow.
The Genesee County Health Department said Tuesday that a school-age child died of a confirmed case of H1N1 influenza. Citing privacy rules, department officials did not release further details.
In another case, Amherst High School sophomore Chelsea Oliver died Sunday when breathing problems developed into pneumonia and sepsis. Tests are being conducted to determine whether she had swine flu.
And two Buffalo students died of complications from the H1N1 virus in June.
“Certainly, this is a tragedy,” Randolph P. Garney, interim Genesee County public health director, said of the case there. “I hope parents will take the H1N1 virus seriously and vaccinate their children.”
With the intense attention being paid to influenza, demand has been strong nationally for both seasonal and swine flu vaccine.
But both are in short supply, although shipments of swine flu vaccine are increasing, according to federal public health officials.
“The gap between supply and demand is closing,” Dr. Thomas Frieden, director of the Centers for Disease Control and Prevention, said last week during the agency’s most recent briefing on H1N1.
As of Monday, 30,033,800 doses of H1N1 vaccine had been allocated, the CDC reported.
The shortage is attributed to manufacturing delays at companies that make the vaccine, as well as to cautious actions the government took related to vaccine safety, such as the decision not to use common additives in the vaccine that could expand the available supply.
Swine flu has swept the country, with 48 states reporting widespread activity to the CDC.
Based on a 122-city survey, the CDC reported last week that since April, when the pandemic began, it has received reports of 114 laboratory-confirmed H1N1 deaths in children, especially those older than 4 and with underlying medical conditions that increase their risks.
Moreover, visits to doctors for influenza-like illness increased steeply in the week ending Oct. 24, and overall, doctors visits and flu-related hospitalizations are much higher than expected for this time of year.
At Women & Children’s Hospital, for instance, the number of daily emergency room visits is nearly double from a year ago, said spokesman John Moscato.
The pediatric hospital usually sees about 110 patients a day. Monday, he said, there were 203 patients.
Much of the increase is attributed to people with flulike symptoms who ordinarily would take care of themselves or their children at home but are worried about H1N1.
What’s different about H1N1 is that it appears to be a younger person’s flu. In a usual flu season, 90 percent of deaths are among people over age 65, CDC officials reported. With H1N1, 90 percent of deaths are in people under age 65.
“Our phone has been ringing off the hook for vaccine,” said Dr. Richard Judelsohn, a physician with Buffalo Pediatrics and medical director of the Erie County Health Department.
His practice received its first shipment of the flu-mist form Monday and expects to receive the injectable form soon. Judelsohn said a handful of pediatric practices in the Buffalo area have obtained supplies in recent weeks, as well.
“It’s unfortunate that the optimism expressed about the manufacturing and distribution of the vaccine [40 million doses by the end of October] didn’t match the reality of what’s going on in the factories where the vaccine is made,” Judelsohn said.
“It has created a lot of frustration, but I’m optimistic things are now speeding up,” he said.
Judelsohn said that despite the tragic deaths, H1N1 has proved so far to generally be a mild illness. Nevertheless, like other public health officials, he urged vaccination as the best way to prevent infection and spread of the disease.
“This is a new and unusual virus. We may see another wave of illness,” he said.
Virtually all the flu now in this country is H1N1 and not the seasonal flu. It’s unclear when seasonal flu will appear or what effect the H1N1 variety will have on its usual spread.
Frieden said 89 million seasonal flu vaccine doses were distributed, but there no longer is enough to satisfy demand. Manufacturers expect to have more ready later this month and in December, he said.
But not everyone is clamoring for a vaccination.
While many Buffalo Public Schools parents are eager to get their children vaccinated, a roughly equal number have qualms, said Samuel L. Radford III, vice president of the District Parent Coordinating Council.
“They’re hearing that the vaccine came out early and that it hasn’t been tested properly,” Radford said. “That concern is kind of percolating.”
hdavis@buffnews.com and psimon@buffnews.com
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