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Massachusetts health authorities took the unprecedented step yesterday of deputizing dentists, paramedics, and pharmacists to help administer vaccines against both the seasonal flu and the novel swine strain expected to make a return visit in the fall.
In another emergency measure, regulators directed hospitals and clinics to provide vaccine to all their workers and some volunteers, a move designed to keep the medical workforce robust and prevent doctors and nurses from making their patients sick.
The actions illustrated the intensifying sense of urgency as health authorities, hospital administrators, and clinic executives across the nation confront the prospect of providing hundreds of millions of doses of vaccine against not one but two deadly types of flu in the same season.
“It’s going to require all hands on deck,’’ said Dr. Alfred DeMaria, the top disease tracker at the state Department of Public Health. “We have to get everybody who’s a target for vaccine vaccinated, and we have to get enough people to give the vaccine.’’
The first truckloads of vaccine against seasonal flu are expected to rumble into Massachusetts later this month, and agencies such as the Boston Public Health Commission are developing major campaigns to persuade people to get shots and sprays that protect against the disease, which kills an average of 36,000 Americans each year. It is estimated that 90 percent of Massachusetts adults and children fall into categories recommended to receive seasonal flu vaccine.
ACIP Recommendations on H1N1 Vaccine Targeted Populations, Prioritization
The Advisory Committee on Immunization Practices (ACIP) convened an urgent meeting on July 29, and based on current information on novel H1N1 Influenza A, recommended targeting the following populations for H1N1 vaccine (which will be in limited supply):
Household contacts of children under 6 months old;
Healthcare workers and emergency personnel;
Children and young adults who are between the ages of 6 months and 24 years; and
Non-elderly adults with conditions that make them high risk.
The elderly are not a targeted population because to a large extent, H1N1 has spared that population. They remain a priority for seasonal influenza where they are at high risk of complications. The five target groups total about 159 million individuals and initially, it is anticipated that there will be about 120 – 160 million doses of vaccine available. Since the expectation is that protection will require 2 doses, there may be a need to prioritize within the targeted populations. On the other hand, CDC noted that not all the targeted population will opt for vaccine and there may be enough for those who want the vaccine. Although ACIP prefers that there not be prioritization, they did recommend subsets within the targeted populations. The first two categories remain the same. The third category, healthcare workers and emergency personnel, would be limited to those in direct contact with infectious individuals. The last two categories were also narrowed to a subset of each.
When the judge signs the Preliminary Injunction, it will stop the federal government from forcing anyone in any state to take flu vaccine against their will. It will also prevent a state or local government from forcibly vaccinating anyone, and forbid any person who is not vaccinated from being denied any services or constitutional rights.