County Revamps H1N1 Vaccine Strategy

Washtenaw public health director: "Nobody's happy"

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At Wednesday’s briefing of the Washtenaw County Board of Commissioners, the county’s top two public health officials gave an update on the H1N1 flu situation and their plans to retool previously planned clinics to deliver the vaccine to high-risk groups.

High demand and lower-than-anticipated supply has led to a “tremendous shortage,” said Dick Fleece, director of the county’s Public Health/Environmental Health department. And in the wake of Tuesday’s public clinic that drew hundreds of people and created safety concerns because of traffic and crowds, the county is canceling four clinics planned for next week at local high schools.

Instead, they’re scheduling a community clinic that will likely be held on Saturday, Nov. 7, at either Eastern Michigan University or Washtenaw Community College. Details will be released on Thursday, Fleece told commissioners. Update: The county will hold a clinic to vaccinate people in its high-priority categories on Thursday, Nov. 5 from 10 a.m. to 7 p.m. at the EMU Convocation Center. [Link to directions]

All orders of the H1N1 vaccine are delivered to the county’s public health department, which is responsible for distributing the vaccines to hospitals, universities and other local health care providers. [Nationwide, counties receive shipments of the H1N1 vaccines based on population.] Because of the shortage of available vaccines nationwide, the county hasn’t been able to provide enough to meet the demand of any of those groups, Fleece said. “Nobody’s happy – we’ve made everybody mad.”

The county’s public clinic on Tuesday, held at the Washtenaw Intermediate School District building on Wagner Road, lasted about one hour out of six hours that had originally been scheduled – the clinic was supposed to run from 3-9 p.m. People started coming hours early.  Before the clinic opened, cars already lined both sides of Wagner from Scio Church to Liberty, forcing people to walk along the busy two-lane road to reach the WISD building. Though nurses gave about 1,000 vaccines, they had to close the clinic because they ran of their supply.

They were surprised by the turnout – last week, the county held three clinics for emergency “first responders” and less than 500 people showed up, Fleece said.

As of last week, the county had received about 14,000 doses of the vaccine, about half of those in the form of nasal spray. Diana Torres-Burgos, the county’s medical director, told commissioners that vaccines were distributed to local hospitals, which received 43% of the total, community health care providers (33%) and the county’s public health clinics (19%), with the remainder going local universities.

Another shipment is expected soon, but it will still fall short of demand. Because of production delays from vaccine manufacturers, the county has so far received only about 30% of the supply it had anticipated by now, officials say. They expect to see supplies increase by mid-November, however. Fleece noted that despite media accounts which make it appear that there won’t be sufficient vaccines for everyone, the county expects that eventually they’ll have enough to meet demand.

But for the moment, Fleece said the county will narrow its focus for who will receive the vaccines first, based on risk and other factors. Using guidelines from the Centers for Disease Control, the county has identified priority groups that will be eligible for the vaccine:

  • pregnant women;
  • household and caregivers of children under 6 months of age;
  • children 6 months through 4 years old;
  • children 5 to 18 years old who have medical conditions that bring a higher risk of flu complications;
  • health care and emergency medical services personnel who provide direct patient care.

At the clinic to be scheduled next week, the county plans to vaccinate about 4,000 people, Fleece said.

Torres-Burgos said the H1N1 virus is actively circulating in Washtenaw County, but the good news is that people are recovering. The county public health website tracks cases of H1N1, and reports that for the week ending Oct. 24, there were three hospitalizations due to that strain of flu. No deaths have been reported in Washtenaw County because of H1N1.

Updates on the H1N1 outbreak and vaccines will be posted on the county public health department’s website. Fleece also plans to make a presentation at the Nov. 4 board of commissioners meeting.