Thursday, December 17, 2009

Important updates on vaccine prioritization and recall

Maine CDC/DHHS Update on 2009 H1N1 Influenza Virus
December 17, 2009

Highlights
Four deaths due to H1N1 have been reported, bringing the total to 17 since August. Please note that an estimated 150 people die in a normal flu season in Maine.
We are now recommending H1N1 vaccine be made available to anyone who wants it, as local supply allows and with an emphasis on prioritizing injectable vaccine for those at highest risk for complications.
A non-safety recall has been issued for about 800,000 doses of H1N1 vaccine nationwide.
We expect the H1N1 flu virus to continue to circulate and additional surges are also possible. We expect to experience a seasonal flu surge as well, as we normally do sometime in the winter. There is still more influenza across the country than is usually seen this time of year, and vaccination remains the best protection against the flu.
Now is an excellent time to get vaccinated, so you will be protected during the next wave of flu.

Flu Activity in Maine and the US
Data indicate that H1N1 flu has been relatively mild in Maine compared with other states, and continues to decline. Nationally, data indicate that H1N1 is striking young people the hardest. However, there were four deaths among people older than 64 since last week’s update. Those individuals lived in Androscoggin, Kennebec, Knox, and Oxford counties. Note: Three deaths were reported to Maine CDC after the surveillance information at the end of this report was compiled, and therefore will not be reflected in that data.

All 17 deaths since August have occurred in people with underlying health conditions. People with underlying health conditions should seek vaccine at their specialty providers, primary care providers, or at public clinics listed at www.maineflu.gov. Anyone with underlying health conditions who experiences flu-like symptoms should contact his or her health care providers immediately to receive a prescription for antiviral medications (such as Tamiflu®).

There were 11 new hospitalizations due to H1N1 in the last week, down from 31 the week before, all ages 25 and older. One individual older than 64 required intensive care. Counties of those hospitalized this past week are: York, 3; Franklin, Penobscot, and Somerset with two each; and one each in Hancock and Knox counties.

Outbreaks were reported in one long term care facility, one acute care facility, one K-12 school, and two other institutions. The outbreaks occurred in Androscoggin, Cumberland, Oxford, and Penobscot counties.

Flu is unpredictable. Although it appears that flu activity may have peaked during the current wave, other waves of seasonal and/or H1N1 flu may occur. We expect H1N1 to continue to circulate for months, if not years, to come. Take precautions to prevent serious illness: stay home when sick, cover coughs and sneezes, wash hands frequently, and get vaccinated against both seasonal and H1N1 flu when vaccine is available to you.

To remind people of the importance of taking these precautions, order flu posters and magnets for your organization, workplace, or health care practice: http://www.maine.gov/dhhs/boh/flu-poster-orders.shtml

H1N1 Vaccine Supply and Prioritization
Since October, we have received more than 500,000 doses of H1N1 vaccine in Maine. Based on recent demand, Maine CDC is now recommending that H1N1 vaccine be offered to anyone who wishes to receive it when local supplies allow. The focus for vaccine will still be the five high priority groups as defined by US CDC, but in many places public clinics will not need to turn others away. We are encouraging health care providers with sufficient supplies to provide vaccine to all who want it, and those without sufficient vaccine to focus their vaccine supply to those in the high priority groups: pregnant and recently pregnant women; household members and caregivers of infants younger than six months old; all people ages 6 months through 24 years; people ages 25 through 64 with underlying health conditions; and health care and EMS workers.

The nasal spray vaccine is available in slightly greater quantities than injectable vaccine. If healthy people who qualify for the nasal spray are given injectable vaccine, this can easily deplete the injectable vaccine supply for those who are most vulnerable to being hospitalized or dying from H1N1. Therefore, we request that nasal spray vaccine be given to anyone who is eligible to receive it. The nasal spray vaccine is a safe and effective vaccine option for healthy people ages 2 through 49 who are not pregnant.

Nasal spray flu vaccine is not new. It has been used successfully in many settings for seasonal flu vaccination since 2003. Even if you come into regular contact with people who cannot receive the nasal spray vaccine themselves you may still be able to receive the nasal spray vaccine as long as you are healthy, not pregnant, and age 2 through 49. The nasal spray vaccine is safe for breastfeeding mothers. Health care workers who cannot receive the vaccine themselves (due to pregnancy, health condition, or age) may still administer the vaccine.

For more information on nasal spray vaccine, please see our Fact Sheet at: http://www.maine.gov/dhhs/boh/maineflu/LAIV_factsheet.pdf

The benefits of getting the H1N1 vaccine far outweigh the very small risk of serious complications from vaccination. Some people getting vaccinated will have mild side effects such as pain, redness or swelling in the arm where the shot was given or a runny nose and headache after the nasal spray vaccine. US CDC and FDA carefully monitor vaccine reports. After millions of doses of H1N1 vaccine being administered in the U.S., the number, pattern and types of adverse event reports are similar to what we see for seasonal influenza vaccine. More than 90% of adverse event reports nationwide have been classified as not serious.

Over the coming days and weeks, vaccine will become more available in a variety of settings, including health care provider offices, public clinics, retail locations, large employer settings, nursing homes, etc. People have three easy options in seeking vaccine: check the clinic locator at www.maineflu.gov, call 211, or call their health care providers.

Vaccine Recall
About 800,000 doses of H1N1 vaccine in the .25 mL pre-filled syringe presentation manufactured by Sanofi Pasteur and approved for children ages 6-35 months have been recalled due to questions of potency. This is not a safety recall.

Maine CDC notified 25 practices on Wednesday that they had received some of the recalled lots of H1N1 vaccine. The remaining vaccine from these lots was pulled from their shelves. About 4,500 doses of the recalled lots had been recently shipped to Maine, and reportedly many of those had not been administered yet. Because there were no safety concerns and the vaccine was slightly weaker than the license standards called for, there are no recommendations for the children who received the vaccine except to proceed with their second dose as would normally occur.

All children less than 10 years old should get the recommended two doses of H1N1 vaccine approximately a month apart for the optimal immune response. Therefore, children less than 10 years old who have only received one dose of vaccine thus far should still receive a second dose of 2009 H1N1 vaccine. Parents of children who received vaccine from the recalled lots do not need to take any action, other than to complete the two-dose immunization series if not already completed.

For more information http://www.maine.gov/tools/whatsnew/index.php?topic=Portal+News&id=86326&v=article-2008


To read the complete update: http://www.maine.gov/tools/whatsnew/attach.php?id=86508&an=2

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