The Food and Drug Administration approved the new swine flu vaccine Tuesday. But health officials across the nation have been planning for months on how to best distribute the vaccine.
Around Louisville, Ky., public health officials have long since scoped out banks with drive-up teller stations that might be used to dispense swine flu shots instead of cash.
"We've done exercises for several years at the state fairgrounds, parking lots, other public places with multiple lanes where we could move a lot of people through quickly,'' said Dr. Adwale Troutman, director of Louisville Metro Public Health and Wellness, speaking during a recent conference on swine flu preparation in Washington.
"We've tried to make plans to use schools for mass vaccinations, but we've found it's logistically difficult for people to come in."
In many of the rural southwest Texas counties served by the Department of State Health Services' District 8, "We don't have much in the way of drive-thru banks,'' said Nancy Walea, a public health nurse at the same Washington conference. "We've done some mass vaccination drills with our hospitals, but most of our banks would be a little cozy."
As a member of the district's epidemiology response team, Walea was on the front lines of initial swine flu outbreak last April, repeatedly visiting the homes of the two San Antonio-area teens who were the first in the state to be diagnosed with the new strain.
"So I did all these interviews and blood draws from these families," said Walea. "I was a regular visitor, but I tried to be unobtrusive about it. They joked that with all the shopping bags I came in with, I looked like the Avon lady.
"There was such intense interest in those boys, because they hadn't been to Mexico and no one could figure out how they became infected."
This fall, H1NI flu is hardly a rarity in Texas or anywhere else in the United States. Officials say flu is already about as widespread as it was at the peak of last winter's flu season -- and that 98 percent of the cases are the result of swine flu.
The focus now is less on tracking the spread of the disease than doing everything possible to slow transmission and limit the effects of the virus on the people most likely to have a bad time with it.
Perhaps by the end of the year, federal officials think there will be enough vaccine available to protect most Americans from the swine flu -- or at least everyone who wants to get the inoculation.
Health Secretary Kathleen Sebelius says the first swine flu shots could be available as soon as the first week of October. The doses should initially be reserved for those known to be at particularly high risk if they get the virus -- pregnant women, health workers (to protect those around them), people aged 6 months to 24 years, and those with chronic medical conditions, like asthma or diabetes.
Public health workers like Troutman and Walea will be among those carrying out swine flu vaccination plans in 2,800 different jurisdictions around the country. The federal government is buying the vaccine and distributing it to health departments, who will in turn distribute doses.
Dr. Thomas Frieden, director of the federal Centers for Disease Control and Prevention, says in some places public health workers will handle most of the shots; in other locales, doctors and private clinics will administer most, if not all, doses.
"Each place will know what the strengths (of the delivery system) are in their area best," he explained.
Although testing on several thousand volunteers is still under way, early results show vaccine from several manufacturers is able to induce a significant immune response in adults with just one dose, with immunity of up to 96 percent for those up to age 64, and about 50 percent for people 65 and older (who have weaker immune systems) after 10 to 12 days.
It's still not clear if children younger than 5 or so, who have less developed immune systems, will need to get two swine flu doses to achieve protection from the virus. Testing of the shots on children started several weeks later than those for adults and results are still pending.
However, Dr. Anthony Fauci, director of the National Institute of Allergy and Infectious Diseases, noted last week "there have been no red flags of safety concern raised in any these studies. People getting the shots are having the same sort of sore arms and redness reactions that people do who receive a seasonal flu shot."
Even with 40 million doses of swine flu vaccine due by this time next month, most Americans will have to tough out the new flu with over-the-counter remedies if they get sick. To avoid catching the virus, officials recommend vigorous hand-washing, adequate sleep and a good diet, plus avoidance of anyone coughing.
"Vaccination is our strongest tool,'' said the CDC's Frieden. "With vaccine not yet here, what we can do now is reduce the number of people who get severely ill,'' by people staying home if they're sick and not rushing to the doctor unless they're severely ill or have medical conditions that require them to take anti-viral drugs.
(E-mail Lee Bowman at BowmanL(at)shns.com).
(Distributed by Scripps Howard News Service, http://www.scrippsnews.com)
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