As jobs cut, will swine flu, traditional flu swamp vaccination efforts?

Public health experts are worried that many state and local agencies will find themselves short-staffed and underfunded if they have to manage a double vaccination campaign against both traditional and the new H1NI swine flu this fall.
Health officials anticipate that the new flu strain will still be in wide circulation in the fall. They're hurrying efforts to develop and test one or more vaccines against the new strain, and, hope, by early fall, to be ready to go to vaccine manufacturers for full production.
While the Obama administration is seeking $11.6 billion from Congress to buy vaccine, "we're concerned that there may not be enough money for the public health sector to oversee administration of the vaccine,'' said Jeff Levi, executive director of the Trust for America's Health, a Washington-based advocacy group for disease prevention that issued a report Thursday looking at the response to the flu thus far and the obstacles ahead.
"The biggest vulnerability is layoffs in local and state health departments that have stretched capacity to the limit,'' Levi added.
The Association of State and Territorial Health Officials says the health budgets of nearly half the states were cut last year, and more cuts are coming as the recession deepens. Some 11,000 public health worker positions jobs have been cut at the state, county and city level, the association reports.
"As more public health professionals are laid off to balance state and local budgets, health departments will become even more strained in the fall, should H1NI turn out to be more lethal,'' Paul Jarris, executive director of the association, told senators earlier this week. The association is urging Congress to devote another $3 billion in emergency funding to shore up battered public health systems.
David Fleming, director of public health for Seattle-King County, Wash., said many of the public health nurses dealing with the new flu outbreak in schools and clinics there over the past six weeks have gotten layoff notices -- although local officials are attempting to find money to keep at least some of them.
"Going into the fall, we will be even less prepared than we are today,'' Fleming added, noting that his agency's capacity to deliver immunizations is already down 80 percent.
Across Puget Sound in Kitsap County, deputy health district director Scott Daniels said budget reductions have not forced layoffs, "but we're concerned about our cash flow the rest of this year and next. It would be a real challenge if we were to have to do a vaccination campaign facing a pandemic."
During most flu seasons health departments around the country give shots to a relatively small proportion of the population. Most get vaccinated by a doctor or private clinic.
But Dr. Thomas Inglesby, deputy director of the Center for Biosecurity at the University of Pittsburgh and a co-author of the report, said state and local public health agencies would need to have a greater role running what could be the largest short-time mass vaccination campaign in U.S. history.
Inglesby and other experts say if the flu should turn out any more severe and widespread than it has been this spring, demand for vaccine is likely to exceed supply. Someone will have to decide who gets a flu shot first. Scientists still are not sure who is most at risk from the new flu, but unlike seasonal flu, younger people -- age 5 to 26 -- seem more prone to infection.
What's clear, though, is that if the government goes ahead with the new vaccine, flu shot season is likely to stretch from September well into next spring -- and mass vaccination sessions will probably be needed.
"We've done mass vaccination drills with regular flu shots in all regions of the state over the past 3 years to test public response and our ability to move a lot of people in and out of a facility,'' said Adam Myrick, a spokesman for the South Carolina Department of Health and Environmental Control.
"It's too early to work out logistics if we had to do that second campaign. But we've had some preliminary discussions and meetings about it. We think our people can handle it if we have to do mass clinics."
(E-mail Lee Bowman at Bowmanl(at)shns.com.)

(Distributed by Scripps Howard News Service, http://www.scrippsnews.com)