Disease Update
Some time has passed since my last update as I have waited and watched the progression of H1N1. The downward trend in disease incidence continued dramatically up to about 4 weeks ago. The level of illness has now remained constant over the last month with a slight uptick the last week or two. The majority of flu across the US continues to be H1N1 disease. The numbers have dropped but the disease remains the same. No significant mutations have occurred and the vaccine remains as important as ever. Those that have been vaccinated are well protected. It appears that our current strain will be included in the seasonal flu shot that will arrive next fall. It remains unclear if those that have not been vaccinated with this years H1N1 vaccine and are less then 10 years of age will need 2 seasonal vaccines in the fall to be fully protected against Swine Flu if they have had seasonal flu vaccine in the past. The best bet is to go ahead and get the current H1N1 now. Safety monitoring covering millions of doses have revealed NO difference then the regular seasonal vaccine.
Previous pandemics have demonstrated multiple waves of disease activity which with this strain can occur at anytime during or outside of the "regular" flu season of January, February, and March. It is estimated that approximately half of the US population remains susceptible to Swine Flu either due to lack of previous exposure or having not been vaccinated. From a public health perspective, this is unacceptable. The vaccine is now readily available even through a lot of the local drug stores.
We continue to hear resistance amongst parents. Since no short term effects have been demonstrated, the focus now appears to be on concerns about long term effects. Remember that this vaccine is manufactured identical to the seasonal vaccine that has been made with the same process for the past 70 years. The process has been refined greatly over the years to reduce the number of potential non flu related antigens in the vaccine that caused the bulk of the short term side effects in the past. No significant long term effects have been demonstrated over the 70 years history. There is no reason to think that the Swine flu vaccine could be any different.
Vaccine By Appointment Scheduler to Close This Week
The response to the on line vaccine scheduler has been solid to say the least. We hope to give that same option for all of the clinics next year. Instructions will be included on next years cards sent out in early fall. In that the bulk of the vaccine that we are now administering is second dosing, the demand has dropped off to the point that we will stop the by appointment only clinics after this weeks scheduled clinic for the 24th.
We will continue to administer doses on a walk in basis any Tuesday through Friday afternoon from 3 to 5 PM. Just let the front office know you are here for your flu shot. We will continue to offer seasonal flu vaccine as well until our supply runs out. We anticipate that the H1N1 vaccine will be available and continue to be administered until we start next year's seasonal vaccine campaign in September.
Sunday, February 21, 2010
Sunday, December 20, 2009
News and Notes
Supply is Holding
Our supply of both seasonal and H1N1 vaccine is still plentiful as we continue to vaccinate through the winter months. It is never to late to get a flu vaccine. We will vaccinate until the supply runs out and we do not see that happening anytime soon. So please make an appointment if remaining doses are needed or if you are someone who has had doubts about the vaccine and still undecided, please reconsider and make that appointment. I think at this point,the argument about this being a new vaccine really can't hold against the millions of doses given to date without any significant side effects. To quote, Dr. Johnson, one of our pediatric infectious disease specialist at the Children's Hospital in Greenville, "So far over a thousand children have died from the swine flu and none have died from the shot". Well said!
Please click on the link below to schedule that vaccine.
https://instant-scheduling.com/sch.php?kn=459988
Vaccine Recall
In the news this past week was the recall on certain lots of vaccine. The recall was for a 10% loss of potency after these vials left the factory. No one receiving those lots need be revaccinated. That said, we were pleased to discover that none of the lots that we used were included in the recall. In that all of these vaccines recalled were single dose vials of thimerosal free vaccine for use in children 6 months to 3 years of age none of this would have been used in the school vaccine program. If you did receive a dose of this type vaccine from another source other then this office or the school program, your child should still be protected.
Revision of Estimates of Hospitalizations and Deaths Reported
The CDC does not know exactly how many people die from flu each year. There are several reasons for this:
◦First, states are not required to report individual flu cases or deaths of people older than 18 years of age to CDC.
◦Second, influenza is infrequently listed on death certificates of people who die from flu-related complications.
◦Third, many flu-related deaths occur one or two weeks after a person’s initial infection, either because the person may develop a secondary bacterial co-infection (such as a staph infection) or because influenza can aggravate an existing chronic illness (such as congestive heart failure or chronic obstructive pulmonary disease).
◦Also, most people who die from flu-related complications are not tested for flu, or they seek medical care later in their illness when influenza can no longer be detected from respiratory samples. Influenza tests are most likely to detect influenza if performed soon after onset of illness.
◦For these reasons, many flu-related deaths may not be recorded on death certificates.
These are some of the reasons that CDC and other public health agencies in the United States and other countries use statistical models to estimate the annual number of flu-related deaths.
Using the same methodology CDC has updated the estimates to include the time period from April through November 14, 2009.
•CDC estimates that between 34 million and 67 million cases of 2009 H1N1 occurred between April and November 14, 2009. The mid-level in this range is about 47 million people infected with 2009 H1N1. That is 15% of the US population and with the predominance of this disease occurring in the younger population that fits with my crude estimate of around 25% of our children that have been affected by the disease.
•CDC estimates that between about 154,000 and 303,000 2009 H1N1-related hospitalizations occurred between April and November 14, 2009. The mid-level in this range is about 213,000 H1N1-related hospitalizations.
•CDC estimates that between about 7,070 and 13,930 2009 H1N1-related deaths occurred between April and November 14, 2009. The mid-level in this range is about 9,820 2009 H1N1-related deaths. The adjustments have pushed the pediatric death estimate to just over a thousand.
Where does that leave us now. The rate of illness continues to decline nationwide although this past weeks activity appears to have not dropped as dramatically as the previous 5 weeks. The next 2-3 weeks will be very telling about the direction of the disease incidence. Will it continue to decline, or will it level off until all are either vaccinated or contract the disease? What will happen to the 75 % of our children that have not had the disease. Hopefully they will be vaccinated.
Our supply of both seasonal and H1N1 vaccine is still plentiful as we continue to vaccinate through the winter months. It is never to late to get a flu vaccine. We will vaccinate until the supply runs out and we do not see that happening anytime soon. So please make an appointment if remaining doses are needed or if you are someone who has had doubts about the vaccine and still undecided, please reconsider and make that appointment. I think at this point,the argument about this being a new vaccine really can't hold against the millions of doses given to date without any significant side effects. To quote, Dr. Johnson, one of our pediatric infectious disease specialist at the Children's Hospital in Greenville, "So far over a thousand children have died from the swine flu and none have died from the shot". Well said!
Please click on the link below to schedule that vaccine.
https://instant-scheduling.com/sch.php?kn=459988
Vaccine Recall
In the news this past week was the recall on certain lots of vaccine. The recall was for a 10% loss of potency after these vials left the factory. No one receiving those lots need be revaccinated. That said, we were pleased to discover that none of the lots that we used were included in the recall. In that all of these vaccines recalled were single dose vials of thimerosal free vaccine for use in children 6 months to 3 years of age none of this would have been used in the school vaccine program. If you did receive a dose of this type vaccine from another source other then this office or the school program, your child should still be protected.
Revision of Estimates of Hospitalizations and Deaths Reported
The CDC does not know exactly how many people die from flu each year. There are several reasons for this:
◦First, states are not required to report individual flu cases or deaths of people older than 18 years of age to CDC.
◦Second, influenza is infrequently listed on death certificates of people who die from flu-related complications.
◦Third, many flu-related deaths occur one or two weeks after a person’s initial infection, either because the person may develop a secondary bacterial co-infection (such as a staph infection) or because influenza can aggravate an existing chronic illness (such as congestive heart failure or chronic obstructive pulmonary disease).
◦Also, most people who die from flu-related complications are not tested for flu, or they seek medical care later in their illness when influenza can no longer be detected from respiratory samples. Influenza tests are most likely to detect influenza if performed soon after onset of illness.
◦For these reasons, many flu-related deaths may not be recorded on death certificates.
These are some of the reasons that CDC and other public health agencies in the United States and other countries use statistical models to estimate the annual number of flu-related deaths.
Using the same methodology CDC has updated the estimates to include the time period from April through November 14, 2009.
•CDC estimates that between 34 million and 67 million cases of 2009 H1N1 occurred between April and November 14, 2009. The mid-level in this range is about 47 million people infected with 2009 H1N1. That is 15% of the US population and with the predominance of this disease occurring in the younger population that fits with my crude estimate of around 25% of our children that have been affected by the disease.
•CDC estimates that between about 154,000 and 303,000 2009 H1N1-related hospitalizations occurred between April and November 14, 2009. The mid-level in this range is about 213,000 H1N1-related hospitalizations.
•CDC estimates that between about 7,070 and 13,930 2009 H1N1-related deaths occurred between April and November 14, 2009. The mid-level in this range is about 9,820 2009 H1N1-related deaths. The adjustments have pushed the pediatric death estimate to just over a thousand.
Where does that leave us now. The rate of illness continues to decline nationwide although this past weeks activity appears to have not dropped as dramatically as the previous 5 weeks. The next 2-3 weeks will be very telling about the direction of the disease incidence. Will it continue to decline, or will it level off until all are either vaccinated or contract the disease? What will happen to the 75 % of our children that have not had the disease. Hopefully they will be vaccinated.
Tuesday, December 8, 2009
FLU SHOT APPOINTMENT UPDATE
Please be sure to enter your child's name in the name field when registering your appointment.
Also, we would appreciate it if you would schedule a time slot for each child you plan to bring to the clinic when bringing more then one for vaccine.
Reserving a time slot will allow your child in that time period to get one or both vaccines if needed. Please be sure about what your child needs in that the nurse will not have your chart in the room.
Thanks for your participation in this trial run of flu shots by on line appointment only. We appreciate any and all feedback and will seek to continue to fine tune this process. We hope to be successful enough to be able to offer it as an option for all of our flu shot clinics next year. Just think, a flu shot clinic with NO LINES!
REMEMBER TO GO TO THE 12/6 POSTING TO ACCESS THE LINK TO THE APPOINTMENT SCHEDULER.
Also, we would appreciate it if you would schedule a time slot for each child you plan to bring to the clinic when bringing more then one for vaccine.
Reserving a time slot will allow your child in that time period to get one or both vaccines if needed. Please be sure about what your child needs in that the nurse will not have your chart in the room.
Thanks for your participation in this trial run of flu shots by on line appointment only. We appreciate any and all feedback and will seek to continue to fine tune this process. We hope to be successful enough to be able to offer it as an option for all of our flu shot clinics next year. Just think, a flu shot clinic with NO LINES!
REMEMBER TO GO TO THE 12/6 POSTING TO ACCESS THE LINK TO THE APPOINTMENT SCHEDULER.
Sunday, December 6, 2009
ON LINE APPOINTMENTS NOW AVAILABLE FOR NEEDED FLU SHOTS
On Line Appointment Scheduling
Due to the delays in getting sufficient supply of both H1N1 and Seasonal vaccines, we still have a lot of vaccine that needs to be dispensed even though our last official flu shot clinic has passed.
We will continue to administer vaccine at well child visits. If you bring a sibling of the child to be seen for a well visit, we will offer vaccine for that child as well. Please notify the staff at check in so they can pull the siblings chart and this will save you a lot of time.
For those that do not have a well visit coming up and are in need of either first or second dosing we have a plan. We are introducing ON LINE APPOINTMENT SCHEDULING with appointments available starting this Tuesday and for now can be scheduled in available slots through the end of January. Please take advantage of this option and schedule your children for any needed flu vaccine as soon as possible. Remember to wait 3-4 weeks between the doses needed for those less then 10 years of age for H1N1 and 4 weeks for those less then 9 years old that are receiving seasonal vaccine for the first time. Also remember that BOTH Seasonal and H1N1 are recommended for ALL children over the age of 6 months.
We are encouraging all to schedule these appointments ON LINE. We hope that if this succeeds, we can offer the same for the clinics next year and cut down significantly on the wait time. If you are unable to schedule on line, the only other option is to come by the office and pick up an appointment time in person. WE ASK THAT YOU DO NOT CALL THE OFFICE TO SCHEDULE ONE OF THESE APPOINTMENTS FOR A FLU SHOT. The staff will be unable to book flu shot appointments by phone. Trying to book these appointments by phone puts even more of a stress on the system as we try to handle your calls regarding illnesses as quickly as we can despite the increased volume due to the ongoing flu season. If you have trouble gaining access to the scheduler, try using a different web browser such as Internet Explorer.
Once you schedule the appointment, please be sure that you check the blog the night before that specific appointment to be sure there is no updated news regarding the supply of vaccine. We do not anticipate any further shortages but the way this whole process has occurred up to this date, nothing will surprise us.
These appointments will be accomplished in the office NOT down stairs. As you exit the elevator on the third floor, there will be signs directing you to the rear entrance to our office. Please wait in the hall at the door until you are called by the nurse.
Please complete all of the information requested on the site and put your child's name in the name slot. Please create a password so that if you have to change your appointment, you can have that option.
Ready or not click on the following link to make your appointment (clicking on this link will open the appoinment schedule in this window):
https://instant-scheduling.com/sch.php?kn=459988
Just click on the grey boxes on the first 2 pages and you will get to the calender to pick a date and time then on to the final page where you will enter the necessary information to confirm the appointment.
Disease Update
The trend continues downward on the disease activity and we are so thankful for that. This in no way should alter our strategy to get as many as we can vaccinated for both strains of flu this year. The early news on the mutated strains is that the vaccine in its' current form will offer protection. Always remember what we do know, vaccines are your BEST protection. What we don't know is what will happen next. Seasonal Flu is unfortunately starting to appear and could impact things significantly. The Holiday season is right around the corner and people will be traveling once again and that could also have an impact on disease activity.
Those that have been affected by the H1N1 disease could experience fatigue and cough for up to 2 weeks after they start feeling better. These symptoms have been shown to persist for even longer if the affected person returns to physical activity too soon. It is now recommended that those affected restrain from physical activity and exercise for 2 weeks following resolution of symptoms. Bottom line is if you can't seem to shake it, then rest will do you the most good. That does not mean that the children need to stay home from school but it might be wise to hold them out of their physical activities for 2 weeks.
Due to the delays in getting sufficient supply of both H1N1 and Seasonal vaccines, we still have a lot of vaccine that needs to be dispensed even though our last official flu shot clinic has passed.
We will continue to administer vaccine at well child visits. If you bring a sibling of the child to be seen for a well visit, we will offer vaccine for that child as well. Please notify the staff at check in so they can pull the siblings chart and this will save you a lot of time.
For those that do not have a well visit coming up and are in need of either first or second dosing we have a plan. We are introducing ON LINE APPOINTMENT SCHEDULING with appointments available starting this Tuesday and for now can be scheduled in available slots through the end of January. Please take advantage of this option and schedule your children for any needed flu vaccine as soon as possible. Remember to wait 3-4 weeks between the doses needed for those less then 10 years of age for H1N1 and 4 weeks for those less then 9 years old that are receiving seasonal vaccine for the first time. Also remember that BOTH Seasonal and H1N1 are recommended for ALL children over the age of 6 months.
We are encouraging all to schedule these appointments ON LINE. We hope that if this succeeds, we can offer the same for the clinics next year and cut down significantly on the wait time. If you are unable to schedule on line, the only other option is to come by the office and pick up an appointment time in person. WE ASK THAT YOU DO NOT CALL THE OFFICE TO SCHEDULE ONE OF THESE APPOINTMENTS FOR A FLU SHOT. The staff will be unable to book flu shot appointments by phone. Trying to book these appointments by phone puts even more of a stress on the system as we try to handle your calls regarding illnesses as quickly as we can despite the increased volume due to the ongoing flu season. If you have trouble gaining access to the scheduler, try using a different web browser such as Internet Explorer.
Once you schedule the appointment, please be sure that you check the blog the night before that specific appointment to be sure there is no updated news regarding the supply of vaccine. We do not anticipate any further shortages but the way this whole process has occurred up to this date, nothing will surprise us.
These appointments will be accomplished in the office NOT down stairs. As you exit the elevator on the third floor, there will be signs directing you to the rear entrance to our office. Please wait in the hall at the door until you are called by the nurse.
Please complete all of the information requested on the site and put your child's name in the name slot. Please create a password so that if you have to change your appointment, you can have that option.
Ready or not click on the following link to make your appointment (clicking on this link will open the appoinment schedule in this window):
https://instant-scheduling.com/sch.php?kn=459988
Just click on the grey boxes on the first 2 pages and you will get to the calender to pick a date and time then on to the final page where you will enter the necessary information to confirm the appointment.
Disease Update
The trend continues downward on the disease activity and we are so thankful for that. This in no way should alter our strategy to get as many as we can vaccinated for both strains of flu this year. The early news on the mutated strains is that the vaccine in its' current form will offer protection. Always remember what we do know, vaccines are your BEST protection. What we don't know is what will happen next. Seasonal Flu is unfortunately starting to appear and could impact things significantly. The Holiday season is right around the corner and people will be traveling once again and that could also have an impact on disease activity.
Those that have been affected by the H1N1 disease could experience fatigue and cough for up to 2 weeks after they start feeling better. These symptoms have been shown to persist for even longer if the affected person returns to physical activity too soon. It is now recommended that those affected restrain from physical activity and exercise for 2 weeks following resolution of symptoms. Bottom line is if you can't seem to shake it, then rest will do you the most good. That does not mean that the children need to stay home from school but it might be wise to hold them out of their physical activities for 2 weeks.
Wednesday, December 2, 2009
SEASONAL FLU VACCINE HAS ARRIVED
Seasonal Flu Vaccine has arrived and will be available for scheduled well child office visits starting tomorrow. We have a sufficient supply and should have plenty for our flu shot clinic this Sat. 12/5 1:30-6:00 PM. We also have a sufficient supply of H1N1 vaccine as well and this will be available for this Saturday's clinic as well.
How to access flu vaccine from our office after this Saturday's clinic will be posted on this blog this Sunday.
I can promise all of you that no Pediatric office has a more dedicated staff then ours. We are asking a lot of them at this time to go the extra mile and work the extended hours in the office during this extended flu season as well as cover these clinics. Now we have to ask them again to cover more clinics due to the delay in the arrival of the seasonal vaccine. They understand the importance of providing this very necessary protection for your children. We can not thank them enough for their efforts. THEY ARE THE BEST!!!
How to access flu vaccine from our office after this Saturday's clinic will be posted on this blog this Sunday.
I can promise all of you that no Pediatric office has a more dedicated staff then ours. We are asking a lot of them at this time to go the extra mile and work the extended hours in the office during this extended flu season as well as cover these clinics. Now we have to ask them again to cover more clinics due to the delay in the arrival of the seasonal vaccine. They understand the importance of providing this very necessary protection for your children. We can not thank them enough for their efforts. THEY ARE THE BEST!!!
Sunday, November 29, 2009
Status Quo
No significant changes occurred this past week in reference to vaccine supply or disease trends.
We anticipate news this week on the return of seasonal flu vaccine so check frequently this week to determine how best to get your children vaccinated with this important vaccine. There has been reports over the last week or two of an increase in severity of illnesses related to influenza in eastern Europe. They feel that the increase is due to 3 different strains of flu, one of which is H1N1, causing disease in their communities. They feel that the increase in severity of illness is due to people contracting more then one strain at a time. This certainly would justify the importance of getting this years seasonal vaccine as well. Remember that the H1N1 vaccine gives no protection against seasonal flu strains and vice verse. Please also remember to get that second dose of vaccine if this is your child's first year to be immunized against seasonal flu and your child is less then 9 and for H1N1 if your child is less then 10. There is no way to predict the level of protection that your child received from dose #1. The first dose is given to prime the immune response and the second dose to provide protection. Responses to dose number one range from no protection to partial protection and there is no way to know how long that partial will persist. DOSE #2 IS VERY IMPORTANT SO DON'T MISS IT!
National trends in disease continue to decline and it is impossible to say if this is due to the natural course of the disease or due to vaccine. If it is due to vaccine efforts, which it has to have had some impact, then the decline will eventually plateau until all of those not vaccinated become immune by contracting the disease. This would leave those not yet affected by the disease and not yet vaccinated an important choice. Please choose vaccination!
We anticipate news this week on the return of seasonal flu vaccine so check frequently this week to determine how best to get your children vaccinated with this important vaccine. There has been reports over the last week or two of an increase in severity of illnesses related to influenza in eastern Europe. They feel that the increase is due to 3 different strains of flu, one of which is H1N1, causing disease in their communities. They feel that the increase in severity of illness is due to people contracting more then one strain at a time. This certainly would justify the importance of getting this years seasonal vaccine as well. Remember that the H1N1 vaccine gives no protection against seasonal flu strains and vice verse. Please also remember to get that second dose of vaccine if this is your child's first year to be immunized against seasonal flu and your child is less then 9 and for H1N1 if your child is less then 10. There is no way to predict the level of protection that your child received from dose #1. The first dose is given to prime the immune response and the second dose to provide protection. Responses to dose number one range from no protection to partial protection and there is no way to know how long that partial will persist. DOSE #2 IS VERY IMPORTANT SO DON'T MISS IT!
National trends in disease continue to decline and it is impossible to say if this is due to the natural course of the disease or due to vaccine. If it is due to vaccine efforts, which it has to have had some impact, then the decline will eventually plateau until all of those not vaccinated become immune by contracting the disease. This would leave those not yet affected by the disease and not yet vaccinated an important choice. Please choose vaccination!
Sunday, November 22, 2009
Things to Consider
Posted Comments
I appreciate the interest in this subject when people post comments, mostly in the form of questions, on the blog. Rather then responding to each individually, I assume these would be questions that the answers to which would be of interest to everyone so I try to encompass the answers within the text of my weekly postings. Hope this works for everyone. Wanted to be sure you realized these comments were not being ignored.
Vaccine Availability
Nothing has changed in our supply of vaccine. We continue to offer both the nasal mist and injectable H1N1 vaccine. We believe we are close to getting our next shipment of seasonal vaccine and I will post when it arrives. There are a lot of little ones that have received the first of the 2 shots needed to be protected to seasonal flu and are due for dose number 2. The recommended spacing of 28 days between the 2 doses is a minimum number of days only and the second dose will be just as effective when given even though for some it may be as long as 3 months between the 2 doses.
How to access those needed doses of seasonal flu will be posted when the vaccine arrives.
A huge thank you to DHEC, our local Public Health Department, and our local school districts for acting and providing the vaccines through the schools. We hear that 50-75% of the families are taking advantage of the program which is good but we obviously wish it were more. If the vaccine is on its' way to your child's school, please take advantage of this opportunity or make plans to have them vaccinated in any venue you feel comfortable with. We are happy to offer our clinics to you but our primary objective is to get as many children protected from the flu as possible.
Vaccine Safety
I continue to hear concerns about this vaccine's safety. To date 48 million doses have been shipped from the CDC to outlets throughout the US. It is estimated that over 60 million doses have been given already around the world. The vaccine is based on sound science. Science is based on scientifically proven statistically significant facts. Those that speak in a negative context about the vaccine, speak in "what ifs" and "might possibles". Theories are great and are truly the backbone of science. But the true scientific method takes theory then proves it one way or the other. Fortunately we have the facts that have been investigated scientifically and continue to be monitored and to date the facts are very reassuring. As negative as the press can be these days, if there were a significant number of significant side effects from the vaccine, we would have heard about it by now loud and clear!
Warning Shot
In the midst of a busy day seeing patients with flu, it suddenly hit me that we have something to be incredibly thankful for. The fact that this strain of the flu as it exist today, has not really affected our elderly population over the age of 65 is nothing short of a minor miracle. Any given flu season this population accounts for the majority of hospitalizations and deaths from seasonal flu. The peak of this outbreak reached a full third higher then any peak in recent times. If the amount of disease that has affected the younger population had affected the elderly, the medical system as we know it today would have been stressed beyond its' limits. I think the medical community should view this as a warning shot and hopefully design new more time efficient ways to respond with a vaccine to a potential pandemic. The 6 month time frame to manufacture a vaccine is grossly inefficient as has been proven from this years H1N1. A large number of disease had obviously already occurred by the time the vaccine came to market. Again, we were blessed by the fact that the disease itself is mostly mild and the elderly were spared but next time we may not be so lucky.
Two words to remember as we go forward with this evolving pandemic. One is resistance and the other is mutation. Yes,the numbers are down again this past reporting week but the disease remains present in our state in a widespread fashion. Where we are headed, no one can predict. I would foresee several different scenarios. The best would be it continues to fizzle, we get everyone immunized, and we will be prepared if it makes a comeback in its' current form and be very thankful if it does not. Another would be it develops resistance to the current anti-virals that have been so effective in controlling the severe disease making treatment in those that are unprotected more difficult. Duke reported 3 such cases within the last week. The last would be that the virus could mutate and in its' next form be more virulent and cause those that contract the disease to experience more severe symptoms and thus complications. Several cases in northern Europe are currently being investigated and may prove to be mutaions in the virus. I know it is easy to look at a few and dismiss those numbers but remember back in April when we were talking about the "few" cases of H1N1 that were being reported outside of Mexico. Any way you look at it, protection with the vaccine presents an excellent and safe alternative.
I appreciate the interest in this subject when people post comments, mostly in the form of questions, on the blog. Rather then responding to each individually, I assume these would be questions that the answers to which would be of interest to everyone so I try to encompass the answers within the text of my weekly postings. Hope this works for everyone. Wanted to be sure you realized these comments were not being ignored.
Vaccine Availability
Nothing has changed in our supply of vaccine. We continue to offer both the nasal mist and injectable H1N1 vaccine. We believe we are close to getting our next shipment of seasonal vaccine and I will post when it arrives. There are a lot of little ones that have received the first of the 2 shots needed to be protected to seasonal flu and are due for dose number 2. The recommended spacing of 28 days between the 2 doses is a minimum number of days only and the second dose will be just as effective when given even though for some it may be as long as 3 months between the 2 doses.
How to access those needed doses of seasonal flu will be posted when the vaccine arrives.
A huge thank you to DHEC, our local Public Health Department, and our local school districts for acting and providing the vaccines through the schools. We hear that 50-75% of the families are taking advantage of the program which is good but we obviously wish it were more. If the vaccine is on its' way to your child's school, please take advantage of this opportunity or make plans to have them vaccinated in any venue you feel comfortable with. We are happy to offer our clinics to you but our primary objective is to get as many children protected from the flu as possible.
Vaccine Safety
I continue to hear concerns about this vaccine's safety. To date 48 million doses have been shipped from the CDC to outlets throughout the US. It is estimated that over 60 million doses have been given already around the world. The vaccine is based on sound science. Science is based on scientifically proven statistically significant facts. Those that speak in a negative context about the vaccine, speak in "what ifs" and "might possibles". Theories are great and are truly the backbone of science. But the true scientific method takes theory then proves it one way or the other. Fortunately we have the facts that have been investigated scientifically and continue to be monitored and to date the facts are very reassuring. As negative as the press can be these days, if there were a significant number of significant side effects from the vaccine, we would have heard about it by now loud and clear!
Warning Shot
In the midst of a busy day seeing patients with flu, it suddenly hit me that we have something to be incredibly thankful for. The fact that this strain of the flu as it exist today, has not really affected our elderly population over the age of 65 is nothing short of a minor miracle. Any given flu season this population accounts for the majority of hospitalizations and deaths from seasonal flu. The peak of this outbreak reached a full third higher then any peak in recent times. If the amount of disease that has affected the younger population had affected the elderly, the medical system as we know it today would have been stressed beyond its' limits. I think the medical community should view this as a warning shot and hopefully design new more time efficient ways to respond with a vaccine to a potential pandemic. The 6 month time frame to manufacture a vaccine is grossly inefficient as has been proven from this years H1N1. A large number of disease had obviously already occurred by the time the vaccine came to market. Again, we were blessed by the fact that the disease itself is mostly mild and the elderly were spared but next time we may not be so lucky.
Two words to remember as we go forward with this evolving pandemic. One is resistance and the other is mutation. Yes,the numbers are down again this past reporting week but the disease remains present in our state in a widespread fashion. Where we are headed, no one can predict. I would foresee several different scenarios. The best would be it continues to fizzle, we get everyone immunized, and we will be prepared if it makes a comeback in its' current form and be very thankful if it does not. Another would be it develops resistance to the current anti-virals that have been so effective in controlling the severe disease making treatment in those that are unprotected more difficult. Duke reported 3 such cases within the last week. The last would be that the virus could mutate and in its' next form be more virulent and cause those that contract the disease to experience more severe symptoms and thus complications. Several cases in northern Europe are currently being investigated and may prove to be mutaions in the virus. I know it is easy to look at a few and dismiss those numbers but remember back in April when we were talking about the "few" cases of H1N1 that were being reported outside of Mexico. Any way you look at it, protection with the vaccine presents an excellent and safe alternative.
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