CDC Media Briefing (3 Sep 2009): Update on 2009 H1N1 Flu

The CDC Media Briefing: Update on 2009 H1N1 Flu (unedited transcript) for September 3, 2009, included the following comments on H1N1 vaccination:

“…The next issue that I’d like to discuss has to do with vaccination.  There’s a lot going on with vaccination.  We continue to anticipate that vaccine will be available by the middle of October.  The vaccine itself will be free.  The administration may be charged by individual providers, although in the public health system, all vaccination will be free, we anticipate.  It will not be easy to get vaccine uptick.  We have the possibility or even likelihood that it will be a two-dose series for children, at least, and perhaps for others.

“We are going to be trying to reach out to children in large number and parents to get kids’ vaccines, because we know that so many kids can get the flu, and the vaccine is likely to be quite effective.  My kids will get the flu vaccine when it becomes available, and I would recommend that all school children get vaccinated.

“We also are recommending that all people with underlying conditions get vaccinated, people who have asthma, diabetes, lung disease, heart disease, neuromuscular conditions, neurological conditions that increase their risk factors and women who are pregnant.

“Vaccination programs will be run by the states and localities throughout the United States.  We are working closely with all jurisdictions to help them identify the challenges that they’ll face in vaccinating the people in their area and in addressing those challenges.  We are in the process of releasing about $1.5 billion in vaccine planning, preparedness and administration funding.  That will allow each jurisdiction to identify what are the strengths there.  And some jurisdictions will work largely with the public sector.  Other jurisdictions will work largely with the private sector.  Each place will know what the strengths are in their area best and will be able to reach out to the speciality clinics.

“For example, children with special needs or people with asthma or diabetes, to have the detailed planning available.  We also are looking very closely at the possibility of reports of adverse events.  We know that every year, there are cases of paralysis, Guillain-Barre syndrome, there are women who have miscarriages, there are people who have sudden death.  In all of those situations, we need to know very clearly how many we would expect if the vaccine doesn’t cause any problems whatsoever.  In an average flu season, just as an example, around 500,000 pregnant women get vaccinated.  That’s important, because pregnant women are more likely to get severely ill from flu.  So, it’s a way of protecting them and ensuring that they have a healthy pregnancy.  Among those 500,000 women, if they hadn’t gotten vaccinated, we would have expected more than 1,000 miscarriages within a week after vaccine.  If they hadn’t been vaccinated.  If they’re vaccinated, we expect about 1,000, 1,500 among women who are vaccinated.  That’s the kind of number we need to track and understand to see whether when we do see adverse event reports, because we know there will be adverse event reports, they’re occurring at a higher rate than expected or not.

“In the coming weeks and months, with school resuming, we do expect to see more cases.  We’re seeing it now.  We expect that will continue.  How long?  No one can predict with certainty.  Influenza is unpredictable.  That means we need to monitor closely and be willing and ready to adapt to different approaches…”

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