FROM NYS HEALTH DEPARTMENT: Vaccine update

The New York State Health Department has issued an update on fall flu season vaccines. Read the entire advisory below; more information is available at the CBS6Albany.com H1N1 Resource Center. 

Flu Season Has Begun
• The fall flu season has begun. The State Health Department has received reports of college outbreaks and many individual community cases of the flu.
• So far, the new H1N1 flu virus is the predominant strain circulating in New York State. However, seasonal flu is expected to circulate along with the new H1N1 virus during the fall-winter-spring flu season.
• Historically, each year the flu causes 36,000 deaths nationwide and about 2,000 deaths in New York State.

Vaccination Provides Most Effective Prevention
• Vaccination is the most effective way to prevent the flu.
• All New Yorkers are encouraged to get the seasonal flu vaccine.
• New Yorkers are also encouraged to get the new H1N1 flu vaccine when it is available after certain priority groups have had ample opportunity to be vaccinated.

Seasonal Flu Vaccine Availability
• Seasonal flu vaccine is currently available from some health care providers. However, seasonal flu vaccine is typically shipped to providers for vaccination in October and November. Many providers have not yet received their full allotments of seasonal flu vaccine.
• At this point in the seasonal flu vaccine distribution, some health care providers are experiencing difficulty ordering additional vaccine. According to the CDC, this difficulty is due to “double booking” (placing the same order with two or more distributors) that occurred earlier in the year by providers seeking to obtain early orders and worried about the possibility of a production shortfall. The CDC has reported that as initial seasonal flu vaccine orders are filled, duplicate bookings will be freed up and providers will be able to order vaccine again.
• New Yorkers are asked to be patient, as more seasonal vaccine is expected to be available in October, November and December -- in plenty of time to provide protection against this year’s seasonal flu. 
• The nation is on track to produce approximately 115 million doses of seasonal flu vaccine this year, as much as has ever been produced and millions of doses more than have ever been used. Health care providers should continue to order and can use the following website to check for availability of seasonal vaccine: http://www.preventinfluenza.org/ivats/
• Alternative sites, such as pharmacies, can also be considered for those who are seeking flu vaccine.

H1N1 Flu Vaccine Availability
• The New York State Health Department is coordinating the distribution of vaccine to New York State outside of New York City. The New York City Health Department is coordinating the distribution of vaccine within the city.
• On Wednesday, September 30, the New York State Health Department submitted its first order to the federal Centers for Disease Control and Prevention (CDC) for New York State’s first allocation of the new H1N1 flu vaccine. The Department was able to submit a second order on Friday, October 2. The two orders combined were for 91,000 doses, the maximum allowable for New York State outside of New York City for the first week of ordering.
• The first allocation of vaccine is expected to be received by health care providers in New York State the week of October 5.
• The Department expects to be able to place orders for the vaccine with the CDC two days a week. Shipments will be delivered to “ship-to-sites” on Mondays and Wednesdays the following week. The amounts available and the arrival times are subject to change.
• Health care providers outside of New York City and county health departments who want to receive the new H1N1 vaccine must pre-register on the State Health Department’s Health Commerce System Web site and electronically sign Provider Agreements required by the CDC. The website is available at: http://nyhealth.gov/diseases/communicable/influenza/h1n1/health_care_providers/
• The first batches of vaccine provided to states by the CDC are expected to be very small. Much larger allocations will be provided in succeeding weekly shipments.
• The CDC expects 3.5 million doses to be available nationwide to order the week of October 5, and then expects 10 million to 15 million doses of vaccine nationwide will be available for distribution each week thereafter until the end of October.
• The federal government has purchased enough vaccine to provide a total of 250 million doses. New York State will receive approximately 6 to 7 percent of the total doses nationwide, based on population.
• While some doses of vaccine will be distributed beginning the first week of October, New Yorkers and health care providers will need to be patient, as initial supplies will be small and it will take several days for those doses to reach health care providers.
• Due to the small amount of the first allocation, the State Health Department is targeting this first allotment to hospitals, federally-qualified community health centers, and county health departments.
• Those facilities and agencies will be instructed to use their allotment for priority groups (individuals at increased risk for serious illness and complications from the flu and those at risk of transmitting the flu to vulnerable individuals).

Priority Groups for H1N1 Flu Vaccine
• Priority groups to receive the H1N1 Flu Vaccine, as established by the CDC, include:
o Health care workers and emergency medical services personnel;
o Pregnant women;
o Persons who live with or provide care for infants under six months of age;
o Children and young people ages six months through 24 years; and,
o Persons aged 25 through 64 years who have medical conditions that put them at higher risk for serious illness and influenza-related complications.
• The first shipment of the H1N1 flu vaccine is expected to consist mostly of the nasal spray vaccine. Two priority groups -- pregnant women and children ages 6 months to under 2 years of age -- should not receive the nasal spray vaccine. Therefore, those two groups will receive priority when the second vaccine shipment, which is expected to include more injectable vaccine doses, arrives later in October.

Flu Can Cause Serious Illness in Pregnant Women
• Pregnant women should receive the new H1N1 flu vaccine as well as the seasonal flu vaccine.
• A pregnant woman who gets any type of flu is at risk for serious complications and hospitalization.
• Pregnant women who are otherwise healthy have had severe illness from the new H1N1 flu. This has occurred nationally, as well as in New York State.
• In comparison to the general population, a greater proportion of pregnant women infected with the new H1N1 flu have been hospitalized.
• In addition, severe illness and death have occurred in pregnant women. Six percent of confirmed deaths related to the new H1N1 flu have been in pregnant women, while only about 1 percent of the general population is pregnant.
• Vaccination is the single best way for pregnant women to protect against the flu.
• Pregnant women should get the “flu shot.” The other type of flu vaccine – nasal-spray vaccine – is not currently approved for use in pregnant women.
• Influenza vaccines have not been shown to cause harm to a pregnant woman or her baby. The seasonal flu shot, which previously has proven safe for pregnant women, and the new H1N1 flu vaccine were made using the same process.

Flu Vaccination of Health Care Workers
• In New York State, the only group for which there are requirements for flu vaccination is health care workers employed in hospitals, clinics and other selected settings governed by a State regulation.
• The regulation does not apply to employees working in nursing homes, adult homes, and adult day treatment facilities. Those facilities are subject to a public health law that requires these facilities to make flu vaccine available to their employees each year. Proposed legislation is currently before the State Legislature to make flu vaccination mandatory for those workers.
• The regulation requiring mandatory flu vaccination for certain health care workers has been put in place to protect patient health and safety, after years of unsuccessful efforts to achieve high rates of flu vaccine coverage in health care workers.
• Unvaccinated health care workers can transmit flu to their vulnerable patients in whom vaccine may not work well because of underlying illness.
• More information about the new regulation is available here.

Younger Persons More Vulnerable to H1N1 Flu
• The initial batches of H1N1 vaccine over the next one to two months will continue to be targeted for vaccination of priority groups. Once the priority groups have been vaccinated, and as more vaccine becomes available, the vaccine will become available to the general public.
• Younger people are more likely to get infected with the new H1N1 flu virus than those 65 years and older. Therefore, younger persons are recommended to receive the first available doses of the H1N1 vaccine before persons 65 years and older.
• However, older persons are at greater risk of complications from seasonal flu and are recommended to get the seasonal flu vaccine as soon as it is available to them.
• Children 10 years and older and adults need just one dose of the new H1N1 vaccine.
• Children ages 9 and younger require two doses of the H1N1 vaccine approximately four weeks apart.

Vaccine Safety
• The H1N1 vaccine is licensed by the Federal Drug Administration (FDA) and is considered very safe, as safe as ordinary seasonal vaccine.
• The H1N1 vaccine was developed and licensed using the same process as the seasonal vaccine, with which 100 million Americans are vaccinated each year.
• The new H1N1 vaccine was not fast-tracked and actually underwent more testing than the seasonal vaccine, which in recent years has not undergone clinical trials because it has been proven safe and effective.
• Unlike the seasonal vaccine, the new H1N1 vaccine was subjected to clinical trials for both effectiveness and safety. The clinical trials indicated that the H1N1 vaccine provides a good immune response to the new H1N1 flu virus and has resulted in no significant adverse events.
• The CDC will be providing a quantity of thimerosal (preservative) free vaccine, particularly for use by pregnant women and children under three years of age.
• More information on vaccine safety is available at:

http://www.cdc.gov/h1n1flu/vaccination/vaccine_safety_qa.htm, and: http://www.cdc.gov/h1n1flu/vaccination/gbs_qa.htm