Posted by: Chris Maloney | July 26, 2010

H1N1 Pandemic 2010: Vaccinate Now?

Patients have asked me about vaccinating in July. If you’ve already received your 2009 vaccination, the new vaccine won’t be out until September? We haven’t heard big announcements of the new vaccine, so my assumption is that this is the 2009 vaccine still being promoted. Below is a short medline article discussing the plans to combine the 2009 vaccine with the 2010 version they are currently working on.

For those patients wanting to know the status of the pandemic, I’ve attached some CDC quotes below. In summary, in the U.S. we had a relatively mild flu season that ended early with average overall mortality. We did have an increase in reported pediatric deaths associated with the influenza, combined with a decrease in average reported deaths of those over 65.

Normally when the influenza levels dip below epidemic levels we get an announcement that the flu season is over, but we never got that announcement and I wouldn’t expect one ever again. Far too much energy and prestige has been invested into generating a new, perpetual pandemic model. For those looking at a history of influenza in the U.S. my response is that we’ve been in an equivalent pandemic since 1918. It isn’t new, we’ve had multiple mutations before, but the level of media coverage and fear has reached new highs.

The pandemic continues so can we see some numbers? All direct from CDC reporting. Outpatient visits for Influenza-like illness (ILI): “As of January 9, 2010, ILI activity had decreased to 1.9% (Figure 1). During the previous three influenza seasons, peak ILI activity occurred later in the season and ranged from 3.5% during the week ending February 17 of the 2006–07 season to 6.0% during the week ending February 17 of the 2007–08 season.”

“Pneumonia and influenza-associated deaths are monitored by the 122 Cities Mortality Reporting System and AHDRA. For the week ending January 9, pneumonia or influenza was reported as an underlying or contributing cause of death for 7.3% of all deaths reported through the 122 Cities Mortality Reporting System, below the week-specific epidemic threshold of 7.6%§§ (Figure 3). The longest period that pneumonia and influenza-related mortality was above the epidemic threshold was for 11 consecutive weeks from the week ending October 3, 2009, to the week ending December 12, 2009. The highest level of pneumonia and influenza-related mortality was 8.1% for the week ending November 21, 2009. In contrast, peak pneumonia and influenza-associated mortality did not occur until later in the three previous seasons, peaking at 7.7% during the week ending February 24, 2007, during the 2006–07 influenza season and at 9.1% in the week ending February 16, 2008, during the 2007–08 season.”

“Of the 236 pediatric deaths reported occurring since August 30, a total of 43 (18.2%) were among children aged <2 years, 26 (11.0%) were among children aged 2–4 years, 87 (36.9%) were among children aged 5–11 years, and 80 (33.9%) were among children aged 12–17 years. Since the week ending May 2, CDC has received 255 reports of pediatric deaths associated with laboratory-confirmed 2009 H1N1 virus. During the 2005–06, 2006–07, and 2007–08 influenza seasons, the mean number of reported pediatric influenza deaths was 74.”

J Pediatr Health Care. 2010 Jul-Aug;24(4):258-66; quiz 267-9.
2009 H1N1 influenza pandemic.
Woo TM.
University of Portland, School of Nursing Kaiser Permanente, Portland, Oregon, USA. woot@up.edu
Abstract
The 2009 H1N1 influenza pandemic took health care workers worldwide by surprise. Early in the course of the pandemic it was determined that children and pregnant women were at high risk of increased morbidity and mortality from the novel influenza virus. The Centers for Disease Control and Prevention and state and local public health officials quickly rallied to develop treatment guidelines for the new strain of influenza A, including emergency approvals for off-label use of some antiviral drugs. Prevention of the spread of influenza via vaccination and environmental controls is critical to the health of children. The 2009 H1N1 influenza virus emerged too late to be included in the 2009/2010 seasonal influenza vaccine, so production of a monovalent vaccine was set in motion. Five months from when the first cases of novel H1N1 appeared in Mexico and the United States, a vaccine was being distributed to high-risk patients. Looking ahead to the 2010/2011 influenza season, it is difficult to predict 2009 H1N1 activity. The 2010/2011 seasonal influenza vaccine will include the 2009 H1N1 strain, so it is critical to get all children vaccinated early in the flu season. Copyright 2010 National Association of Pediatric Nurse Practitioners. Published by Mosby, Inc. All rights reserved.
PMID: 20620852

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