The opening of the vaccination campaign for swine flu is “going to be a little bumpy,” the director of the Centers for Disease Control and Prevention predicted Friday as he gave new details about how the vaccine would be distributed.
The first doses should reach doctors by Oct. 6, said the director, Dr. Thomas R. Frieden, but almost all will be the FluMist nasal spray version, which has some limits on who may use it. By mid-October, 40 million doses of both the nasal spray and injectable versions should be out.
The FluMist version is not recommended for infants under 2, adults over 49, pregnant women or anyone with a range of underlying health problems. But it is easy to use, and some pediatricians prefer it because many children fear needles.
With vaccines going from 5 manufacturers to 90,000 distribution points, Dr. Frieden said he expected shortages in some places and oversupply in others. Distribution will be different from that of seasonal flu vaccine, which doctors buy on their own. All the swine flu vaccine has been ordered and paid for by the federal government, which is also paying for its distribution and providing syringes and other items with it.
In some states, the swine flu vaccine will be injected at public sites like schools and city clinics, as polio vaccine was doled out in the 1950s. The best-prepared school systems have already asked parents to sign consent forms and have discussed plans at parent-teacher association meetings, Dr. Frieden said. Doctors, pharmacies and companies may also dispense it; the government is urging them to keep fees minimal.
Dr. Frieden said that the virus had not mutated in any threatening way and that the vaccine was still a good match for it.
Flu activity, normally almost nonexistent in September, is now widespread in 26 states, up from 23 a week ago. Dr. Frieden said activity was “beginning to trend down in some areas,” including Georgia, the site of his agency. But, he added, that predicted little because in New York City, where he was health commissioner last spring, swine flu surged after being introduced at a school in Queens, quieted down briefly and then resumed until schools closed for summer.
Dr. Frieden also discounted news reports in Canada that some doctors there thought that having had a seasonal flu shot made a patient more likely to catch swine flu. No data from Canada supporting that has been published in medical journals, he said, and a review of data from New York City and the United States over all, as well as by Australian authorities of their recent winter flu season, showed no such effect.
Dr. Frieden said seasonal flu shots did not protect against swine flu but did not create a proclivity for it either.
NY Times by Donald G NcNeil
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