Despite a countywide shortage of the H1N1 vaccine — reflecting a nationwide problem — a small number of local schoolchildren will receive it in the coming weeks.
While the eventual goal is to immunize at least an estimated 60 percent of San Luis Obispo County’s 34,000 public schoolchildren — to provide what is known as “herd immunity” that will prevent the spread of the disease — the county has nowhere near the necessary vaccines now.
The county Public Health Department received only 5,600 doses of the vaccine last week, and 1,800 will be administered at five elementary school clinics. Locations are not known for those clinics, even though parents across the county have been receiving information and release forms about the shots this week.
“By any stretch of the imagination it is not enough vaccine for all of the county’s elementary students,” said county Public Health Department spokeswoman Michelle Shoresman. “We are expecting to get more vaccine, but we just don’t know when.
“Our intention is to vaccinate as much of the kindergarten to 12th grade population as we can and in the long run provide the vaccine to as many members of the public as we can.”
Focus on children
The H1N1 swine flu is not believed to be any more virile than the seasonal flu, but it is still the subject of a worldwide pandemic and great public health concern because much of the population has no immunity to it.
Children are a particular concern in this flu outbreak because it has proven to be more deadly for young people than some past influenza viruses.
The national Centers for Disease Control and Prevention has reported there have been 114 known child deaths nationwide related to H1N1, with two-thirds of those deaths among children who had a prior health problem. The CDC has also stated that 90 percent of the total deaths have been in people younger than age 64; in a typical flu season, 90 percent of the deaths are among those 65 and older.
The county has had one adult death connected to H1N1, but it is not part of the CDC-counted fatalities because it was confirmed clinically but not by laboratory test, according to county Health Officer Penny Borenstein.
The reason the swine flu seems to be disproportionately affecting the young is that they do not benefit from immunity from a prior outbreak. The last time a similar H1N1 epidemic occurred was in the mid-1950s, explaining why older people exposed to the flu at that time may be faring better this season, according to national experts.
Priority for shots
The remaining 3,800 flu shots the county received — those not reserved for schoolchildren — have been distributed to pediatricians, obstetricians, and emergency medical staffers as long as the providers administer the shots according to federal priorities.
The priority list recommended by CDC calls for the vaccines to be first administered to pregnant women, those ages 6 months to 24 years, persons from 25 to 64 years old, people who live with or care for those younger than 6 months, and health care and emergency medical workers.
Pediatrician Rene Bravo said he received 300 of the doses this week, and his office is seeing that patients who are high-risk get the vaccine.
“We are looking at babies from 6 months to 5 years and anybody who for whatever reason has a compromised pulmonary system,” he said. “That could be asthma or a heart condition.”
Bravo said he is also immunizing mothers and family members who have contact with newborns up to the age of 6 months.
His own practice confirms what national officials have said, that the number of flu cases is high right now when compared to a normal year, and the cause is probably H1N1.
“Most of the flu season really hits around Thanksgiving and Christmas,” Bravo said. “This one hit four weeks ago. We have just been busy with sick kids. In my very unscientific opinion it is a tough virus, nasty, it causes kids to cough for a long period of time. But they do finally get over it.”
When will it subside?
Borenstein said that there is no way of knowing if the disease will show the usual uptick in cases that occurred during past winter outbreaks of influenza.
“Can it get worse — yes,” she said in an e-mail response. “We have no way of knowing where we are on the ‘curve’ of the illness and when it may die out because we’ve reached herd immunity.”
She said such herd immunity can be achieved by people suffering through the flu and through a combination of naturally acquired immunity and vaccine-acquired immunity.
The county received 2,800 doses of the vaccine weeks ago, and they were distributed by pediatricians and health department sites to high-risk populations.
Shoresman said that of the initial doses, the bulk was reserved for children 2 to 4 years old, or parents and caretakers of children younger than 6 months.
“We did not give it to first responders because children and their caretakers were deemed a higher priority,” Shoresman said.
Ron Yukelson, a spokesman for Sierra Vista Regional Medical Center, said the hospital received vaccines for its employees on Friday and started giving them out this week.
Yukelson said there have been more cases of the flu in the hospital’s emergency room, up to 10 a day, but most of the patients have not required hospitalization.
“The majority have not needed hospitalization,” Yukelson said. “We admitted two children with H1N1 today (Tuesday) and we have admitted a smattering of adults.”