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Although the amounts of H1N1 vaccine being delivered to North Carolina each week are on the increase, public health officials are still asking that priority be given to those targeted populations who are at more risk than others.  This means that we are relying on the good character and citizenship of our residents to be patient and to refrain from seeking H1N1 vaccine until we are comfortable that these target populations have been protected.

The five groups that have been targeted include:

• Pregnant women because they are at higher risk of complications and can potentially provide protection to infants younger than 6 months of age who cannot be vaccinated;

• Household contacts and caregivers for infants younger than 6 months of age because younger infants are at higher risk of influenza-related complications and cannot be vaccinated.  Vaccination of those in close contact with these infants will “cocoon” them from the virus;

• Health-care and emergency medical services personnel, because they are at increased risk of exposure to the virus and because infections among health care workers is a potential source of infection for vulnerable patients.  Also, increased absenteeism in this population could reduce healthcare system capacity;

• Persons 6 months of age to 24 years old, because we have seen many cases of 2009 influenza A/H1N1 in this age group, and they are in close contact with each other in educational, living, and work settings and serve as a source of influenza transmission in the population; and

• Persons aged 25-64 years who have medical conditions that put them at higher risk for influenza-related complications.

(Emergency medical services personnel can include persons in an occupation (e.g. EMT, fire fighters, and police officers) who provide emergency medical care as part of the normal job duties.) 

In recent days the CDC’s Emerging Infections Program has determined that people with asthma account for nearly one third of all 2009 H1N1 hospitalizations in the United States.  Because people with asthma are at higher risk of serious flu-related complications, we want to emphasize that they should seek treatment promptly when ill with either influenza like illness (ILI) or an asthma exacerbation.  It is very important that people with asthma have an updated asthma action plan and have their condition well-controlled.  Medication to control asthma (usually inhaled corticosteroids) should be used as prescribed by each patient’s health care provider.  Persons with asthma who are under 65 years old are strongly recommended to be vaccinated against 2009 H1N1 with inactivated vaccine (shots).  All people with asthma over 6 months old should be vaccinated against seasonal influenza with inactivated vaccine.

People with asthma and suspected to be infected with 2009 H1N1 should be promptly treated with oseltamivir (trade name Tamiflu®). Zanamivir (trade name Relenza®) is NOT recommended for people with asthma.  Also, people with asthma should NOT get the live attenuated influenza vaccine (LAIV), also known as the nasal spray vaccine, for either seasonal flu or 2009 H1N1.

For more information about asthma and influenza, please visit www.cdc.gov/h1n1flu/asthma.htm.

To date North Carolina has received two shipments of H1N1 vaccine.  While the total of these allocations is roughly equal to about 10 percent of the total doses we expect to receive, the CDC assures us that there will be enough vaccine for every North Carolinian who wants it. 

The goal in determining allocations during the past two weeks was to make sure the vaccine was distributed equitably throughout the state.  With such small amounts of vaccine – and a requirement to ship in increments of 100 doses – it was impossible to provide vaccine to every interested provider.  The first shipment went to every local health department to ensure that vaccine was distributed to every part of the state.  With the next shipment, we were able to extend delivery to also include most hospitals and private providers who had signed on to administer the vaccine.

By the end of this week, we expect to have received enough vaccine so that all providers who have submitted a contract will be shipped at least some vaccine.  Providers who requested a large amount of vaccine will not receive their complete order all at once, but will receive parts of their order during the next couple of months until the amount they requested is completely filled. Vaccine will continue to be sent to providers as long as the provider data continues to show a need for vaccine.  

To help North Carolina residents determine when and where vaccine is available, the NC Division of Public Health is working with the federal Department of Health and Human Services to create a “vaccine locator.”  When completed, residents will be able to locate vaccine in their area simply by going to flu.nc.gov and typing in a zip code.  Until then, people should either call their health care provider, their local health department, or call the NC CARE-LINE at 1-800-662-7030 (TTY 1-877-452-2514) for more information.