Friday, September 18, 2009; 6:05 PM
Pandemic H1N1 influenza vaccine will be distributed on a three-day turnaround time from four regional warehouses around the country next month. The vaccine deliveries, expected to equal 20 million doses a week by the end of October, will be distributed among 90,000 immunization "providers," including health departments, hospitals, clinics, doctors' offices and pharmacies.
Those were among the details unveiled Friday by the Centers for Disease Control and Prevention as part of the federal government's increasingly complex response to the pandemic of H1N1 influenza, also known as "swine flu."
"This is a huge logistical process. There's not [going to be] a sudden appearance of vaccine in 90,000 refrigerators around the country," said Jay Butler, an epidemiologist heads CDC's task force on the pandemic vaccine.
About 3.4 million doses of nasal-spray flu vaccine -- which can be used only by people age 2 to 49 -- are expected to be available the first week of October. The injectable vaccine, which will form the vast bulk of the 195 million doses the government has ordered, won't be available until later that month when many experts believe the flu outbreak will be in full-swing.
All the pandemic vaccine will be bought by the federal government. It will be divided among states and territories on the basis of population. Providers, including private companies such as pharmacies, will get it for free. They won't be permitted to charge consumers or health insurers for it, but they can charge an "administration fee" for giving the shots or sprays. In some settings, such as public health clinics, people will get the shots for free.
Earlier this summer, the committee of experts advising the federal government on vaccine policy drew up a list of who should be at the front of the line for flu vaccine. They include, among others, children and teenagers, pregnant women, and people with chronic illnesses who are at higher risk of serious or fatal infection.
As the vaccine arrives at the four distribution centers -- their location for the moment is secret -- CDC will tell each state what its allocation will be. States will put in orders based on the need in their jurisdictions and the number of doses that hospitals, clinics and other providers say they can use in the immediate future.
Vaccine will then be sent directly to providers; CDC expects to have 90,000 names and addresses on file. Orders will be filled in three business days and the vaccine shipped overnight, Butler told reporters in a teleconference Friday.
Government planners expect demand for vaccine will outstrip supply in the first weeks after it becomes available. During that time, states will have to decide which hospitals, clinics and offices are most apt to reach the priority populations and thus should get vaccine first.
The CDC won't police those decisions and expects that very quickly there will be enough vaccine to fill essentially all that states will order.
"If we were looking at a long-term shortage, we would be much more involved in this process in terms of how to allocate vaccine," Butler said.
In a related matter, a World Health Organization spokesman said that donations of vaccine to WHO from wealthy countries (including the United States) for use in the developing world will begin in early November and continue for six to eight months.
The Obama administration on Thursday said it will give 10 percent of the U.S. supply to WHO. At least eight other countries will do the same, with 10 percent "a rough estimate" of the fraction to be given, WHO spokesman Gregory Hartl said.
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