Robert Roos 
Jul 9, 2009 (CIDRAP News) – If an effective vaccine for pandemic H1N1 influenza is available, the federal government expects to mount an H1N1 vaccination campaign this fall, initially targeting schoolchildren, adults with health problems, pregnant women, and healthcare and emergency workers, a top US official said today.
Health and Human Services (HHS) Secretary Kathleen Sebelius discussed the vaccination plans at the Obama administration's H1N1 Influenza Preparedness Summit, a one-day meeting designed to stimulate preparedness nationwide. The session drew about 500 state, tribal, and territorial health and education officials to Bethesda, Md., and was streamed over the Web.
"While we have made no final decisions about its scope, and have 'off ramps' built into our decision making process if the circumstances change, at this point, we expect to initiate a voluntary fall vaccination program against the 2009 H1N1 flu virus," Sebelius said in her prepared remarks.
She commented that the risk of increased antiviral resistance in the H1N1 virus is a "serious consideration," underlining the importance of vaccination.
Sebelius said the current estimate is that some vaccine will be ready for distribution in mid-October.
HHS is working with its advisory committees to decide which groups will be offered vaccine and in what order, but added, "We know that young people have been disproportionately impacted by this virus, and we anticipate that school-aged children, non-elderly adults with underlying health conditions, pregnant women, and healthcare and emergency workers who are likely to come in contact with the virus will be priority groups to whom vaccine will be offered."
The National Institute of Allergy and Infectious Diseases (NIAID) hopes to evaluate the first candidate H1N1 vaccine in early August, said NIAID Director Dr. Anthony Fauci, who preceded Sebelus on the summit program.
"This information will be critical to decisions about how and if to start a vaccination program this fall," Fauci said.
$350 million to states
While urging states and other jurisdictions to help prepare for the potential vaccination drive, Sebelus promised that some money will be available to support those preparations. Tomorrow HHS will formally announce the availability of $350 million for preparedness grants to states, money that Congress included in the recently passed 2009 supplemental appropriation bill.
The sum includes $260 million to go to state health departments "to support your ongoing work and to prepare for the vaccination campaign, while $90 million will help hospitals prepare for the surge of patients they will treat if an outbreak impacts their community," Sebelius said.
In response to questions, she said HHS plans to provide information this week on how to apply for the grants and that applications will be due Jul 24. "We hope to push the money out the door by July 31," she added.
Vaccination planning starts now
She urged state and local health officials to begin planning now for the likely vaccination campaign. "It may not be possible, at lest in the early stages, to use the standard channels to distribute the vaccine," she said. "We will need your assistance to identify vaccination sites."
The federal government will pay for the vaccine, Sebelius promised: "The vaccine will be purchased by the federal government and made available for distribution by state and tribal governments, and we will provide financial and technical assistance all along the way."
Responding to questions, she said Congress has already approved about $1 billion to buy the bulk vaccine ingredients and that another $7.5 billion will be available for the program.
"This will be a federally funded program that may have an opportunity to recover some funding back from folks with private insurance," she said. "But don't expect this will be done through private sources as seasonal flu vaccination is; this will really be a public effort funded by the federal government."
HHS expands flu Web site
Outlining other HHS efforts to strengthen preparedness, Sebelius said the agency is upgrading and expanding its flu Web site, flu.gov. She urged the public to use the site to learn how to prepare for the flu season.
In another step to raise public awareness, HHS is inviting Americans to record and submit their own short public service announcements (PSAs) about the H1N1 virus, Sebelius announced.
An HHS news release said the agency will pick the best PSAs and let the public vote on them. The winning announcement will be shown on national television, and its creator will win $2,500.
Today's meeting also included speeches by other federal officials, a short talk by President Barack Obama via telephone, and presentations on school closures and state, tribal, and local experiences with H1N1 to date.
Dr. Tom Frieden, director of the Centers for Disease Control and Prevention (CDC), gave a short update on the H1N1 situation. He stressed, among other things, the widely varying dimensions of the epidemic in different places, saying, "There's actually a 100-fold difference in the level of documented infections in different states in the US, and even within states and within cities there are differences."
Obama, echoing comments from Sebelius and others, stressed the importance of state and local preparations for the likely vaccination drive and for good communication.
"We've looked at past cases of this [a flu pandemic] being properly handled and improperly handled, and one of the most important differences is that where it's well handled, state and local officials have complete ownership over the issue," he said.
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