In the same week that we learned H1N1 (Swine Flu) vaccines were delayed in reaching much of the country, the President yesterday declared the H1N1 epidemic to be a national state of emergency. These are tough developments to reconcile for many people. Is this a true national state of emergency and, if so, how could we have allowed flu vaccine availability to fall below expectations?
Unfortunately, the answers are complicated. Declaration of a national state of emergency allows health care providers to bypass some of the red tape that would have slowed down the delivery of standard care – hospitalizations, clinic visits, the opening of alternate facilities, etc. – all of which will be necesary if the rate of acceleration of the epidemic continues as it has for the past several weeks. On the other hand, the “declaration” of a national state of emergency also raises the public panic level and/or raises the “crying wolf” skepticism, depending on how hard your part of the country has been hit so far. The delays in vaccine availability have not been limited by red tape or by governmental inefficiency. They have been caused by eggs. Yes, eggs. We still produce flu vaccines the way we have for decades – growing live influenza virus in chicken eggs. This is a slow, inefficient, and notoriously delay-prone process. As much of science and medicine have advanced into a high tech, molecular mode, the process of flu vaccine development is stuck in the 1950s. Much more on flu vaccines and the history of flu pandemics in this country can be found in Germ Proof Your Kids (The Complete Guide to Protecting (without Overprotecting) Your Family from Infections (ASM Press, Washington, D.C., 2008).
So, we’re left with both a national emergency and a national vaccine shortage. A bit of “good news” also emerged this week with the projections by the CDC that as many as 20% of all kids in the U.S. have already been infected with the H1N1 (Swine Flu) vaccine. How is this good news? Because it means the level of immunity in the general population is increasing dramatically – natural immunization, if you will. As the virus has fewer susceptible kids in the community, the spread will slow even without the vaccine.
Meanwhile, as you wait for your H1N1 vaccine, make sure you and your kids get the seasonal flu vaccine – the season for that virus begins in the next couple of months, and right now there’s plenty of seasonal flu vaccine available.