DrAnneSchuchat

CDC on H1N1 Vaccine: 'We're Not Where We Hoped We'd Be'

As of Oct. 29, there were 24.8 million doses of H1N1 vaccines available for U.S. states to order, and while that was 1.6 million more doses than were available on Oct. 28, it still is not enough to meet current demand. The Centers for Disease Control and Prevention (CDC) held a press conference Thursday, focusing on issues surrounding the availability and distribution of the vaccine. The agency said that although a dearth of the medicine in some areas is creating “challenging circumstances” across the country, increasingly more doses will be readily available in coming weeks.

"I know that [the vaccine] is hard to find in many places," said Anne Schuchat, M.D., director of the National Center for Immunization and Respiratory Diseases. “A lot of people do want to be vaccinated, which is great. I appreciate the frustration people are seeing as they are unable to find vaccine. Over the next several weeks it should become more easily available, and, as I’ve been saying each day, we are seeing forward progress. We're expecting a lot of vaccination efforts this weekend in a number of places."

Schuchat added that while many state and local health departments have had to adapt their plans based on projected distribution numbers not being met, CDC expects the situation to improve soon. "We all had hoped to have more vaccine by now than we have . . . but as you’ve been seeing around the country, more and more states have been finding that they have sufficient doses to initiate school-located clinics and some other mass clinics, [and] many doctor’s offices are beginning to get doses. So, hopefully things will be getting better, but as I said, we're not where any of us hoped to have been by this point."

CDC is aware of reports that antiviral medication, particularly for children, is, in places, also difficult to find, Schuchat said. "So, what have we been doing about this? A few weeks ago the secretary ordered 300,000 courses of the liquid Tamiflu for children to be shipped out to the states, and that's all going out to the states through the strategic national stockpile,” she said. "We're working closely with the manufacturers to really understand the supply horizon and understand what is out there in the commercial sector. We’re working closely with the states who are managing their stockpiles of these antivirals to get them to the places that don’t have them."

Schuchat added, "What we think is going on is really much more of a 'spot shortage,' where here and there there's a pharmacy without usually the liquid formulation, but there’s quite a bit of the capsule formulations out there."

Pharmacists can use the capsule form of the medicine and adapt it to dosing that is appropriate for children through a process called compounding, which essentially involves breaking up the capsules and mixing them with a syrup. According to Schuchat, more pharmacists and national chain pharmacies are getting on board with the process and performing the compounding procedure. She added that tips on Flu.gov can help parents when the family doctor prescribes capsules for children who cannot tolerate capsules.

"The formulation you get from your doctor may not be the one you were expecting, but kids can take the capsules mixed in with the syrup and that should be just fine,” Schuchat said. “We’re working very closely with the states to understand their needs and be able to fill the gaps that are there."

Schuchat noted that while most people who get infected with the H1N1 virus will recover with just a few days bed rest and "TLC," staying home from work or school, others will need to receive the antiviral medicines that are an important part of the nation’s response to the virus. She recommended that parents visit Flu.gov for warning signs to look for when deciding if a child needs professional care.

CDC plans to hold another press conference today, Oct. 30, at 1:30 p.m., with CDC Director Thomas Frieden, M.D., giving an update on the number of pediatric deaths thus far from H1N1. In a preview of that, Schuchat said, "We do know that the number of children who have died has increased since our last report. . . . And we expect there to be more, unfortunately."

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