# 4059
While we’ve heard the mantra that a large number of novel H1N1 fatalities have had `pre-existing underlying conditions’, we really haven’t had a good feel for how much risk is attached to these conditions.
Edward Goldstein, a research Scientist at Harvard School of Public Health, and Marc Lipsitch, Professor of Epidemiology at Dept of Epidemiology and Center for Communicable Disease Dynamics, Harvard School of Public Health have attempted to quantify the risks.
They also argue that high-risk adults, more so than healthy school-aged children, ought to be targeted next for vaccination if the goal is to reduce fatalities.
Using available data they calculate that pregnant women are roughly 5 times more likely to die from H1N1 than the general population, morbidly obese patients are 8.7 times more likely to succumb, and immunocompromised victims are 16 times more likely to die.
I’ve only printed a brief excerpt (reparagraphed for readability). Follow the link to read the entire study.
H1N1 vaccination and adults with underlying health conditions in the US
65% of fatalities from pH1N1 infections in a large US case series occur in adults with underlying health conditions other than pregnancy, but it appears that only relatively few high-risk adults will get vaccinated during the fall wave of pH1N1 transmission.
There are several reasons for this problem; the most important is vaccine shortage. High risk adults (other than pregnant women) were not part of the initial, narrow priority cohort which included pregnant women and children ages 0.5-4; this is despite the fact that some of those high risk groups, such as immunosuppressed adults and possibly individuals with neurological disorders, have a relative risk for fatality (per capita) higher than pregnant women, and over 28-fold higher than healthy children under the age of 4.
With more vaccine becoming available than needed in the initial priority cohort, a broader group which includes high risk adults and individuals under 24 becomes eligible for vaccine in many locations. Nonetheless, due to continuing high demand, high-risk adults face competition for vaccine from healthy individuals under 24; additionally, some locations specifically prioritize school students over high-risk adults.
Finally, there is an issue of awareness and a shortage of specific channels that target high risk adults other than pregnant women and facilitate vaccine distribution among them in the US.
