# 2950
Last July, we received the long-awaited guidance from the HHS (Dept. of Health and Human Services) on pandemic vaccine allocation called Guidance on Allocating and Targeting Pandemic Influenza Vaccine.
Pandemic vaccines are almost certainly to be in very short supply during the first year of a pandemic, with little or none available until 5 months into a crisis. After that, vaccine should begin to come off production lines, but even then, only in limited quantities.
Accordingly, since there won’t be enough vaccine to inoculate everyone at the same time, priority groups needed to be established.
(Click to Enlarge)
There are variations to these tiers at different pandemic levels (Cat 1-5).
The one's listed here assume a CAT 4 or CAT 5 pandemic. Tier 1 priorities remain the same at all pandemic intensities, but adjustments may be made to lower tiers depending on the virulence of a pandemic.
As you may have noted, these recommendations are packaged in what the HHS calls `Guidance’. Individual states, ultimately, still have a large say in how they will dispense vaccines during a pandemic.
Each state will receive an allocation of vaccines as it becomes available in proportion to the State’s population. They are encouraged to use the Federal guidelines, but it is not mandated.
Hawaii will begin a public education campaign next month, and open up a dialog with their residents, on who should receive priority for scarce vaccines during a pandemic.
What follows is a rather long, and detailed, story from the Honolulu Advertiser. I’ve only posted excerpts. It is well worth reading in its entirety.
Hawaii working on list of who gets shots first in flu pandemic
Public's input wanted on who'll be vaccinated first if outbreak strikes
By Dan Nakaso
Advertiser Staff WriterState health officials want the public's views on deciding who should get vaccinated — and who should not — against the next flu pandemic that reaches the Islands.So far, a wide-ranging advisory group of about a dozen community members representing religious groups, the chamber of commerce and even an expert in mediation have been working to set up a system that will help determine who will be inoculated first and who will have to face the pandemic unarmed, at least until more vaccine can be manufactured and shipped to Hawai'i.
The final determination will rest with Gov. Linda Lingle.
"The decision is with the governor," said Lingle spokesman Russell Pang.
There is no way to stockpile vaccine for an unknown virus that has yet to arrive. And no way to calculate how much vaccine will be needed, how many people will be infected and how many could die, according to Bill Gallo, senior management official with the Centers for Disease Control and Prevention in Honolulu.
So it could take months before federal officials isolate the virus, create a vaccine for it and send it to Hawai'i.
By then, untold lives could be lost.
"It is a very sobering scenario to be thinking about," said Jim Tollefson, president and CEO of the Chamber of Commerce of Hawai'i who sits on the advisory committee. "But it's best to be prepared and educated."
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public campaign
To that end, the Health Department plans a public education campaign that will begin next month to explain the project and get community opinions.
"We're responsible for making science-based decisions all the time," said Dr. Sarah Y. Park, state epidemiologist and chief of the Disease Outbreak Control Division. "Without neglecting the scientific basis for our state's pandemic planning, this project gives us a unique opportunity to focus on the values-based aspects of some of our decision-making. We encourage everyone to participate in the public activities and let their voice be heard."
Park is the principal investigator for Hawai'i's pandemic priorities grant.
Hawai'i's position as a gateway to and from Asia makes any potential pandemic of particular concern since air travel could quickly spread the disease. To guard against such problems, a disease surveillance and quarantine system was begun at Honolulu International Airport in 2005. It was the nation's first such system, and it screens sick passengers as they arrive for signs of serious illness.
Hawai'i and five other states have been chosen to participate in a federal program to carry out further pandemic planning.
<snip>
Three live one-hour broadcasts on KHNL in April. A panel of speakers will discuss who should get vaccinations during a pandemic and solicit viewer opinions on air and via e-mail. The shows are tentatively scheduled from 8 to 9 p.m. April 15, 22 and 29. An "Alternate Reality Game" will be available in late April or early May. Details are still being worked out, but the game is aimed at Island residents. People on the Mainland probably will be able to access the game as potential tourists. Community-based meetings around O'ahu from April through May 30, still to be scheduled. Reach Dan Nakaso at dnakaso@honoluluadvertiser.com.
