# 3796
Although we are getting reports that smaller than anticipated deliveries of the swine flu vaccine are scheduled to begin next week, the mere fact that we have any vaccine delivered just 5 months after the isolation of this virus should be viewed as quite an accomplishment.
That’s a month sooner than most experts would have predicted six months ago.
And we would probably all be celebrating that fact had we not heard early, overly optimistic estimates of the quantities of vaccine that we could expect to see delivered this month.
Originally, back in July, we were told that we could see as many as 120 million doses of vaccine in mid-October. That number was `downsized’ in August to about 45 million doses (see Revised Vaccine Estimates From NBSB Meeting).
Now, it appears that goal is in doubt as well.
Of course, vaccine manufacturing has always been fraught with uncertainties, and so coming up short of these early `best case projections’ isn’t terribly surprising. This is something I’ve explored several times in the past, including an essay entitled The Plan And The Challenge back in May of this year.
Most of the `early vaccine’ delivered this month will be in the form of Flumist, which is only appropriate for healthy children and adults aged 2-49. Those who are pregnant, or fall into other high risk medical categories, are going to have to wait a bit longer for the shot.
Commonground over at Flutrackers has compiled several recent reports from Massachusetts, Texas, and Florida on the revised vaccine expectations.
First from Boston.com we get this report.
Swine flu shots delayed for most
Wide availability expected in mid-Nov. Those at high risk get vaccine earlier
WORCESTER - Vaccine against swine flu will not be widely available in Massachusetts until mid-November, the state’s public health commissioner warned yesterday, even as specialists fear that cases of the viral disease will increase markedly in coming weeks.
The Department of Public Health expects the first vaccine doses to arrive in the state no later than Oct. 12, but that initial shipment is expected to include only about half as many doses as originally anticipated.
Underscoring the fluid nature of the response to the H1N1 virus, state health authorities left their offices Tuesday night believing the shipment would contain 63,500 doses; by midday yesterday, it had been cut to 36,800.
The state now expects to receive 1.1 million doses by early November and 700,000 more by early December. Still, that is not even half of the 4 million vaccine shots and nasal sprays designated for Massachusetts by the federal government, which is buying all of the nation’s vaccine supply.
“For the public, it’s important to know not to expect the large public [flu shot] clinics until middle to late November,’’ John Auerbach, the public health commissioner, said in an interview during a statewide conference on swine flu that attracted more than 800 health, education, and public safety officials.
Texas to get half of swine flu vaccine it expected in season's early weeks
October 1, 2009
By SHERRY JACOBSON / The Dallas Morning News
Texas will receive half the doses of swine flu vaccine it originally expected in the next few weeks, blindsiding Dallas County health officials Wednesday.
The officials said they are concerned that the local flu outbreak could peak in the coming weeks with relatively few people being vaccinated.
"We're worried that we're not going to reach all the people that we need to reach," said Zachary Thompson, director of the Dallas County Department of Health and Human Services.
"The plan keeps changing, and we don't know how much vaccine we're getting or when we're getting it."
The state health department said it was expecting 3.4 million doses of the H1N1 vaccine by mid-October but will get no more than 1.7 million doses by then. The state blamed a complicated distribution system and manufacturing delays.
"The vaccine will trickle in week to week," said Dr. David Lackey, commissioner of the Texas Department of State Health Services. "It's a fluid situation driven primarily by how much vaccine the manufacturers produce each week."
State orders swine flu vaccine
Updated: Friday, 02 Oct 2009, 7:04 PM EDT
Published : Friday, 02 Oct 2009, 7:04 PM EDT
ORANGE COUNTY, Fla. (WOFL FOX 35) - The State of Florida placed its first order for H1N1 Swine Flu vaccine on Friday, but the vaccine will be arriving initially in limited quantities and the exact arrival date from the shipping vendor is unknown.
"We anticipate that the first shipment of vaccine will be flu mist, a nasal vaccine, and the first of what is expected to be a continuing stream of vaccine from federal partners over the next several months," read a statement released to FOX 35 by Dain R. Weister, Public Information Officer for the Orange County Health Department .
But of course, manufacturing and deploying the vaccine is just part of the challenge. Delivering it to the arms of hundreds of millions of people – both here in the US, and around the world - over the next few months will be the really big test.
It would be unrealistic to expect everything to run smoothly.
This is a huge undertaking, involving thousands of jurisdictions, and tens of thousands of providers. Here in the US we don’t really have a coordinated adult vaccine delivery system in place, and so thousands of local public health agencies are scrambling to create one.
All of this comes at a time when most public health departments are trying to cope with budget and personnel cuts, as well.
We are going to be asking them to tackle a difficult, complicated, and gargantuan task with far fewer resources than they need or deserve.
One hopes that we take that into account as we judge their performance. And that the lesson we take away from all of this is the need to aggressively fund and support public health, even when we aren’t in a pandemic.
