H1N1 Reaches Falls Church City: Where’s the Vaccine?

By CHRISTINE KILGORE
Falls Church Times Staff

The spread of novel H1N1 influenza appears to have increased significantly in Falls Church City in the past two weeks, just as the vaccine has begun trickling into local providers’ offices.

“With the number of children in our neighborhood coming down sick this past week, it now definitely feels like a race to either get sick or get the vaccination, and I’d rather have my children get the vaccination,” said Falls Church City resident Jackie Handly.

For the past several weeks, this Falls Church City mother of two has called her family’s physicians and searched the Internet almost daily looking for clinics—in or out of Fairfax County-that could provide her healthy 8- and 10-year olds with vaccine. It looks as if it may be a while.

Statewide, vaccine supply was down 47% last week compared to original projections, and physicians have been alerted by the state health department to expect continued delays. (The Centers for Disease Control allots the vaccine to each state based on state population; Virginia receives 2.517% of every allotment, according to the state health department.)

On Friday, Oct. 30, Fairfax County announced a second week of limited vaccine dispensing at its five health department clinics, including the Falls Church Clinic located on Leesburg Pike in the Seven Corners area (www.fairfaxcounty.gov/flu). The vaccines will be offered on a walk-in basis this Wednesday and Thursday, Nov. 4-5, to the first 300 individuals who are in one of the following high-risk groups: children 6 months through 6 years of age, pregnant women, and parents of children less than 6 months of age.

While still far from covering all priority groups—including all children and young adults 24 years of age and under—the county is gradually inching up its eligible age group since holding its first mass vaccination clinic at the Fairfax County Government Center on Saturday Oct. 24. (This clinic took the place, due to unexpected vaccine shortages, of the school-based vaccination clinics that had been planned for a host of Fairfax County middle schools.)

Approximately 4,300 pregnant women and children aged 6-36 months received the vaccine at this first mass vaccination clinic. Since then, in clinics held at each of the five district health offices this past week, over 6,250 individuals (including children up to age 5) were vaccinated, according to Glen Barbour, information officer for the Fairfax County Health Department, which serves Falls Church City.

Others have just recently found the vaccine in physicians’ offices. In communication sent to physicians and other providers on Friday, Oct. 30, Dr. Karen Remley, the state health commissioner, said that as of last week, novel H1N1 vaccine had been sent to every provider in the state registered to dispense the vaccine.

Local providers who spoke with the Falls Church Times said they have received only a fraction of the vaccine doses they requested and consequently have needed to narrow down the CDC target groups in deciding whom to offer vaccine to.

As of Oct. 31, most local primary care providers did not appear to be posting notices on their websites regarding vaccine availability or otherwise advertising availability, but rather contacting patients who have the highest risk of developing complications from novel H1N1 influenza. Several parents of children in Falls Church City who have high-risk conditions such as asthma and diabetes said their children have received the vaccine from their regular physicians.

Accounts and personal anecdotes of high levels of school absenteeism and full school clinics abound among families and students in the City. Local family physician Dr. Gordon Theisz, who estimates that his visits for influenza-like illness have at least doubled in the past few weeks, observed last week that novel H1N1 infection “seems to really be hitting the schools now.”

Late last week, the FCCPS communications office referred questions about absence rates and influenza flu-like illness in the schools to the Fairfax County health department.  Fairfax County spokesman Barbour said on Friday that the current absenteeism rate is about 6-7% in Fairfax County- up from about 3% at the beginning of October—and that the absenteeism rate in FCCPS  was mirroring this rate. “The number is no greater (in Falls Church City) than in Fairfax County schools and other school systems,” he said.

State-level data show that up to 14% of all emergency department visits and urgent care visits are for influenza-like illness—double what has been reported in the last two seasonal flu seasons. “The majority of them are children and young people,” Dr. Gloria Addo-Ayensu, Fairfax County’s health director, told the Falls Church Times late last week.

Novel H1N1 influenza is continuing to “behave very much like seasonal flu, where you have a spectrum of illness, from mild and moderate illness to very severe illness with hospitalizations and death,” Dr. Addo-Ayensu said. “What’s different is who’s getting ill and who’s getting severely ill.”

Many cases of H1N1 influenza can be treated at home, but individuals with conditions that put them at increased risk for complications—such as asthma, diabetes, pregnancy, morbid obesity, and neuromuscular conditions—should seek medical care promptly for flu symptoms, she said.

Falls Church City resident Melisa Atkeson did not hesitate to bring her 5-year-old son Ben to see the doctor when he “went from being not ill at all to being very ill” in little over 24 hours.

Ben came home from school one recent Thursday saying “he’d coughed so hard it hurt in his stomach,” she recalled. His fever went from 100-101 degrees in the late afternoon to 103 degrees at night, and by the next morning “he was really sick.” Ben has a history of asthma and respiratory issues, Atkeson said, “so we felt he really needed to be seen.”

“We started Tamiflu on Friday afternoon,” she recalled, “and by Saturday he was significantly better. By Sunday, you would not have known he’d been sick.”

“Even without Ben having had the respiratory issues, though, I think I would have still taken him to the doctor. I don’t tend to over-react, but this has worried me a lot more than other things,” said Atkeson.

Dr. Theisz said he reminds his patients that “when respiratory symptoms happen, they happen fast. Shortness of breath, chest tightness, any difficulty breathing—these are signs that patients should be seen.” He also explains to patients that the CDC is urging health care providers to save Tamiflu—the anti-viral drug most commonly prescribed for influenza—for patients at high risk for complications.

The unexpected delays in vaccine production have made vaccine distribution in the public health sector especially tricky, said Dr. Addo-Ayensu.  Planning vaccine clinics “has been challenging, to say the least, because our immediate goal is to vaccine the priority groups who are at high risk of complications while not over-promising the vaccine and inviting a whole lot of people only to have them disappointed and angry that they came and waited for hours.”

“It’s like the difference between going to the airport and the flight being overbooked by two people versus it being overbooked by 100 people,” she said. “If it’s 100 people, you can’t help but ask, what were you thinking?”

In addition to the Fairfax County Health Department website, the state’s website, www.vdh.state.va.us , as well as its telephone hotline, 1-877-ASK-VDH3, are good resources for questions about vaccine availability and other H1N1 issues.

Please share any experiences with novel H1N1 influenza by posting a comment, or e-mail Christine Kilgore at [email protected] with any questions/issues you’d like to see addressed in future stories.