Fairfax Health Director Speaks about H1N1 Flu Virus

EDITOR’S NOTE: Events  changed after this story was written. We are leaving it in print because it still contains a great deal of useful information. Note, however, that the school-based clinics have been canceled. You can read the latest information at the link below:

VACCINE SHORTAGE: School H1N1 Clinics Cancelled — But Limited Doses Offered Saturday

The Fairfax County Health Department is planning to hold its first school-based H1N1 vaccination clinics on Saturday October 24 and Sunday October 25 at a host of Fairfax County middle schools, a public health official has announced.

“Our first priority is to the schools and to the kids,” said Glen Barbour, public safety information officer for the Fairfax County Health Department, which serves Falls Church City as well as the county.

The planned clinics are aimed primarily at children who attend public and private schools in the area, including the Falls Church City public schools, as well as home-schooled children.

Vaccination planning is fluid, and final details are contingent on how much vaccine the county receives each week. Depending on vaccine availability, it is possible that children who are not yet school-aged may be eligible to receive a vaccine at the school-based clinics. “That’s the hope,” Mr. Barbour said. On the other hand, if vaccine supplies are not large enough, there could be age restrictions even within the school-age range, he said.

The mass vaccination clinics are being planned for 9 middle schools for October 24 and 25: Franklin, Frost, Glasgow, Hughes, Key, Kilmer, Liberty, Longfellow, and Sandburg.

It is possible, based on vaccine supply in the next few weeks, that the County will add additional school-based mass vaccination clinics, Mr. Barbour explained. If the number of school-based clinics increases enough, then George Mason High School could be involved as a vaccine-dispensing site.

Fairfax County received its first vaccine shipment from the state this week, and is distributing the 1,900 doses largely to healthy, non-pregnant front-line health care workers and emergency services personnel.

[The vaccine received thus far is in the form of the live attenuated intranasal vaccine (the nasal spray), which is recommended only for individuals ages 2-49 who are not pregnant or do not have high-risk conditions or an immunocompromised state.]

At an informational session on H1N1 that was broadcast live on FCC-TV last week, Fairfax County Health Director Dr. Gloria Addo-Ayensu explained that health department officials have been discussing three possible tiers of school-based vaccine dispensing, with the top tier involving 25 schools and requiring the most available vaccine. In a sign of the fluidity involved in such a large public health effort, Mr. Barbour said on Thursday that the current plan involves 9 schools.

The county expects a “soft roll out” of weekly vaccine shipments initially that should progress quickly to a “steady flow” by mid-October, Dr. Addo-Ayensu said. Future shipments are expected to include inactivated vaccine (“flu shot”).

At a town hall meeting several weeks ago, Dr. Addo-Ayensu said that school-based vaccination clinics were part of a “plan B” vaccination effort that would be implemented if an insufficient number of physician offices and other traditional vaccine providers had not registered with the state health department to receive and administer novel H1N1 vaccine.

At this point in time, however, the community of traditional vaccine providers is still in flux, with some providers still registering with the state and others still waiting to receive final approval. Several local physicians in Falls Church City who spoke with the Falls Church Times said their practices were registered as vaccination dispensing sites and are ready to administer vaccine once they receive their first doses.

With respect to the school-based clinics, “our hope is still that people will contact their providers first,” Mr. Barbour said.

It is now clear that children aged 10 and older need only 1 dose of the FDA-approved H1N1 vaccine, the CDC says. Children aged 6 months to 9 years of age should receive 2 doses of H1N1 vaccine several weeks apart.

Dr. Addo-Ayensu shared another bit of good news at the session on Monday—the finding that “circulating H1N1 isolates are similar to the reference virus selected for vaccine production,” which means the vaccine should be highly effective in protecting its recipients, she said.

At this meeting on Monday, Dr. Addo-Ayensu was asked whether one should still get the vaccine if he or she has already been ill with novel H1N1 influenza. This depends, she answered, on whether the diagnosis of H1N1 infection was actually “a lab-confirmed diagnosis.”

If not, “then yes, you should still get the vaccine when it becomes available… because you can’t be sure (you’ve had H1N1 infection),” she said. This will often be the case, since physicians are confirming H1N1 influenza cases through testing only in patients who are severely ill.

Getting the vaccine after having already had H1N1 infection would not be harmful, and the risks of going unprotected if prior illness was not actually caused by H1N1 infection can be significant, she said.

Dr. Amin Barakat of Northern Virginia Pediatric Associates said he tells his patients that “it’s critical to be prepared through vaccination, especially since it’s a new virus—we don’t know how it will behave and change in the future.”

The CDC is currently instructing vaccine providers to focus on the key populations that have been most impacted the H1N1 influenza pandemic thus far:

• Pregnant women
• People who live with or care for children younger than 6 months of age
• Health care and emergency medical services personnel
• Individuals aged 6 months-24 years
• People aged 25-64 who have chronic health disorders or compromised immune systems.