12/7/2009 9:25 AM
H1N1
– Current vaccines available Injectable thimerosal
free vaccine for 6-35 month olds Nasal Mist for 2 years and older without
chronic medical conditions Injectable vaccine for 4 year olds and older (does
contain thimerosal) Please be understanding if your
appointment is postponed or cancelled due to the unavailability of vaccine.
We are doing our best with a difficult situation. Seasonal
Influenza – We currently only have vaccine for
patients under 3 years old. I ordered 300 more doses of vaccine than I
administered last year, but demand has been significantly higher. Since we
had to prebook our orders last February, there
has been no way to adjust our requests. I still have thimerosal
free vaccine for 6-35 month olds and should be able to order more if
needed. Logistics
– We have experimented with various options regarding scheduling
immunizations. Each option has had its pros and cons. We currently cannot
schedule appointments if we do not have the vaccine. We are putting
together a list of patients who have requested vaccine and will call via
dialer software when vaccine is available. We, like every other pediatric office,
have been stressed to the max this season and are trying to do our best for
all of our patients. We appreciate your patience and understanding. Please do not call the office for our opinion about the safety
of this vaccine or whether or not you should have your child receive it. It is safe and the
decision is up to you. We believe the vaccine is safe and
effective and our recommendations are those of the CDC and American Academy
of Pediatrics which is that all children over the age of 6 months should
receive both the H1N1 and seasonal influenza vaccines. Please do not call the office to ask our
opinion about whether or not your child should receive the vaccine. Read
the following information and check www.CDC.gov. Our phones are being inundated with these
questions and make it difficult for patients with illnesses to get through.
This is the latest
release from the NY State Dept of Health.
A Message from State Health
Commissioner Richard F. Daines, M.D., to Health Care
Providers Wanting to Receive H1N1 Flu Vaccine October 29, 2009
The production of the H1N1 flu
vaccine has encountered delays. As a result, the federal Centers for Disease
Control and Prevention (CDC) has told New York and other states not to expect
large amounts of vaccine to be available until mid-November or later.
The supply of vaccine is
coordinated by the CDC. Whenever the CDC notifies the State Department of
Health (DOH) of available vaccine, DOH quickly distributes the vaccine to
clinical sites across the State.
Based on the most recent CDC
projections of vaccine supply, many providers may not receive vaccine for
several weeks.
We ask everyone to be patient as
we wait for larger quantities of vaccine to become available.
DOH is taking H1N1 vaccine
orders now in order to be prepared to place orders on your behalf with the CDC
national warehouse as soon as vaccine is available.
During the first week of taking
orders by phone (October 19-23) DOH received requests from health care
providers for 3.16 million doses of vaccine but was notified by the CDC that
only 160,000 doses of vaccine were available to ship to providers in New York
State (outside of New York City). As a result, DOH had only 1 dose of vaccine
to fill for every 20 doses requested.
If you order H1N1 vaccine today
from DOH, due to lack of supplies you probably will not receive the vaccine for
several weeks and you probably won’t receive your full order. DOH will fill
unfilled back orders when more vaccine is available. DOH will send weekly
emails to provide you with the status of your order.
Governor
Patterson declares State of Emergency, okays use of
vaccines with thimerosal in patients less than 3.
For a
copy of the Executive Order
The latest on my
order for H1N1 vaccine from the NYS Department of Health.
“Last week, the New York State Department of Health received
orders for TEN TIMES more than the number of doses of vaccine currently
available to ship, due to delays in vaccine delivery on the national level.
Allocation of the limited supply of vaccine for the first ordering week is not
yet complete and providers will be notified of their order status. Those who
receive vaccine are likely to only receive a partial order and it may take
several weeks before vaccine supplies are sufficient to complete all orders.”
We have ordered more vaccine than we ever
have and are doing our best to accommodate everyone’s needs but are at the
mercy of the manufacturers. We thank you for your patience.
VACCINE INFORMATION STATEMENTS
Click to open
2009-2010
Seasonal Influenza Inactivated Virus (injection)
2009-2010 Seasonal Influenza Live Attenuated Virus (nasal spray)
2009-2010 H1N1 Influenza Inactivated Virus
(injection)
2009-2010 H1N1 Influenza Live Attenuated Virus (nasal spray)
FOR
MORE INFORMATION ABOUT THE FLU
FLU FACTS FOR 2009/2010 SEASON
1. What is flu?
Flu is a viral infection of the respiratory tract (nose, throat, lungs). Every year seasonal flu appears in our community. There are many strains of the flu virus.
2. What are the symptoms of flu?
The main symptoms are fever (usually over 100.5 F) and cough, sore throat, runny nose. Other common symptoms are feeling tired, muscle aches and pains, headaches, drop in appetite and activity level, and some people have vomiting and diarrhea. The fever can last 3-5 days, the runny nose 1- 2 weeks and cough 2-3 weeks.
3. What is the difference between the flu and a cold?
Both flu and a cold can cause runny nose and cough; however fever is always present with the flu, the onset of symptoms is more abrupt and symptoms are more severe. The fever with the flu can last 3-5 days. Usually a fever (<100.5 F) with a cold will go away in a day or two.
4. What is H1N1 (Swine Flu)?
H1N1 is a new strain of flu that presented in the spring of 2009. Currently, this strain causes the same symptoms as the regular “seasonal” flu strains.
5. How is flu spread and how can I protect myself?
The flu virus (seasonal and H1N1) is spread mainly from person to person through coughing or sneezing. Sometimes people may become infected by touching something with flu viruses on it and then touching their mouth or nose.
Covering your cough and sneezes, frequently washing your hands with soap and water, keeping your hands away from your eyes, nose and mouth, and avoiding contact with sick people are the best ways to prevent the spread of the virus.
A person is contagious from 1 day prior to 7 days after the fever starts. After exposure, a person will likely come down with the seasonal flu in 1-3 days and the H1N1 flu in 4-6 days.
6. Who is “high risk”?
In general, people are mildly ill with the flu for 5-7 days and get better on their own; however for some people the flu virus can cause more severe illness. Complications can include pneumonia, respiratory distress, dehydration, Reye’s syndrome, myositis (muscle pain) encephalitis (brain infection), myocarditis (heart infection), and in rare cases death.
Seasonal Flu - infants and children < 5 years of age and elderly > 65, and pregnant women are at higher risk for complications from the flu. Other high risk patients include those with heart problems, asthma, diabetes, chronic lung disease, neurologic diseases, muscle diseases, sickle cell disease, kidney disease, cancer, immunosupression, HIV and diseases requiring long term aspirin therapy such as Rheumatoid arthritis or Kawasaki disease.
H1N1 - This strain appears to be affecting younger patients (< 24 years old ). In addition pregnant women, infants and children < age 2 are more susceptible to it. Other high risk patients are the same as for seasonal flu.
7.
Which children should get the flu vaccine? What about the H1N1
Vaccine?
· The recommendations for this season are:
· Children between 6 months and 18 years should receive the seasonal flu vaccine (which is currently available and we are administering it). Children who have never had a flu vaccine who are less than 9 years old require 2 doses a month apart (children less than 3 receive half doses). The vaccine that I carry is thimerosal free.
· Anyone living with a child under the age of 6 months and pregnant women should also receive the vaccine.
· The H1N1 vaccine is a separate vaccine that will not be available until mid to late October. I have preregistered for the vaccine but there are no definite distribution plans as of now.
· Currently the recommendations for administration are the same. Pregnant women are the top priority, people caring for children under 6 months of age and then children 6 months to 24 years are prioritized in that order. As of today, the recommendation is for 2 doses a month apart and separate from the seasonal flu vaccine so seasonal vaccination should be done earlier this year. There are rumors that 1 dose will suffice, but I am not certain if that holds for children under 9 years. Also, even if people have had what we think is the H1N1 flu this year, the recommendations are for vaccination since the diagnosis is not certain.
· Although there are discussions about the H1N1 vaccine being administered through schools in NY state, I was told today that Monroe County will not be using schools as sites of administration.
· Anyone who has an egg allergy or has had a prior reaction to a flu vaccine should not receive the vaccine.
8. How is flu treated? Do Antibiotics work?
Since the flu is a virus, antibiotics will not cure the flu or shorten the course of the illness, nor will they prevent the complications of the flu. Antibiotics are only used for patients who have secondary bacterial infections. Antiviral medications (i.e. Tamiflu, Relenza, Amantadine, Rimantadine) are indicated for treatment and prevention of flu in HIGH-RISK patients only. (see above.) For best results, it needs to be started within 48 hours of the onset of fever. These medicines are not used for everyone because they can have side effects, and overuse of them will cause resistance. Some resistance to H1N1 has already been reported.
Symptomatic treatment – push fluids, acetaminophen (Tylenol) or Ibuprofen (motrin, advil) for fever and aches/pains. Cold medications are not recommended. Use of saline (salt water – ½ tsp salt in 8 oz water) nasal wash and suction may help. For children over age 5, throat lozenges may be used.
9. When should my child be seen?
Most children will tolerate the flu very well. However, your child should be seen if your child has the following symptoms:
All HIGH-RISK patients who have symptoms of flu should be seen.
Fever > 100.5 if < 4 months of age;
Fever > 101.0 if 4 – 12 months of age;
Fever > 104.0 if > 1 year of age;
Fever that goes away over 24 hours and then returns;
Ear pain or ear discharge;
Fast or difficult breathing;
Severe cough or wheezing;
Nasal discharge lasting more than 2 weeks;
Cough lasting more than 3 weeks
10. When can my child return to day care or school?
Stay home from day care, school, or work for at least 24 hours after the fever is gone.