Maryland wigs out over swine flu scare

Md. wants to give swine flu vaccine to millions


Excellent point right here:

Nationwide, about 34 percent of U.S. residents were vaccinated against seasonal flu during the 2008-09 season, according to the CDC, despite its recommendations that 83 percent of the population be immunized.

"There's going to be a lot of unknowns about that vaccine in terms of the uptake," said Dr. John Bartlett, a professor at the Johns Hopkins School of Medicine. "If it turns out to be a serious flu with some deaths, I think people are going to want to get it and really bite and scratch to have it available."

Under that scenario, Dr. Bartlett is doubtful that the available domestic supply of the vaccine will allow Maryland to fulfill its goal of making it available to everyone.

Dr. Bartlett also noted that the flu season will be well under way before anyone becomes immunized. Vaccination against swine flu is likely to require two doses, three weeks apart, with immunity taking effect three weeks after the second dose, he said.

"The vaccine is going to be late," Dr. Bartlett said. "They can't make it any faster."

Another open question: how will the state pay for all those flu shots? The Department of Health and Mental Hygiene has received nearly $7 million in federal grants for swine flu preparation and will get more once it begins implementing its plans.

"The public sector can't do this alone. We can't vaccinate all Marylanders perhaps two times. We're relying on partners," Ms. Phillips said, including private insurance and Medicare. "We're hopeful we get the resources we need."

Part of the state's plan is to make the vaccine available at schools, preferably in the form of a nasal spray, Ms. Phillips said. But it's unclear whether there will be enough doses of nasal-spray vaccine to immunize Maryland's 1 million school-age children.

The state is also trying to project what would happen if hospitals became inundated with swine flu patients. It is common during flu season for patients to be sent to hospitals other than the ones closest to their homes, but if swine flu hits hard, some patients may be hospitalized much farther away, Ms. Phillips said.

To prevent emergency rooms from being overrun, the state is planning a communication and education campaign about how to treat mild flu symptoms. Information will be available on Web sites, and the state may also set up call centers, Ms. Phillips said.

The World Health Organization has estimated that up to 2 billion people could be sickened during the swine flu pandemic, which is already known to be responsible for more than 1,400 deaths, including six in Maryland.