Given that I took all 3 of my kids to finally get the H1N1 vaccine yesterday, it's about time I link to this Slate story I've been meaning to.  I think one of the under-reported facets of the flu story is the fact that H1N1 has basically completely crowded out the seasonal flu virus.  In short, if you've got the flu, you've got H1N1.   Of course, my seasonal flu vaccine is thus pretty much worthless, but I've mostly been worried about getting the boys the H1N1 vaccine as 1) they are the primary vectors I need to worry about, and 2) Alex has a reasonable probability of breakthrough seizures if he gets the flu and David has underlying respiratory issues that could make it worse. 

Anyway, Marc Siegel's story in Slate is an interesting look at why there's been such shortages of the vaccine.  I found the most interesting criticism to be not technical, but in health care bureaucrats being too conservative.  

The slow process is compounded by the fact that our health officials
believe too much in the old technology. The Centers for Disease Control
and Prevention and the Department of Health and Human Services decided
to finish making the seasonal flu vaccine before transitioning to the
new vaccine, even as evidence suggested that the new pandemic was going
to crowd out the yearly flu. "It is difficult to turn production to new
directions based on inertia," says Lone Simonsen, an epidemiologist and
nationally recognized flu pandemic expert at George Washington
University. But it is just this inertia that makes redirection in
vaccine production so crucial.

Last March, as the emerging
influenza flu strain took hold in Mexico, infecting thousands before
taking hold in the United States, studies showed that this new flu was
dominant: It was found in more than 90 percent of the flu cases in
Mexico. This new crab grass taking over the lawn was predictable. Since
most people (especially the young) had never been exposed to this virus
before, there were few barriers to transmission.

Instead of
switching immediately to the manufacture of a new pandemic vaccine, the
seasonal flu vaccine was completed first. By early fall, 115 million
doses of the seasonal flu vaccine were rolled out, and compliance was
at an all-time high, thanks to a massive national campaign to promote
compliance. Health and Human Services Secretary Kathleen Sebelius said
during a Sept. 10 press conference that "getting vaccinated for
seasonal flu right now is good advice." Accordingly, more than 60
million rolled up their sleeves and got the vaccine by October, despite
the fact that there was no seasonal flu to be found. Lost in the frenzy
for flu shots was the fact that the yearly flu season didn't typically
peak until late January or February, while pandemics characteristically
do not obey the boundaries of traditional winter flu seasons.

Meanwhile, apparently many Americans have been listening to Bill Maher and Glenn Beck rather than public health and medical professionals for their health care advice.  

About Steve Greene
Professor of Political Science at NC State http://faculty.chass.ncsu.edu/shgreene

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