Today, the CDC reports 7,963 hospitalizations and 522 deaths from laboratory confirmed novel H1N1 influenza A. H1N1 influenza continues to disproportionately impact younger people. In the Southern Hemisphere, H1N1 cases are starting to decrease.
H1N1 Vaccination Program
States are in the process of developing plans to distribute H1N1 vaccine. Since health care workers, including long term care, are one of the five groups targeted for vaccination according to CDC Advisory Committee on Immunization Practices (ACIP) recommendations, it is advisable that providers and affiliates check in with their local and state public health departments now to alert the agencies to their H1N1 vaccination needs. According to the CDC, 75% of the states have H1N1 distribution information on their state public health web sites.
Please remember that according to the ACIP recommendation, residents over 65 are NOT eligible for vaccine. This makes it all the more important that direct care staff are vaccinated.
According to CDC, at this time, there are no plans to prioritize among the five targeted groups. The five targeted groups are 1) pregnant women, 2) people who live with or care for children younger than 6 months, 3) healthcare and emergency medical services personnel, 4) persons between the ages of 6 months through 24 years, and 5) people ages 25 through 64 years who are at higher risk for H1N1 because of chronic health disorders or compromised immune systems. If prioritization becomes necessary, direct care staff are targeted third (after pregnant women and people who live with or care for children younger than 6 months).
Currently, the federal government estimates that 45 – 52 million doses of vaccine will be available in mid-October and then doses will be available weekly up to 195 million doses. Vaccine will be provided to states based on population and shipped to clinics, offices, health departments and other project area-designated sites via centralized distribution. This is the same process that is used to ship vaccines under the childhood immunization program. For more information, please see CDC Q&As at http://www.cdc.gov/h1n1flu/vaccination/public/vaccination_qa_pub.htm.
Vaccine trials began on August 7 and to date, there are no red flags.
There is no charge for the vaccine, needles, syringes, sharps containers and alcohol swabs as they are being provided by the federal government.
H1N1 Infection Control
As reported in previous H1N1 updates, whether the CDC will change its current recommendation for N95 respirators for health care workers caring for H1N1 patients remains to be seen. The Institute of Medicine (IOM) will make its recommendation by September 1, 2009. CDC will issue revised guidance shortly thereafter.
In a CMS Open Door Forum conference call yesterday, CDC stated that the interim guidance overemphasis personal protective equipment to the detriment of other infection control methods. The revised guidance will provide additional focus on engineering and administrative controls, e.g., visual alerts for visitors on respiratory and cough hygiene, facility access and control, management of ill healthcare personnel (e.g., sick leave policy for both personnel and contractors) and encouraging vaccination for health care workers.
Other News
On August 19, the CDC released new guidance for businesses to plan for and respond to the upcoming flu season was released. The guidance is designed to help employers prepare now for the impact that seasonal and 2009 H1N1 influenza could have this fall and winter on their employers and operations. While not intended for healthcare, the guidance still provides useful information including a communication toolkit for businesses and employers. Both the guidance and toolkit are available at www.flu.gov.
For those of you with children off to college, the government also released guidance and a tool kit for institutions of higher education and that also may be found at www.flu.gov.