Health and Human Services Secretary Kathleen Sebelius said Thursday at a government-wide summit on the H1N1 virus that a vaccine for swine flu should be ready by mid-October.
The summit, which was attended by Sebelius, Homeland Security Secretary Janet Napolitano, Education Secretary Arne Duncan, and White House Homeland Security Adviser John Brennan, was meant to begin coordinating federal, state and local governments in preparation for the possibility of a magnified H1N1 outbreak this fall.
Public health officials worry that H1N1 could behave like the Spanish Flu of 1918, which experts estimate killed as many as 50 million to 100 million people worldwide over a period of about two years. That flu first appeared as a mild strain in the spring only to reappear in a deadlier form in the fall.
As of July, the World Health Organization has reported that the H1N1 virus has infected nearly 95,000 people worldwide and killed about 430. About a third of the cases and nearly 170 of the deaths, occurred in the United States.
President Obama, who is in Italy for a meeting of the G8 nations, joined the summit briefly by telephone.
“In conversations with world leaders, it is clear we are ahead in our preparation,” Obama said.
His message contrasted slightly with that of the secretaries: Be prepared, because we don’t know what’s coming yet.
“All the experts tell us is, prepare to be surprised,” Sebelius said.
“What we’ve been advised to do is anticipate a worst-case scenario,” she added. “What we can’t do is wait until October and then decide we’ve got a serious situation on our hands.”
While many major decisions about vaccinations have yet to be made, including whether to provide any at all, some details emerged at the summit. Sebelius said the priority groups for receiving swine flu vaccine would be different from those receiving the seasonal flu, and the delivery of the H1N1 vaccine probably wouldn’t go through traditional health care systems.
“We’re anticipating not doing it through the traditional vaccination systems, but looking at different sites,” Sebelius said.
Schools might be used for delivering vaccine because the virus has hit school-age children particularly hard, the secretary said.
The first vaccine should be ready for testing in August, said Thomas Frieden, the director of the Center for Disease Control and Prevention. Vaccine manufacturers were able to speed up the manufacture of seasonal flu vaccines, clearing up the production lines for H1N1, he said.
Anthony Fauci, director of National Institute of Allergy and Infectious Diseases, said vulnerable groups will be given priority to receive the vaccine, including school-age children, pregnant women, health care employees, and adults with underlying diseases. However, a decision to go ahead with vaccinations will have to wait until health officials assess the activity of the virus in Southern Hemisphere, where it is flu season, as well as the progress of the virus here this summer.
So far, he said, the virus is not changing in any substantial way.
“That’s a good thing,” Fauci said, because it means vaccines developed from H1N1 in the spring will still work this fall.
In addition, antiviral drugs are working against the virus, which could mean only a limited amount of vaccine will be needed.
Meanwhile, scientists are unsure about the amount of vaccine that could be needed to trigger an immune response in people. The standard flu shot is about 15 micrograms, but vaccines developed to combat the H5N1 avian flu required two shots of 90 micrograms each and produced a response in only 50 percent of the recipients.
Fauci said the current form of swine flu has reacted similarly to other flu strains, and H1N1 vaccines should produce a response with a smaller dose.
Federal Funding
At the summit, the governors of several states, including Maryland, Vermont, Maine, Connecticut, Kansas and Wisconsin, asked the three Cabinet secretaries questions via video-conference about federal preparations and funding to combat the virus.
Pointing to funds already appropriated by Congress in the last war spending bill (PL 111-32), Sebelius assured them of federal support and said HHS hopes to spend $350 million in preparedness grants, $216 million of which would go to state health departments, by July 31.
However, states hoping to qualify for federal assistance under the Stafford Act (PL 100-707), which authorizes federal disaster-response activities, could be out of luck, Napolitano said.
The bill is designed to help with natural disasters, not epidemics, she said: “The act and the flu do not match up well.”
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