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Pregnant women, elderly, kids to get first flu shots


Pregnant women, health care workers and children six months and older should be placed at the front of the line for swine flu vaccinations later this year, a U.S. government panel has recommended.

The panel also said those first vaccinated should include parents and other caregivers of infants; nonelderly adults who have high-risk medical conditions; and young adults ages 19 to 24.

The Advisory Committee on Immunization Practices voted to set vaccination priorities for those groups during a meeting last week in Atlanta. The panel’s recommendations are usually adopted by federal health officials.

The recommendations are designed to address potential limits in vaccine availability later this year if there is heavy demand and limited supplies.

The government estimates that about 120 million swine flu vaccine doses will be available to the public by late October. Roughly 160 million people are in the priority groups considered most vulnerable to infection or most at risk for severe disease. There are more than 300 million people in the U.S.

Although the number recommended to get doses exceeds the projected supply, health officials don’t think everyone will run out and get vaccinated. Traditionally, less than half of the people recommended to get seasonal flu shots get them. Only about 15 percent of pregnant women get seasonal flu vaccinations.

If there is ample vaccine, vaccinations also would be recommended for all non-elderly adults, the panel also voted. And if there’s still plenty of vaccine, the swine flu shots and spray doses should be offered to people 65 and older. Fewer illnesses have been reported in the elderly, who appear to have higher levels of immunity to the virus, health experts say.

However, the elderly should be pushed to get shots against seasonal flu, which is a significant health risk to older adults.

Panel members say they hope swine flu vaccinations will be opened up quickly. “The only sin is vaccine left in the refrigerator,” said Dr. William Schaffner, a Vanderbilt University flu expert, in a comment to the panel.

The panel also said if vaccine is scarce, the government could require that a much tighter group be at the front of the vaccination line, numbering about 40 million. That would include pregnant women and household contacts of small children, just like in the general priority recommendation. But the others would be children ages 6 months through 4 years, children with chronic medical conditions and only health care and emergency services workers who have direct contact with patients.

It’s a worst-case scenario that officials aren’t expecting, but they wanted to have a plan for it just in case, said officials with the U.S. Centers for Disease Control and Prevention, the federal agency that reviews the panel’s recommendations.

The range of recommendations reflects how hard it is to plan for swine flu, officials said.

Variables with the swine flu virus can range from whether it mutates into a form that is more deadly, spreads more efficiently, or is better at fighting off current antiviral medications.

Variables with the vaccine include potential production problems. Production of the vaccine will be a prodigious feat: The government has already purchased 195 million doses for the coming autumn and winter, which far eclipses the 125 million or so doses generally produced for seasonal flu vaccine.

Four vaccine manufacturers are wrapping up seasonal flu vaccine production and have begun production of swine flu vaccine. But another company, Sanofi Pasteur, has been more delayed and may not finish seasonal vaccine production until September, a company spokeswoman said. Sanofi is among the largest producers of flu vaccine, so those delays could have a significant ripple effect.

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