In the next two months, with the assistance of the U.S. military and police officials, medical care professionals are culminating months of false flu evidence into a mandatory vaccination movement that will specifically target five key populations.
The Centers for Disease Control and Prevention's
Advisory Committee on Immunization Practices (ACIP)
has issued direction for the use of the H1N1
vaccine. The vaccines are to be administered across
the U.S. between October and November of this year.
The target demographic is so generalized and vast, that it will literally emcompass more than half of the U.S. population. The key populations include those who are "only considered" (with no official data) a high risk of disease or complications, those who are likely to come into contact with novel H1N1, and those who could infect young infants. When the vaccine is first available, the committee recommended vaccinations for:
* pregnant women,
* people who live with or care for children younger than 6 months of age,
* health care and emergency medical services An
Emergency medical service (abbreviated to initialism
"EMS" in many countries) is a service providing
out-of-hospital acute care and transport to definitive
care, to patients with illnesses and injuries which
the patient believes constitutes a medical emergency.
* persons between the ages of 6 months and 24 years of age, and
* people from ages 25 through 64 who are at higher risk for novel H1N1 because of chronic health disorders or compromised immune systems.
The groups listed total approximately 159 million people in the US.
The committee warns that if there is a shortage,
first in line will include: pregnant women, people
who live with children less than 6 months of age,
health care and emergency personnel with direct patient
contact, children 6 months through 4 years of age,
and children 5 through 18 years of age who have chronic
The ACIP recommendations assumed that the H1N1 vaccines to be used would not contain adjuvants, because using an adjuvant would create regulatory complications that would delay vaccine availability. Adjuvants have not been used with flu vaccines in the United States, but Health and Human Services ordered 119 million doses of two different adjuvants, MF59 and ASO3 for use in the pandemic.
Without releasing any statistics related to incidents of infection, by the end of June 2009, the CDC stated that one million Americans had been exposed to H1N1 swine flu.
To date, despite pressure from public health agencies, the World Health Organization (WHO) and the CDC have refused to make any distinctions between the H1N1 swine flu and seasonal influenza. No data is being collected on the spread of H1N1 based on systematic lab confirmation. "Non-confirmed" cases are being categorized as "confirmed" cases and the numbers are then used by WHO to prove that the disease is spreading.
New estimates suggest that the death rate compares to a moderate year of seasonal influenza, said Dr Marc Lipsitch of Harvard University.
"It's mildest in kids. That's one of the really good pieces of news in this pandemic," Lipsitch told a meeting of flu experts being held by the U.S. Institute of Medicine.
"Barring any changes in the virus, I think we can say we are in a category 1 pandemic. This has not become clear until fairly recently."
The Pandemic Severity Index set by the U.S. government
has five categories of pandemic, with a category 1
being comparable to a seasonal flu epidemic.
Lipsitch took information from around the world on how many people had reported they had influenza-like illness, which may or may not actually be influenza; government reports of actual hospitalizations and confirmed deaths.
He came up with a range of mortality from swine flu, from 0.007 percent to 0.045 percent.
Either way, having new information about how many people were infected and did not become severely ill or die makes the pandemic look very mild, he said.
"The news is certainly better than it was in May and even better than it was at the beginning of August," Lipsitch said.
H1N1 swine flu was declared a pandemic in June after flashing around the world in six weeks. Experts all said a true death rate would not be clear for weeks because it is impossible to test every patient and because people with mild cases may never be diagnosed.
This lack of information made the epidemics in various
countries and cities look worse at first than they
actually were, Lipsitch said. People sick enough to
be hospitalized are almost always tested first.
The CDC has issued a list of lengthy recommendations to persuade clinicians to respond accordingly. These include using dangerous antiviral chemoprophylaxis (administration of antiviral drugs such as tamiflu) and dosage recommendations for each group.
There are also reports from hospital clinicians across the United States who are receiving an outdated interim guidance white paper on identifying the H1N1 virus. The white paper has not been updated since May 4, 2009.
Many critical policy documents for guidance issued by the CDC, which dictate how emergency and medical care professionals define their policies on H1N1, have not been updated in almost 4 months.
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