Tuesday, February 2, 2010
QD: News Every Day--Vaccine shortages become surpluses
ACP Internist's daily digest continues with an update on H1N1 influenza and other vaccine news.
H1N1 influenza
Many wealthier countries now have a surplus of H1N1 influenza vaccine, while poorer countries continue to struggle. The obvious solution seems to be sending vaccine from countries with too much to those without enough, but the reality is much more complex. (The New York Times)
Vaccines and autism
The Lancet today retracted a study from 1998 linking the measles-mumps-rubella vaccine to autism, after the U.K. General Medical Counsel's Fitness to Practice Panel concluded last week that the research had been conducted unethically. (The Lancet, L.A. Times)
In case you missed it ...
Baptist Princeton Hospital in Birmingham, Ala. uses employee badges to track whether staff wash their hands when entering and leaving a patient's room. Hospital officials, including the CEO, get the details on habitually noncompliant staff, who in turn could get a private text or e-mail to prod them. (NPR)
Labels: H1N1, patient safety, QD, vaccination
posted by Jennifer Kearney-Strouse at
3:40 PM
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Monday, January 11, 2010
ACP President: Not Enough Americans Have Been Vaccinated Against H1N1 Flu
Editor's note: Val Jones, MD, guest authored this post, which originally appeared on her blog, Better Health.
Over 10,000 Americans (mostly young) have already died of H1N1 flu, and yet we've only vaccinated 10-20% of those who need protection. January 10-16 is National Influenza Awareness Week, and the American College of Physicians is doing its part to raise awareness of the ongoing need to protect Americans from the next wave of influenza.
I interviewed ACP President Joseph Stubbs, FACP, about the current influenza season and Americans' vulnerabilities to the virus. Please enjoy the audio of our conversation or click below on the word "More" to read the transcript here.
Dr. Val: I think a lot of Americans feel that the major push for flu vaccine is over. How many Americans do you estimate are still unvaccinated against H1N1 flu?
Dr. Stubbs: Only 10-20% of at-risk individuals have gotten the H1N1 vaccine so far. We really need people to get vaccinated as soon as possible in order to avoid a deadly increase in illness during the next wave of influenza.
Dr. Val: What have we learned about the virulence of this H1N1 strain?
Dr. Stubbs: So far the H1N1 virus has infected about 45 million Americans, resulting in 200,000 hospitalizations and 10,000 deaths. Most of these deaths have occurred among young people, which is particularly tragic.
Dr. Val: How does the death rate of the H1N1 virus compare to the regular seasonal flu?
Dr. Stubbs: So far the H1N1 virus is killing about the same number of people that the seasonal flu kills, but the H1N1 has a predilection for the young, and pregnant women.
Dr. Val: Is the death rate from flu additive this year--meaning, are the H1N1 and seasonal flu viruses together killing twice as many people?
Dr. Stubbs: Absolutely. The next few months we could see a bump in the seasonal flu and a resurgence in the H1N1 virus. But both are preventable with vaccines.
Dr. Val: How have we done with seasonal flu vaccine rates this year?
Dr. Stubbs: We're on track to get about 30% of the population vaccinated against the seasonal flu. The one silver lining in the 2009 flu season is that the H1N1 virus brought a lot of focused media attention to the importance of vaccination and the dangers of influenza.
Dr. Val: Are there still vaccine shortages in certain pockets across the country?
Dr. Stubbs: There are. We have enough supply now but the distribution process has slowed things down. In my region in Georgia, the amount of supply has increased dramatically in the last few weeks and I hope that's indicative of what's happening across the country.
Dr. Val: Who should get vaccinated now?
Dr. Stubbs: For the seasonal flu, young women, pregnant women, those with chronic diseases, and people over age 65 are the main targets. For H1N1, pregnant women, children and young adults under the age of 25, those with chronic diseases between the ages of 25 and 64. I think that if you have a chronic medical condition, no matter what your age, you ought to be vaccinated with both the H1N1 and seasonal flu vaccines. Healthcare professionals and their staff should also get both vaccines so they don't spread the flu to patients.
Dr. Val: What's your goal for vaccination of at-risk populations? I know we're only at 10-20% vaccination rates now ...
Dr. Stubbs: I like to set the bar high. My goal is 80-100%. The government regrets the slow start we got with vaccine supply and they're doing all they can to get people vaccinated now. If we can get more people vaccinated we can avert problems in the coming months and even in the coming years.
Dr. Val: What's your take home message for Americans entering this new year?
Dr. Stubbs: You can stay healthy by getting vaccinated.
***
Vaccination Resources from the American College of Physicians
--Immunization
--Adult immunization 
This post originally appeared on Better Health a network of popular health bloggers brought together by Val Jones, MD. Better Health’s mission is to support and promote healthcare professional bloggers, provide insightful and trustworthy health commentary, and help to inform health policy makers about the provider point of view on healthcare reform, science, research, and patient care.
Labels: flu, H1N1, vaccination
posted by Ryan DuBosar at
8:00 AM
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Tuesday, November 10, 2009
H1N1, or how I learned to stop worrying and love the flu
How did I get vaccinated for H1N1? I showed up at a free community health clinic. There were plenty of doses available. I didn't stand in a line. It took me longer to figure out parking than to get inoculated.
With a newborn at home, my wife and I decided to make H1N1 vaccination a priority. We'd already gotten seasonal flu shots and whooping cough updates. But the H1N1 vaccine shortage is well-documented. You need me to Google it for you? Click and pick for yourself from among 739,000 results.
But our family doctor posted a sign that he won't get the H1N1 vaccine at all. Our pediatrician's phone system collapsed under the weight of all the calls for H1N1; we couldn't get through for any reason.
We're not alone. A Harvard poll said that two-third of parents who'd tried couldn't get their children vaccinated.
So when the county announced it would have vaccines available one afternoon, my wife took our older son to stand in line. She arrived just as it started and waited 45 minutes. But by the time she left there was no line, so she called me to come over.
For comparison, here's what happened at a clinic that same day in an adjoining county. Friends of ours got stuck in that mess. Certainly, the death of a teen there spurred a lot of response. And I can imagine that some clinics are better advertised than others.
But by the time I stopped work and slogged through rush hour, the clinic in my county was busy, but there was no waiting. One piece of paperwork later I was getting injected--painless, not counting rush hour traffic. It was a pocket of availability amidst a lot of shortage. My wife wonders if we got a discount version of the vaccine--H1N2. But you can't beat free swag; I even got a nifty, palm-sized can of wipes.
(If you're interested in duplicating my success, WebMD chimed in with ways to get vaccinated.)
Labels: H1N1, vaccination
posted by Ryan DuBosar at
8:00 AM
1 Comments
Wednesday, October 28, 2009
QD: News Every Day--public option unsettles Senators
ACP Internist's daily digest of news and events wraps up how the public option has shifted the balance of opinion in the Senate, how the public itself has shifted on H1N1 vaccination, and the economic impact of a rural physician.
Health care reform
The introduction of a public option has precariously shifted Senators' support. Democrats are divided. What bi-partisan support there was has evaporated. Liberals are happy, but that won't carry the day. (AP, Los Angeles Times, Boston Globe)
H1N1 influenza
Some hospitals are seeing their emergency department patient volumes double from H1N1 influenza as doctors are being recruited as the flu police, trying to prioritize who gets vaccinated. To ease the crunch, more than 22 million doses of H1N1 flu vaccine are now available now, and health officials are still saying better late than never. (USA Today, New York Times, AP/MSBNC.com)
Data produced by a supercomputer shows that there could be a third wave of the H1N1 virus in the spring. The University of Texas is using
the "Ranger" supercomputer to make its predictions. (KXAN-TV)
Handshaking was out, and now so is the simple fist bump. Here's some humorous ways to greet people. (NPR)
In case you missed it ...
Doctors' economic contributions are as important to rural communities as their medical ones. The National Center for Rural Health Works estimates that a rural hospital loses $236,565 from clinic visits and $451,169 net revenue for every half-a-physician they are short. When extrapolated to include services purchased by the physician, the clinic and employees, the shortage translates to 13.8 jobs and $533,493 in income. (Iowa Independent)
Irving Harper, ACP Member, discusses how he handles his patients with e-mail, cell phone and video chat. Ahhh, but it's good to practice in Hawaii. (U.S. News & World Report).
Labels: H1N1, health care reform, health information technology, QD, telemedicine, vaccination
posted by Ryan DuBosar at
11:32 AM
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Friday, August 28, 2009
ACP Master speaks his mind on H1N1 vaccines for health care workers
Following studies on Canadian and Hong Kong health workers unsure about getting vaccinated for H1N1, William Schaffner, MACP, now questions whether American health workers will, as well.
"There isn't a doubt that it's a severe challenge," Dr. Schaffner told MSNBC. "It's primarily a patient safety issue."
He's not only a Master of the College but also chairman of the infectious diseases division at Vanderbilt University in Nashville, and is in a position to encourage others. Clinical trials for it appear safe, he said, and health care workers should protect themselves and their patients.
"It's a professional and ethical responsibility of every health care worker to be vaccinated," he said.
Labels: flu, H1N1, infectious disease, vaccination
posted by Ryan DuBosar at
4:00 PM
1 Comments
Wednesday, August 26, 2009
More health workers unsure about H1N1 vaccination
In a follow-up to Tuesday's post that found Canadian health workers might refuse an H1N1 vaccine during a pandemic, another report finds about half of Hong Kong's health workers would refuse the swine flu vaccine. According to the BMJ, when the World Health Organization raised the H1N1 flu alert level to 5 in May, only 47.9% of 2,255 Hong Kong surveyed health workers were willing to get vaccinated, up from 28.4% surveyed a few months prior. An accompanying editorial in BMJ gently encourages vaccination while quelling fears of potential harms from vaccination.
Labels: H1N1, infectious disease, vaccination
posted by Ryan DuBosar at
12:11 PM
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Tuesday, August 25, 2009
Health workers, public may refuse H1N1 vaccines
Health care workers will balance the risks of H1N1 flu against the novelty of vaccines developed to combat it, according to research published in Emerging Health Threats Journal.
Canadian researchers conducted 11 focus groups (eight community groups and three for health care workers) in Vancouver asking participants how willing they would be to accept a new vaccine in case of a pandemic. They found that respondents were reluctant to get vaccinated against an illness they perceived as mild.
"Participants were very concerned that in a pandemic, a vaccine would be brought to market without sufficient testing for safety," researchers wrote. Many among all 11 focus groups believed that hand washing, social distancing or a good diet conferred protection. In the words of one health care worker: "A lot, well all of us probably practice basic body, blood, fluid precautions, right? ... So, we're equipped in that way to handle new diseases. We know how to protect ourselves. At least we think we do."
Similarly, health care workers are balancing the severity of the disease vs. any potential risk in a new vaccine. One health care worker told researchers: "Information would be key and I'd have to weigh the cost and the benefit of ... I'd have to know what would be the implications of getting the disease. And what would be the implications of getting the vaccine."
Meanwhile, a panel of U.S. presidential advisors finds looked at a plausible planning scenario--not a prediction--that H1N1 could infect 60 million to 120 million Americans (20%-40% of the population), killing 30,000 to 90,000 people. And the Washington Post looks at history for a lesson from the flu outbreak of 1957.
Labels: H1N1, infectious disease, vaccination
posted by Ryan DuBosar at
11:59 AM
4 Comments
Friday, August 21, 2009
2 years and counting...HPV vaccine controversy continues
Some medical advances slide quietly into practice; others seem to be neverending sources of controversy. The HPV vaccine definitely falls into the latter category. When we first covered it, the big issues were whether vaccination should be mandated and whether insurers would pay enough for it. There was also public debate about the moral message of vaccinating pre-teens against a sexually-transmitted disease. Then came horror stories about mysterious side effects.
The latest issue of JAMA digs into all these issues. One article reports postlicensure safety data from the Vaccine Adverse Event Reporting System. Basically, they didn't find anything particularly out of line with other vaccines, except higher rates of fainting and blood clots (mostly in women who were also on the pill). A less reassuring article delves into the marketing strategy employed by Merck, particularly the involvement of professional medical associations. Not that pharma marketing usually is, but it's not pretty.
All together, the research causes the author of an accompanying editorial to come to a fairly negative conclusion on the value of the vaccine. "The net benefit of the HPV vaccine to a woman is uncertain. Even if persistently infected with HPV, a woman most likely will not develop cancer if she is regularly screened. So rationally she should be willing to accept only a small risk of harmful effects from the vaccine."
Only one thing is certain--this controversy doesn't seem likely to go away any time soon.
Labels: HPV, vaccination
posted by Stacey Butterfield at
9:53 AM
0 Comments
Tuesday, July 28, 2009
Scary statistic of the week
The CDC is predicting that, without vaccination, up to 40% of Americans could catch swine flu and hundreds of thousands could die this winter, the Washington Post recently reported. Aah! What are they trying to do? Make us panic?
I don't think the CDC would do that, but then when I read this other article--about the government's plans for the biggest vaccine promotion campaign ever--I started to wonder. "Everything is going to be done to try to encourage people to get it," an official told AFP. Everything...including the distribution of apocalyptic statistics?
Labels: CDC, H1N1, vaccination
posted by Stacey Butterfield at
12:41 PM
0 Comments
Friday, July 24, 2009
They're not going to ask for a shot
To the long list of things about which young American adults are woefully ignorant (history, geography), you can add the importance of vaccines, according to a new survey. Less than half of 18- to 26-year-olds know that tetanus causes lockjaw and should be prevented with a vaccination every 10 years, reports HealthDay. Compare that to 84% of people over 50 who claim that knowledge.
The impetus for change is on physicians, according to an official with the National Foundation for Infectious Diseases, which sponsored the survey. "The majority of adults [87 percent] are very likely to get vaccinated if their doctor or other clinician advises that they get vaccinated," she told HealthDay.
Either that, or kill off one of the characters on Grey's Anatomy with tetanus.
Labels: McDreamy, vaccination
posted by Stacey Butterfield at
9:00 AM
0 Comments
Thursday, June 25, 2009
If they don't give you the flu...
It's good news for people who like to cuddle wild animals. The CDC's Advisory Committee on Immunization Practices has determined that four, rather than five, rabies shots are enough to protect an exposed human, according to an AP report.
Apparently (bet you didn't know this either) there's been a nationwide shortage of rabies vaccine, so the experts are hoping that reducing the number of shots will help to alleviate that problem. On the other hand, Novartis, which charges $100 to $200 per shot, expressed concern about the recommendation and hasn't announced any plans to change their labeling info from 5 shots to 4.
Maybe you can offer that extra shot to your friendly neighborhood bat. They seem to be having a rough year.
Labels: rabies, vaccination
posted by Stacey Butterfield at
2:41 PM
0 Comments
ACP Internist hosted Grand Rounds on June 16, wrapping up the best of the medical blogosphere. Click here for the complete wrap-up.
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