Shipment of H1N1 vaccine delayed

The Student Health Service announced Monday afternoon that its shipments of H1N1 vaccine from the City of Philadelphia have been delayed, meaning it will be unable to hold its scheduled vaccination clinic on Nov. 6.

Two other clinics, scheduled for Nov. 13 and 20, are pending the delivery of the vaccine, according to SHS Director Evelyn Wiener. SHS has also added a third clinic on Dec. 4, which is also pending the delivery of vaccine.

All three clinics will be in the ARCH building, located at 3601 Locust Walk.

Wiener said SHS expects the vaccine shipments to arrive in mid-November, though she called such a prediction premature.

“We know that the City is trying to get these to us as quickly as possible,” she said.

The delay is part of a nationwide trend, since the vaccine is taking longer to grow and is yielding less vaccine per unit than expected, Wiener said.

The vaccine is grown in chicken eggs — a “very old” technology, according to Neil Fishman, director of healthcare epidemiology, infection prevention and control for the University of Pennsylvania Health System.

“That’s the technology we’re stuck with for now,” Fishman said, noting that a meticulous quality-assurance program also plays a role in slowing down the vaccine’s delivery.

Fishman said UPHS is experiencing a similar vaccine shortage. He estimated UPHS has received less than 7-and-a-half percent of the vaccine it ordered.

He added that the hospital has had to prioritize certain groups that are most at-risk even beyond the CDC shortage paradigm, pointing to pregnant healthcare workers and lab technicians who work with H1N1 as examples.

Wiener emphasized that the shortage will only delay vaccinations and is not permanent.

She noted that the decision to cancel the first clinic follows protocol established by the Centers for Disease Control and Prevention.

Wiener pointed to an August CDC report which originally targeted five segments of the population for vaccination: pregnant women, people who live with or care for children younger than six months old, healthcare and emergency medical personnel, people between six months and 24 years old and people between the ages of 25 and 64 with medical conditions that put them at an increased risk of flu complications.

If there is an inadequate supply to vaccinate everyone within these groups, the report recommends vaccinating only pregnant women, people living with or caring for children under 6 months old, healthcare and emergency medical personnel in contact with H1N1, children between the ages of 6 months and 4 years and children up to 18 years old at a higher risk of complications.

“That cuts out just about everybody that we would immunize in the public clinics,” Wiener said.

She estimated that under the original criteria, approximately 15,000 students would be eligible for vaccination. Under the shortage condition, however, the number drops to “under 3,000.”

“We are as anxious to get them vaccinated as they are to be vaccinated,” Wiener said, but “we need the vaccine in order to do that.”

The CDC report estimated that 159 million people nationwide would be eligible to receive H1N1 vaccinations under non-shortage conditions. In a shortage, the national number falls to 42 million.

Fishman said it takes a patient approximately two weeks after receiving the vaccine to become immune.

However, he advised students to get the vaccine as soon as it does arrive.

Since some people might not contract H1N1 during the current wave, getting the vaccine in late November would protect against a potential third wave that public health experts are forecasting for late winter or early spring, Fishman said.

Additionally, even if someone was to contract the flu after receiving the vaccine but before becoming immune, Fishman said he or she would likely experience milder flu symptoms.

“It’s not an optimal situation, and no one can sugarcoat that, but it’s not a hopeless situation,” he said.

The announcement about Penn’s clinics comes after Philadelphia Mayor Michael Nutter declared a state of “public health emergency” for the City on Friday, following a similar declaration at the national level by President Barack Obama.

According to a press release from the Philadelphia Department of Public Health, Nutter’s declaration was prompted by an approximate 25-percent increase in emergency room traffic for this time of year in Philadelphia.

Declaring a public-health emergency allows hospitals more flexibility in dealing with an inundation of H1N1 patients by removing some administrative barriers, the release said.

“It doesn’t necessarily mean that people are getting sicker,” Wiener said.

For example, Fishman said, the Hospital of the University of Pennsylvania could triage patients in the lobby if its emergency department were to fill up, or convert additional space into intensive-care areas if no intensive-care beds were available.

He added that such contingencies are unlikely.

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