Expert Discusses Plans For H1N1 Vaccine Distribution

Melissa Block speaks to Dr. David Fleming, director of the Office of Public Health for Seattle and King County, Wash., about his plan for distributing the H1N1 vaccine. He discusses what he knows about the vaccine, who will get it, plus where and how it will be distributed.

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MELISSA BLOCK, host:

So, how will a vaccine campaign against H1N1 flu be carried out? The numbers are daunting. The CDC projects that 40 percent of Americans could get swine flu in the next two years and several hundred thousand could die if a successful vaccine campaign is not in place. We're going to hear how one large metropolitan area is planning its inoculation program. David Fleming is the public health director for Seattle and King County. Dr. Fleming, welcome to the program.

Dr. DAVID FLEMING (Public Health Director, Seattle and King County): Thank you very much.

BLOCK: And when you think about the target populations in your area, how much vaccine do you figure you're going to need and do you think you'll have enough?

Dr. FLEMING: Well, the population of Seattle and King County is 1.8 million and when you look at the national recommendations that have come out, we're sliding slightly less than one million people for whom the vaccine will be recommended and that's the planning that we're conducting now, is to figure out how to make that vaccine as available to as many of those people as soon as possible.

BLOCK: And how do you do that when you think about where you would try to inoculate a million people?

Dr. FLEMING: Well, in Seattle and King County, what we're adopting as our approach is to say, you know, influenza vaccine is something that people receive every year and there's a system in place through health care providers to deliver it. And so the primary way that we are going to achieve vaccination for H1N1 is by strengthening our delivery system.

So we're working with hospitals to ensure that they can get vaccine to vaccinate health care providers and the pertinent patients that they're following. We're working with our primary care providers, who every year administer seasonal vaccine to make sure that we're getting this new vaccine to them. And importantly, we're also working with the mass providers of immunizations - the pharmacists, some of the other companies that are out there to enlist them in making vaccine available in a widespread way in the population.

BLOCK: Are you planning anything additional? In other words, you know, renting a big warehouse for widespread H1N1 vaccination.

Dr. FLEMING: We're optimistic and hoping that as many people as possible can be served by what this distributed system that I'm talking about, where vaccine would be available at many, many different areas in the county. That's the way to successfully vaccinate a million people, rather than thinking about one place where you have a million people in line.

But we also do need to be thinking about who will fall through the cracks of that system? Who out there might not be able to afford the administration charge? Who might have difficulty accessing these sites? And so we're having a secondary system using our public health clinics and other safety net providers to provide places, in essence, of last resort for folks to go to if they can't get the vaccine through other routes.

BLOCK: You talked about an administration charge. In other words, this wouldn't be free?

Dr. FLEMING: The vaccine is being purchased and will be free to people, but there is a cost for administering it. And in the health care system, that cost would be borne by the insurance companies. For people who do not have insurance, we do need to make the vaccine free to them. And that's the safety net system that we're developing to make sure that if they come, for example, to a public health clinic, that they will not be asked to pay.

BLOCK: Dr. Fleming, when do you assume you're going to have the H1N1 vaccine?

Dr. FLEMING: The best information we have right now is that if things go as scheduled, the vaccine would become available, the first doses, in mid to late October. And so that's what we are planning for is a shipment of vaccine during that time. And our job, really, is to make it as quickly available as possible after we receive it. And so we're working with our providers to make sure that they're geared up to start sponsoring these clinics during that same time for late October, early November.

BLOCK: And do you figure that by that time swine flu will already have hit pretty hard?

Dr. FLEMING: Well, I wish I had a clear, crystal ball than the one I currently have. It's - it, really, the challenge here is dealing with the uncertainties with H1N1 and figuring out and then adapting in real time. I think it's likely that looking at what happened in the Southern Hemisphere that H1N1 will arrive before mid to late October and it could arrive as early as September, when our schools start up.

So we are planning for a couple of months of H1N1 activity in our area before we're able to offer vaccine. We're hoping that we're being just extra cautious and that it won't arrive till later.

BLOCK: Dr. Fleming, good to talk to you. Thanks very much.

Dr. FLEMING: Hey, thanks for talking.

BLOCK: That's Dr. David Fleming. He's the public health director for the city of Seattle and King County, Washington.

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