Health officials aren't certain that a swine flu vaccine will be ready by early fall. Nonetheless, a government-appointed panel of vaccine experts met Wednesday to vote on a priority list of who should get the first batch.
The tentative list that the CDC advisory committee came up with was -- in no particular order:
-- Pregnant women, for two reasons. First, because the evidence suggests they're more likely than other adults to develop serious complications or die when infected with swine flu (or seasonal flu). And second, because they pass their immunity on to the fetus, which health officials hope will also help protect the infants after birth.
-- Household contacts and caregivers of children under six months. Infants that young can't be vaccinated, so immunizing their family members and others who care for them is the best way to keep the babies under six-months-old safe.
-- The 14 million health care and emergency service workers in the United States. That's because they could spread the illness to vulnerable populations, and also because high absenteeism among health care workers could bring down the health care system.
-- All children, adolescents, and young adults age six months to 24 years. A number of reasons for this. Epidemiological data gathered so far suggest that the youngest in this group have a higher-than-average risk of getting so sick with the new H1N1 flu that they need hospitalization. And older kids, teens and young adults tend to quickly spread flu through schools. Plus, there's a domino effect through the economy when parents have to stay home to care for sick kids.
-- Adults age 25 through 64 who have underlying medical conditions, such as heart or respiratory illness, diabetes, or other conditions that suppress their immune systems. Swine flu is likely to hit them harder than healthy adults.
(Read past the jump to find out who's at the back of the line and why.)
Beyond those targeted groups, healthy people through the ages of 25 and 64 are next up -- if there is enough vaccine left.
Last on the list are people 65 and older, said the members of the CDC's Advisory Committee on Immunization Practices. This sounds cold-hearted, but the committee says its reasoning is based on the science of the pandemic so far. There have been far fewer cases of swine flu in this elderly group. Researchers think that's because older people have higher levels of immunity to this strain of flu.
Still, the committee is asking people over 65 to get their seasonal flu shots as soon as that vaccine is available; seasonal flu takes a heavy toll on older adults.
The officials on the CDC's Advisory Committee on Immunization Practices said this was just a tentative plan. If fall vaccine supplies are slimmer than expected, they're prepared to make changes.
At this point, they expect 120 million doses of vaccine to be ready by late October. That's not enough to cover the roughly 160 million people in the target groups they've described above, especially if this summer's studies ultimately show that most people need two doses of the vaccine to be protected.
But members of the panel, most of whom are old hands at giving flu shots, say they're not much worried about running out of vaccine.
Why not? Even during pandemics, the researchers say, history shows that the vast majority of people who are urged to get shots never show up to be immunized for one reason or another.
More vials of swine flu vaccine should become available by November and December, these health officials say, so there should eventually be enough for anyone who needs a second dose to get it then.