In the race between vaccine and virus, the virus is still ahead. But the jockey on the vaccine horse -- Health and Human Services Secretary Kathleen Sebelius -- is using her whip.
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Who benefits from limited early-October supply of H1N1 vaccine?
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After weeks of saying no swine flu vaccine would be ready until mid-October, Sebelius is now sounding confident that the first doses will be going into some Americans' arms in the first week of October.
But is that early enough to do much good?
Depends on when this second wave of swine flu crests. ( Or the H1N1 flu of 2009, as the government prefers to call it.)
Two flu pandemics ago, in 1957-58, the Asian flu started spreading in early September, which sounds like the pandemic of 2009. The '57-'58 pandemic peaked in mid- to late-October. So if that's the pattern this time, not many Americans will get vaccine-protected until post-peak.
This doesn't mean it won't help.
The last pandemic before H1N1 of 2009 -- the Hong Kong flu pandemic of 1968-69 -- didn't peak until November or December. So if the current pandemic follows that model, getting the vaccine out in early October would be a definite plus.
Still, this is a suspenseful horse race.
Scientists at the Fred Hutchinson Cancer Center in Seattle just published an analysis saying that the best use of the new vaccine would be to get it into children first. That's because they spread the new virus faster than anyone else. The typical infected student, they say, will infect 2.4 other classmates. The overall "reproductive rate," as it's called, is between 1.3 and 1.7.
The Seattle researchers say this virus ranks on the higher edge of transmissibility -- 32 percent of the population can expect to get infected over the course of a year.
But the early release of vaccine will presumably not be available for children. That's because the pediatric studies of vaccine safety and effectiveness are still underway. Ditto for pregnant women, also considered at increased risk of swine flu infection and hospitalization.
Sebelius and others in her department have not announced who will be eligible to get the first doses. One spokesman at the Centers for Disease Control and Prevention says they're likely to be the nation's 13.5 million health care workers and 2.6 million first responders.
It's not clear how many doses will be released in early October. Back on July 29, one federal official said that the government had "over 20 million doses already produced and ready to be formulated" -- that is, put into vials. Conceivably, there might be more by now.