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H1N1 Vaccination Clinic
As all parents should be aware, the Kingman County Health Department is conducting a free vaccination clinic for our students on Thursday, November 19, 2009. The following information is from the Kansas Department of Health and Environment. It was published in their weekly newsletter, Public Health Connections dated October 5, 2009. Questions concerning the clinic should be directed to the Kingman County Health Department.
State Health Officer Statement on LAIV
presented by Jason Eberhart-Phillips, MD, MPH
Kansas State Health Officer/Director of Health, KDHE
In coming months, approximately 20 percent of the entire H1N1 flu vaccine supply will be in the form of live attenuated influenza vaccine (LAIV). For better or worse, the live vaccine comprises nearly the entire early allotment ofpandemic vaccine to states.
Several medical providers around Kansas have
indicated to me or to local public health directors that they will discourage healthy patients and health care workers from receiving LAIV on the mistaken belief that the vaccine is ineffective or unsafe. I am also aware that some local
health department administrators have been unable to convince their medical consultants to sign standing orders to give LAIV as part of their county H1N1 flu vaccination campaigns.
As state health officer these reports concern me. This vaccine is both safe and effective in preventing pandemic influenza. It has been licensed through a rigorous process involving more than 20 clinical trials. The live viruses contained in the vaccine are attenuated, unable to cause influenza illness. They are cold adapted, so that they only cause infection at the cooler temperatures found in the nose. Side effects are generally very mild, limited in most cases to a runny nose and nasal congestion lasting no more than a few days.
By law the package insert for LAIV must state that a person can shed the vaccine virus for up to three weeks, but shedding alone should not be equated with person-to-person transmission. In fact, studies have found that transmission is very rare. In one large study designed to maximize the chance of detecting vaccine virus transmission, there was actually only one documented
case of LAIV transmission.
The vaccine virus is shed in lower titers than typically occur with shedding of wild-type influenza viruses. So even if transmission were to occur, there are not enough viral particles to make a person ill. The virus also retains its attenuated characteristics, thus cannot replicate in the lower respiratory tract. This means that shedding and any rare cases of subsequent transmission cannot be presumed to cause disease. Only people with regular, ongoing contact with others who have severely weakened immune systems (such as caregivers for patients in a bone marrow transplant unit) should not get LAIV. People in contact with persons having lesser degrees of immunosuppression, such as diabetes, pregnancy, people taking corticosteroids
or people infected with HIV can get LAIV. Of course, no
one should receive LAIV if they have had another live vaccine during the previous four weeks, as the protection LAIV provides could be diminished.
Because there is no sound medical reason not to give
LAIV to those groups for which it is licensed, counties that
refuse LAIV or fail to administer their doses, will not be able to make up those doses with additional doses of inactivated vaccine. I personally stand ready to speak with any medical consultant who is confused about the safety and efficacy of LAIV, and will do everything I can to ensure that this lifesaving vaccine is used to its full advantage in Kansas.
At a time like the present, when total H1N1 vaccine supplies fall well short of demand, healthy health care workers and others in priority groups who accept receipt of LAIV will be helping to conserve the limited supplies of inactivated H1N1 vaccine for high-risk persons who do not have the option of using LAIV. Their decision to do the right thing could possibly save a life.
