MMS Flu Advisory: FDA Approves H1N1 Vaccine; Some Seasonal Flu Vaccine Shipments Delayed

The U.S. Food and Drug Administration has approved four vaccines against the 2009 H1N1 influenza virus. The vaccines will be distributed nationally after the initial lots become available, which is expected within the next four weeks. The state will be responsible for distributing vaccine to health care and public health providers. Massachusetts health care practices wishing to receive vaccine must complete an online registration by October 9. Click here to read the FDA press release.

Seasonal Flu Vaccine Delayed
Due to prioritization of H1N1 vaccine and other challenges, remaining shipments of seasonal flu vaccine may be delayed. The state Department of Public Health (MDPH) has received over 40% of its seasonal flu vaccine supply to date. Remaining doses are expected to become available over the next 4-6 weeks. The majority of doses are still expected by the end of October and all doses expected by early November. Additionally, doses of both state-supplied and privately purchased pediatric formulation vaccines (0.25ml pre-filled syringes for <4 years of age) have also been delayed. Currently, less than 30% of the state’s total supply is available now; the majority of doses are expected to be delivered by the end of October. 

Almost all of the influenza viruses currently circulating are H1N1.

MDPH Recommendations
MDPH recommends that all health care providers continue to vaccinate patients with seasonal influenza vaccine during routine visits and in scheduled clinics as supply allows.

Pediatric Providers
MDPH recommends that pediatric providers:

• Continue to vaccinate patients based on their available vaccine supply and formulation types.
• For infants who cannot now be vaccinated due to lack of current supplies, schedule vaccination appointments in late October, when MDPH expects supplies of both state-supplied and privately-purchased pediatric formulation seasonal flu vaccine to be sufficient.
• Plan for simultaneous administration of both seasonal and H1N1 flu vaccine starting in mid-late October. H1N1 flu vaccine will become available starting in early October. Young children are one of the highest risk groups for H1N1 influenza. Pediatric providers will be allocated some of the initial doses of H1N1 vaccine that become available in Massachusetts. Note: Doses of the intranasal H1N1 LAIV and seasonal LAIV must be separated by 4 weeks, but  you can administer H1N1 and seasonal vaccines simultaneously if one or both vaccines are the injectable vaccine.

School and Public Clinics
MDPH is recommending that large public clinics and school based flu clinics be delayed until mid October (and possibly into early November) unless there is sufficient vaccine on hand to meet the expected demand.  By mid-October, we anticipate vaccine supplies will be sufficient to mount large clinics efforts. 

MDPH is advising schools and public health departments to anticipate holding clinics for H1N1 flu vaccine starting in early November as well, and to consider offering both seasonal and H1N1 flu vaccine at these clinics.

Sources: U.S. Food and Drug Administration (September 15, 2009) and Massachusetts Department of Public Health (September 17, 2009).

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