Swine Flu Vaccine-Is Rationing Right?


The CDC Swine Flu vaccine rationing scheme published in a press release on July 29, 2009  for the predicted fall-winter 2009-2010 season eliminates  those 65 and older from the equation.  CDC Newsroom Press Release July 29, 2009 The  problem is that this age group utilizes more healthcare dollars during influenza season than any other age group and is 10 times more likely to die of respiratory and cardiac complications of influenza than those 50-64. Prevention and Control of Seasonal Influenza with Vaccines This rationing has angered our senior citizens and the AARP and seems to support their idea that government bureaucrats are rationing healthcare away from the aging population.

from freerepublicCANCELED3

Pharmaceutical companies are quickly producing and studying this new H1N1 Swine Flu vaccine, but there won’t be enough for everyone.  National infectious disease groups and public health advocacy groups support vaccine rationing and there are many reasons to justify this allocation.

1.  Data from case reports of those severely affected by this past spring/summer H1N1 pandemic suggests those under 60 required more life saving intensive care measures, higher hospitalization rates and had higher mortality rates than those over 60. CDC Novel H1N1 Flu | Facts and Figures

2. Currently the three individuals who either died or required extreme life saving measures at my hospital were ages 20-24.

3.  The economic burden of influenza in the US, including loss of productivity,  is 87 billion dollars.  This  includes 10 billion in  healthcare dollars.  A swine flu epidemic this winter would cost the US even more with a younger age group severly affected.  Loss of wages in this  group would also affect the tax base which is an important issue in this period of national economic crisis (the bail out of Wall Street) and the revamping healthcare.

Therefore, despite these guidelines being in oppososition to recommendations from past seasonal influenza experience, the evidence is there to support and justify this rationing.

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4 Responses to “Swine Flu Vaccine-Is Rationing Right?”

  1. Marwan Haddad Says:

    Thanks for the interesting topic which I am certain we will be hearing more of as time for vaccinating against H1N1 influenza quickly approaches.
    Recommendations are made based on the best evidence we have to date. So far, the H1N1 epidemic in the US has been one that has been relatively non-virulent and, surprisingly, has attacked a proportion of the population that excluded those over age 65. This is definitely contrary to the seasonal flu epidemics that we have seen over the years.
    The anticipation that the H1N1 epidemic is going to rear its ugly head this Fall/Winter as the stronger, deadlier version is definitely a possibility but may also end up being wrong. A prime example of viruses not doing what may be expected of them is the SARS epidemic several years back when the outbreak held the world in terror and then it just seemed to disappear. In such a case, who gets vaccinated first really becomes a moot debate.
    If, on the other hand, we do see a resurgence, we are hoping to have an available vaccine ready in time before the H1N1 epidemic rears its head again but this is not a guarantee. And if the vaccine does become available in time, we may not have enough vaccine to even cover the highlighted risk groups that are to be first in line to receive the vaccine. Lastly, though the virus so far has not attacked those aged 65 or above, that certainly does not mean that if and when it does come around again, it would not have changed its character so as to also or even preferentially attack the elderly population. And if that does happen, we will not be prepared enough for it to be able to protect our elderly in time.
    Much speculation is being made here, I know, and the best we can do, as stated earlier, is to look at the evidence we have had so far. To compensate for that evidence that we have NOT witnessed yet, however, I strongly hope that we are planning to have enough vaccine available and in time to be able to vaccinate everyone who desires it and the prioritizing would become simply an academic exercise.

  2. HealthBlogger Says:

    I remember having this discussion in a health class during the Avian Flu emergence a few years ago. Someone put it in a way that really stuck with me…if they were talking about your mom, dad or grandparent, how would you answer this then? I know I sure would advocate for them. But as with many difficult decisions we all must make in life, where should the cut off be? Or should there even be one? I for one don’t think there is a good answer. Great topic!

  3. eevers Says:

    Thanks for the information. I had not heard that senior citizen groups were reacting to this policy announcement. In the event of a shortage, it is logical to give the vaccine to the high risk groups. As pointed out, unlike seasonal flu, H1N1 has shown to be more of a threat to the under 65 population. Considering this fact, and the fact that most caregivers to the elderly are in the younger age categories, it makes sense to vaccinate them first. If the younger cohorts are going to be more affected by the circulating virus, the elderly population may not benefit overall by receiving the vaccine if it results in a loss of care due to family members and caregivers falling ill. Of course, if circumstances change, the policy may need revision.

  4. schmidtidp Says:

    Unfortunately what is great policy is not personal reality as all my friends and family over 64 expect me to vaccinate them. In addition, the graphs of those affected in the CDCs facts and figures illustrates that the some of the 65 and older are affected, and if it happens to be the family member I don’t vaccinate I’ll feel awful. I am just hoping we have an adequate supply for all. Of course, I heard Bill Gates wants to give some our supply to developing countries (can’t find a reputable source to confirm this)….now there is another discussion.

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