Distribution of H1N1 Vaccine

H1N1 allocation based on flu severity, other factors

By Robert McCoppin | Daily Herald Staff

Published: 11/8/2009 12:02 AM

The allocation of vaccines for the H1N1 flu virus in recent weeks may have seemed haphazard.

In suburban Cook County, many children with serious medical conditions couldn't get a shot.

Initially, DuPage and McHenry counties had only nasal sprays, which pregnant women and people with conditions like asthma can't take.

In Kane County, mass vaccination clinics were canceled after demand overwhelmed the supply.

And in Lake County, some people seeking vaccinations gave up when they saw jammed parking lots and hours-long lines. And parents who didn't qualify for the shots were given vaccines they didn't even ask for.

Yet in Chicago, officials have received nearly 330,000 doses, more than double suburban Cook, and started getting the vaccine nearly a month before the collar counties.

The allocation of vaccine created such anomalies as Kane County at one point getting more doses than DuPage County, though it has almost half the population.

Story continues below







Maureen McHugh, executive director of the DuPage County Health Department, said there have been some discrepancies, but state workers are trying their best with a limited supply.

"It's been an awkward couple of weeks," she said, "but it will even out."

Despite the inconsistencies, public health officials say they are trying to dole out the doses as fairly as possible.

Distribution is based not strictly on population, but on a number of factors, Illinois Department of Public Health spokeswoman Melaney Arnold said.

H1N1-related hospitalizations and deaths, along with population, are the primary considerations. The state no longer tracks overall cases by county because the illness is widespread.

State officials also try to keep distribution spread evenly across the state, and consider logistics such as the refrigeration storage capacity of each county.

"We're ordering as much as we can as soon as we can," Arnold said. "Right now, supply is so limited, we're all clamoring to get it. We hear some concerns, 'I live in this county but it's coming to this (other) county.' It's not a perfect system. Our objective is to get as much vaccine as we can into people."

Further complicating distribution is that federal authorities treat Chicago, New York and Los Angeles the same way they do states, sending the cities their own allotments of vaccine separate from their states, because of their large populations. Illinois, then, doled out its allotment to the rest of the state.

As the supply evens out, county health departments now are taking steps to serve a previously underserved group, those with underlying medical conditions who are at greatest risk of dying from the flu.

On Friday, DuPage County began holding the first of two immunization clinics for schoolchildren with medical conditions that endanger them, such as heart, lung, neurological, and immune-suppressing conditions.

DuPage officials sent letters to the children as identified by nurses at schools throughout the county. All 3,000 appointments were very quickly filled.

Cook County started allocating some of its supply to obstetricians and pediatricians Thursday, spokeswoman Amy Poore said, in an effort to get vaccines to some of the most at-risk patients: pregnant women and children with underlying medical conditions.

But some pediatric specialists have said they are unequipped to provide the shots because they don't normally provide vaccines, so officials are trying to find the right providers.

And Will County will hold clinics this week specifically for people with severely compromised immune systems, such as transplants recipients, chemotherapy patients, and those getting oxygen for acute lung disease.

Statewide, all 95 county health departments should have received vaccines by now, and most have held or scheduled vaccinations. Much of the initial shipments were in the form of a live virus in a nasal spray, which pregnant women and people with underlying medical conditions cannot take.

Story continues below







There are also signs the scarcity of vaccine may be starting to loosen up, as Chicago, suburban Cook, and all the collar counties got additional doses this past week.

After initially getting the smallest allotment per person, with a paltry 20,000 doses for 2.5 million people, suburban Cook suddenly has by far the biggest supply outside Chicago, with almost 150,000 doses. Officials hope to start supply day care centers and walk-in clinics soon.

Vaccine remained scarcest in McHenry County, with just one dose for every 100 residents - all nasal spray.

Plagued by delivery delays, the U.S. Centers for Disease Control and Prevention has shipped 327,000 doses to Chicago and more than 1 million doses to the rest of the state, with ultimate allocations based strictly on population. But the CDC leaves the method of allocation up to each state.

In addition, the U.S. Department of Defense announced Thursday it has started receiving 3.7 million doses for its personnel - though many are not necessarily in the highest-risk groups for serious complications from the flu. The states also reserve additional vaccines for members of military families.



County
Population
Doses ratio
Distribution

Cook suburbs
2.5 million
36:1
Schools, appointments

DuPage
930,000
58:1
Appointments

Kane
500,000
29:1
Line-up clinics

Lake
700,000
55:1
Line-up clinics

McHenry
300,000
91:1
Appointments




Source: U.S. Census, county health departments






Debra Quackenbush MPH CHES

Community Information Coordinator

McHenry County Department of Health

2200 N. Seminary Avenue

Woodstock IL 60098

815-334-4456 815-334-4456 office

815-236-3238 815-236-3238 cell

815-334-4635 fax

daquackenbush@co.mchenry.il.us



Visit our new webpage www.mcdh.info

Follow us on Twitter www.twitter.com/mchenrycohealth