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Schools tapped as vaccine centers

Local plans remain in process

July 12, 2009


SOUTHBRIDGE — Last week, the U.S. government urged school districts to prepare for giving H1N1 (swine) flu vaccinations to their students this fall, but local officials are still crafting plans to do so.

"I personally think it's a great idea," said Board of Health Chairman Dr. Thomas O'Leary. "I certainly remember getting them when I was a kid. The logistical problem, the stick in the wicket, is getting parental consent."

It's also figuring out how to deal with the potential of allergic reactions in some people, how to distribute hundreds of doses in a short time frame, how to juggle that with the fact the same period will see new vaccinations for the seasonal flu, a separate illness, and, in some cases, how to address concerns of those opposed to vaccination.

There's still time to finish such planning, since the vaccine is still being developed. The July 10 Washington Post reported the goal is to distribute the first 100 million doses sometime in October.

O'Leary, who is also a school committee member, said he had preliminary discussions on how to implement such a process with Superintendent Dale Hanley last month, but she was on vacation and unavailable for comment last week. He predicted a "classroom by classroom kind of thing may be the best way to do it."

Madeline Brouillard, principal at Trinity Catholic, agreed, saying her school's approach would mirror whatever the public health authorities create. She said Trinity will probably have the school nurse give shots one-on-one to protect student's privacy a few days after a school-wide assembly describing what's happening.

She said 80 to 90 percent of her school's parents get their children the annual flu shots, and all students have the regularly required vaccinations.

"Every once in a while we do get a family who doesn't believe in vaccination, but we don't have anybody like that now," Brouillard said. "We haven't had someone like that in several years."

Regarding such folks, Charlton's Terri Gough, "quartermaster" for Tri-EPIC (the regional emergency network), said there is no plan to mandate vaccinations.

"Everybody has a right of refusal; it's illegal to force someone to take it," she said. "It's being offered as a preventive measure."

She said Tri-EPIC, the towns, Harrington Hospital and the state are all updating their plans to address how to vaccinate large numbers of people.

Targeting school-age children for vaccination is somewhat unusual for an influenza outbreak. Normally, the flu hits the very young, the very old and those with compromised immune systems hardest, but people between their teens and 30s seem to be most susceptible to this H1N1 variant, according to health data. At this point, the huge majority of cases are mild — the World Health Organization's most recent figures (from July 6) show 94,512 confirmed cases globally with 429 deaths, a 0.4 percent fatality rate.

Southbridge has had "a few isolated cases," O'Leary said.

"But doctors aren't testing for it as scrupulously as before," he said. "I was advised at my practice [in Dudley] that testing is only for the most severe symptoms."

A similar approach on the large scale means the actual number of H1N1 cases is unknown. Some reports in the last two weeks suggest the U.S. has already seen well over 1 million of them.

According to the U.S. Department of Health and Human Services' pandemicflu.gov Web site, such numbers would put H1N1 close to the bottom of the pandemic severity index, even using just the confirmed caseload. If that continues to be true this fall,

The agency's draft guidelines create five priority tiers. In all pandemics, tier 1 (the first vaccine recipients) features approximately 23 million people deemed to have various "critical occupations" or be "high-risk," including deployed military forces, police, fire, EMS, healthcare, government leaders, vaccine and antiviral manufacturers, pregnant women, infants and toddlers. In each job group above, it emphasizes, "only persons who are deemed critical to provide services that are essential to maintain during a pandemic, not the entire workforce" get tier 1 ranking. The other four tiers get somewhat reshuffled depending on the pandemic's severity, allocating more vaccine to the general public during early phases of a vaccination effort in weaker pandemics.

"In general, vaccine allocation within a tier will be proportional to the populations of the targeted groups, though changes in this allocation scheme at the time of the pandemic may occur based on the impacts of the pandemic and the specific needs identified at that time," the draft states. Allocation to the states follows a similar proportional system, it adds elsewhere.

"One of the most important findings of the working group analysis, and the strongest message from the public and stakeholder meetings, was that there is no single, overriding objective for pandemic vaccination and no single target group to protect at the exclusion of others," it observed.

Gus Steeves can be reached at 508-909-4135 or by e-mail at gsteeves@stonebridgepress.com.

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