As of 1 p.m. yesterday afternoon, my little family is as protected from the flu as we can be. Pumpkin got the second of her two H1N1 vaccine doses yesterday. Hubby and I had gotten ours last week (we qualify because we have a newborn in our house). We all got our seasonal flu shots last month.
Phew. I'm glad that's done.
I sure hope the people in charge of planning for pandemic avian flu have been paying attention, taking notes, and thinking about what we can do better, because I give our performance during the swine flu pandemic a C-minus at best.
On the plus side, a vaccine was produced and expedited through the necessary tests (and yes, I think it has had plenty of testing and is safe). A sensible plan for who should get priority access to the vaccine as it rolled off the production lines was put in place. Public health experts made valiant efforts to communicate the priorities and the reasons for those priorities.
On the negative side, the distribution of the vaccine has been unnecessarily confusing. I can only speak to what happened here in San Diego, but I don't necessarily mean this as a criticism of our San Diego authorities. My understanding from my inside sources is that some of the screwiest decisions were taken at a higher level of government. I have two main observations of things that could have been done better:
1. Once the vaccine started arriving in San Diego county, its availability was announced on the San Diego county website, and eventually, in the local media. The majority of the vaccine went to doctor's offices and clinics, not to the county's own public health clinics. However, the county's website and the media only reported the locations of the public health clinics- they didn't say where else the vaccine had gone. Not surprisingly, long lines formed at the public health clinics, since this was the only place we knew had the vaccine (I had checked with my doctors, and they did not have it).
If we wanted to rely on our usual vaccine distribution networks- i.e., people's primary care physicians- then more of an effort should have been made to make sure that most doctors got at least some vaccine. My family uses one of the big medical groups in San Diego, and some friends of ours use one of the other ones. Neither had any vaccine.
If we wanted to rely more on vaccination clinics, then the locations of all of those clinics should have been announced. My family was able to stand in long lines on multiple days only because I am out on maternity leave. Asking working parents to do that is just ridiculous. Yes, we all want to protect our kids from the flu. But we want to keep the jobs that allow us to feed and clothe them, too.
2. We needed to prioritize not just who got the vaccine, but who got each type of vaccine. Our public health department received far more of the FluMist (live, attenuated) vaccine than the shot. The FluMist is just as safe and effective for most people, but there is a lot of misinformation out there about it, so some people chose the shot even though they could have had the FluMist. This meant that they ran short of the shot and had to limit its distribution to just pregnant women, leaving children under 2 and people with chronic conditions (like asthma) with no options. I think they should have told people that if they met the criteria for the FluMist, that is what they were getting, and saved the more limited shot supplies for the people for whom FluMist is not an option.
We went to get Hubby and me vaccinated on the third day after a large batch of doses arrived (they arrived on Friday afternoon, and we waited until Monday so that we could send Pumpkin to day care and not try to wait in a two hour line with a toddler AND a newborn). While we were waiting in line, they announced that only FluMist would be available. Technically, I should have skipped the vaccination at that point. I have very mild asthma. However, getting me vaccinated (and getting antibodies into my breastmilk) was the only protection available to Petunia. I called a friend, who looked up what the concern was for asthmatics. It was that the live, attenuated vaccine might induce an asthma attack. I have never had a true asthma attack, so I made the decision to neglect to mention my asthma to the workers distributing the vaccine. This worked out fine for me (but I'm not advocating that anyone else do this!) but I shouldn't have even had to make that call. The perfectly healthy people who are listening to talk show hosts rather than medical authorities about what vaccines are safe should have been told that they could have the FluMist or nothing at all.
This particular virus is worrying for certain groups, but it is nothing compared to what could come eventually. I hope we learn from our "trial run" on pandemic management, and do better next time- when the stakes may be much higher.