Maine CDC H1N1 Update
Maine CDC/DHHS Update on 2009 H1N1
Flu Activity in Maine
and the US
Data indicate that H1N1 flu
has been relatively mild in Maine compared with other states, and continues to
decline. There have been no new deaths since the last update.
There were 9 new
hospitalizations last week, down from 11 last week, and across all age groups.
There were no new admissions to intensive care. Individuals were hospitalized
in Cumberland, Franklin, Kennebec, Oxford, Penobscot, Washington, and York
Outbreaks were reported in
one long term care facility and two K-12 schools. The outbreaks occurred in
Penobscot, Somerset, and York counties.
Flu comes in waves.
Protect yourself and those you care about by getting vaccinated before
the next wave.
To remind people of the
importance of washing hands, covering coughs, staying home when sick, and
getting vaccinated, order flu posters and magnets for your organization,
workplace, or health care practice: http://www.maine.gov/dhhs/boh/flu-poster-orders.shtml
H1N1 Vaccine Supply
To date, we have received a
total of about 575,000 doses of H1N1 vaccine in Maine, and by the first week of
January we expect to have about 675,000 total cumulative doses – enough for
about half of the state’s population. Based on recent demand, Maine CDC is now
recommending that H1N1 vaccine be offered to anyone who wishes to receive it
when local supplies allow.
If you are an H1N1 vaccine
provider and are running short of vaccine, please contact
firstname.lastname@example.org to inform us of your needs. This will help our
short terming planning and distribution of vaccine.
The focus for vaccine will
still be the five high priority groups as defined by US CDC, but in many places
public clinics will not need to turn others away. We are encouraging
health care providers with sufficient supplies to provide vaccine to all who
want it, and those without sufficient vaccine to focus their vaccine supply to
those in the high priority groups: pregnant and recently pregnant women;
household members and caregivers of infants younger than six months old; all
people ages 6 months through 24 years; people ages 25 through 64 with
underlying health conditions; and health care and EMS workers.
The nasal spray vaccine is
available in slightly greater quantities than injectable vaccine. We request
that nasal spray vaccine be given to anyone who is eligible to receive it. The
nasal spray vaccine is a safe and effective vaccine option for healthy people
ages 2 through 49 who are not pregnant. For more information on nasal spray
vaccine, please see our Fact Sheet at: http://www.maine.gov/dhhs/boh/maineflu/LAIV_factsheet.pdf
The benefits of getting
the H1N1 vaccine far outweigh the very small risk of serious complications from
Some people getting vaccinated will have mild side effects such as pain,
redness or swelling in the arm where the shot was given or a runny nose and
headache after the nasal spray vaccine. US CDC and FDA carefully monitor
vaccine reports. After millions of doses of H1N1 vaccine being administered in
the U.S., the number, pattern and types of adverse event reports are similar to
what we see for seasonal influenza vaccine. More than 90% of adverse event
reports nationwide have been classified as not serious.
We expect vaccine to be
more readily available in retail pharmacies over the next several weeks, in
addition to public clinics, doctors’ offices, and through occupational health
and certain large-scale employers. To find vaccine in your area: check the
clinic locator at www.maineflu.gov, call
211, or call your health care provider.
On December 18
and 21, MedImmune notified CDC and FDA that the potency of 13 lots of
monovalent 2009 (H1N1) nasal spray vaccine had decreased below a
pre-specified limit or were at risk of falling below that limit in the next
week. This slight decrease in vaccine potency is not expected to have an impact
on the protective response to vaccination. There are no safety concerns with
these lots of 2009 H1N1 vaccine. This is not a safety recall. All
lots successfully passed pre-release testing for purity, potency and safety.
However, because their potency is now or might soon be below the specified
lower limit, MedImmune will send providers directions for returning any unused
vaccine from these lots.
The potency of
these lots is now or might soon be slightly below the specified range for the
product. CDC and FDA are in agreement that the slight decrease in vaccine
potency is not expected to have an impact on the protective response to
vaccination. For this reason, there is no need to revaccinate persons who
have received vaccine from these lots.
received vaccine from the recalled lots do not need to take any action.
Children and adults aged 10 years and older who received the vaccine do not
need any further doses of vaccine. As is recommended for all 2009 H1N1
vaccines, all children younger than 10 years old should get the recommended two
doses of 2009 H1N1 vaccine approximately a month apart. Therefore, children
younger than 10 years old who have only received one dose of vaccine thus far
should still receive a second dose of 2009 H1N1 vaccine. It is best to use the
same type of vaccine for the first and second doses.
The 13 lots
subject to the recall include approximately 4.7 million doses. These doses
were shipped to CDC’s contract distributor in October and early
November. Approximately 90 vaccine providers in Maine received these doses,
primarily in late October. Most of the doses are believed to have already
been administered while fully potent and within specifications. However,
there may be some doses that have not yet been used.
issue described here is specific to 13 lots of nasal spray 2009 H1N1 influenza
vaccine. Subsequent lots of the vaccine were produced with a slightly
higher initial potency to decrease the chance that the potency would fall
“below specification” before their expiration dates. Following its routine
practice, the manufacturer will continue to monitor the stability of these
Maine CDC will
be contacting all Maine providers who received doses from any of the 13 lots of
vaccine so that they can return any unused vaccine.
· For Questions and
Answers related to the withdrawn vaccine see
· Call CDC’s toll-free
information line, 800-CDC-INFO (800-232-4636) TTY: (888) 232-6348, which is
available 24 hours a day, every day.
· For manufacturer’s
information about the recall, see http://www.medimmune.com/pdf/H1N1_Recall_QandA_122209.pdf
· For manufacturer’s
instructions to providers on actions to be taken, see http://www.medimmune.com/pdf/H1N1_Recall_letter_122209.pdf
for Vaccine Administrators
All public clinics must
be posted on Maine CDC’s clinic locator: http://www.maine.gov/dhhs/boh/maineflu/fluclinics/clinic-form.shtml.
If you have questions about completing this form, please e-mail email@example.com.
All H1N1 vaccine
providers and/or administrators must submit the vaccine administration
data into Maine CDC’s weekly vaccine reporting system. The weekly vaccine reporting form
can be found at: http://www.maine.gov/dhhs/boh/maineflu/h1n1/health-care-providers.shtml.
Detailed instructions are
also available at: http://www.maine.gov/dhhs/boh/maineflu/h1n1/H1N1-Weekly-Reporting-Form-instructions.pdf.
The only vaccines that
should be returned to McKesson are those that arrive non-viable or appear to be
damaged during transit. Providers with concerns about vaccine viability
during transit from McKesson should call 877-836-7123 immediately upon receipt
of the package.
Once a provider takes
receipt of the vaccine as a usable product, it is that provider’s
responsibility to ensure proper disposal of any damaged, expired, or un-used
vaccine unless it has been recalled.
Due to national production
delays and the recent recall of .25 mL pre-filled syringes, Maine CDC makes the
following recommendations for vaccinating small children:
Use the Sanofi or CSL
multidose vial for all children ages 6 months to 2 years of age
Use the nasal spray
vaccine for healthy children ages two and older, when available and appropriate
Use the Sanofi or CSL multidose
vial for children ages two and older who are not eligible to receive nasal
spray vaccine, or when nasal spray is unavailable
Vaccine Dose Spacing and
Those who have questions
about H1N1 vaccine dose spacing and administration with seasonal flu or other
vaccines should consult this table from US CDC: http://www.cdc.gov/H1N1flu/vaccination/dosespacing_admin.html.
information for health care providers can be found on our web site at: http://www.maine.gov/dhhs/boh/maineflu/h1n1/hc-providers/vaccine-info-hcp.shtml
Updates from Federal
US CDC has updated its recommendations
for clinicians regarding H1N1 and severely immunosuppressed patients: http://www.cdc.gov/h1n1flu/immunosuppression/index.htm
US CDC has updated its H1N1 Fact Sheet
for people age 65 and older: http://www.cdc.gov/h1n1flu/65andolder.htm
If you think 2009 H1N1
flu can't affect you, your family, or your friends—think again. Take 60 seconds
to watch this reminder on why vaccination is so important. All of the excuses
any of us make don't stand a chance against this serious disease. http://www.cdc.gov/CDCTV/INever/
This USDA study (http://www.usda.gov/documents/ARS_STUDY_H1N1_Pork_12-16-09.pdf)
confirms that people cannot get H1N1 from eating or preparing pork from pigs
exposed to the H1N1 virus.
From the US Department
of Health and Human Services: H1N1 Year in Review: http://www.flu.gov/about/h1n1yearreview.html
CDC has not
implemented a state vaccination program requiring registration on www.cdc.gov. Users who click on e-mails
directing people to create a personal H1N1 vaccination profile are at risk of
having a computer virus installed on their system. For more information: http://www.cdc.gov/hoaxes_rumors.html
How to Stay Updated
· Flu News: View current Maine CDC press
releases, Thursday weekly updates, and urgent updates from our Health Alert
Network (HAN) by visiting: http://www.maine.gov/dhhs/boh/maineflu/flu-news.shtml.
RSS feeds are available for the weekly updates and HAN.
· Follow Maine CDC’s
Social Media Updates:
o Facebook (search for “Maine CDC”)
o Twitter (http://twitter.com/MEPublicHealth)
o MySpace (www.myspace.com/mainepublichealth)
o Maine CDC’s Blog (http://mainepublichealth.blogspot.com)
· Please note that
weekly conference call updates will not be held for the next several
weeks. Any future
calls will be listed in advance in these updates.
· For clinical
consultation, outbreak management guidance, and reporting of an outbreak of H1N1 call Maine
CDC’s toll free 24-hour phone line at: 1-800-821-5821.
· For general
o call 2-1-1 from 8 a.m. to 8
p.m. seven days per week
o e-mail firstname.lastname@example.org
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