Big Picture: KDHE today provided this overview: We are 200 days into this pandemic and H1N1 remains the dominant strain everywhere in the world. It has not significantly mutated and it is very closely matched to the strain in the H1N1 vaccine. 40 million Americans have received the vaccine so far. Sixty-five million doses have been given in 16 countries with very few side effects. 3,414 H1N1 vaccinations have been given at the Riley County-Manhattan Health Department in the last month.

Better Watch Out! We have come through two waves of H1N1 flu (last Spring and last month) and a third wave seems likely. Most of the U.S. population that has not been immunized has also not yet been exposed. This includes Kansans who think they have had the H1N1 flu but who have not. Since H1N1 is the current dominant strain, because the rapid test is not that reliable, or simply because flu symptoms are assumed to be H1N1, some people think they have had H1N1 when they have not. Holiday gatherings and the fact that there are still a lot of people who have not been immunized may help set the stage for a third wave. The vaccine provides excellent and safe protection, not only for the individual but also for the rest of the population that person comes in contact with! 

Vaccine Apathy? This vaccine has been extensively tested and proven to be very safe. It is highly effective. It is available for free in health departments. Some reports indicate that Americans are more dubious of the H1N1 vaccine than of others. If so, that is ironic, since this vaccine has had more testing and oversight than most any vaccine and certainly more than any flu vaccine.

Pneumonia Concerns & Vaccination:     Influenza predisposes people, especially high risk individuals, to developing bacterial pneumonia. During each of the influenza pandemics of the 20th century, secondary bacterial pneumonia was a frequent cause of illness and death. Pneumococcal infections have been identified as an important complication in severe and fatal cases of 2009 H1N1 influenza virus infection. A key difference between this pandemic and those of the past is that now we have vaccines that help prevent pneumonia. Not everyone needs a pneumonia vaccination and for those who do, two in a lifetime is generally sufficient.

CDC's Advisory Committee on Immunization Practices (ACIP) recommends a single dose of pneumococcal polysaccharide vaccine (PPSV) for all people 65 years of age and older and for persons 2 through 64 years of age with certain high-risk conditions. For those 19 through 64 years of age, these include: having asthma or smoking cigarettes. For those 2 through 64 years of age, high-risk conditions include: chronic cardiovascular disease (congestive heart failure and cardiomyopathies), chronic pulmonary disease (including chronic obstructive pulmonary disease and emphysema), diabetes mellitus, alcoholism, chronic liver disease (including cirrhosis), cerebrospinal fluid leaks, cochlear implant, functional or anatomic asplenia including sickle cell disease and splenectomy, immunocompromising conditions including HIV infection, leukemia, lymphoma, Hodgkin's disease, multiple myeloma, generalized malignancy, chronic renal failure, nephrotic syndrome; those receiving immunosuppressive chemotherapy (including corticosteroids); and those who have received an organ or bone marrow transplant, and residents of nursing homes or long-term care facilities. Please consult your physician for advice on getting the pneumonia vaccination.

Availability:  Pneumonia vaccine is available at the health department, but not during H1N1 clinics.

The Riley County-Manhattan Health Department will hold its next H1N1 flu vaccination clinic on Tuesday, November 24^th  from 4:00 – 5:30. We will have several different types of H1N1 vaccine available for specific populations; nurses will assign dosage types. We will serve all those in line by clinic closing time, unless we run out of vaccine. The health department only has H1N1 vaccinations available during these special clinic times. Second doses will be available for children.

KSU Lafene is now holding regularly scheduled H1N1 vaccination clinics at the Student Union. Several physician offices in town have H1N1 vaccine for their patients, including Stonecreek Family Physicians.

Child Dosage Information: Children under 10 years of age require two doses of H1N1 vaccine, 28 days or more apart. This is true regardless of what type of H1N1 vaccine a child receives. A 28 day wait is also required between any two live vaccine doses (these could include vaccinations for chicken pox, the MMR, and others). The CDC has determined that, if necessary, 21 days between children's doses of H1N1 inactivated vaccine is acceptable, but 28 days is preferred. Also, although a 28 day interval is preferred between doses of FluMist, KDHE announced today that the CDC has determined that a 14 day interval between doses of FluMist provides protection.  Please count the days and be sure to get your child a second dose!

Eligible Populations are still largely defined by the U.S. Centers for Disease Control. Eligible populations are listed below (in no particular order):

1)  Pregnant women
2)  Persons between the ages of 6 months and 24 years
3)  Persons between the ages of 25 and 64 years who have chronic medical conditions that put them at higher risk for influenza-related complications
4)  Health care workers, preschool – 12^th grade teachers, and emergency medical services personnel including police who act as first responders
5)  Caregivers for, and people who live with, infants under 6 months of age

Riley County is making no changes in eligible populations at this time; we are focusing on having enough vaccine for school clinics. School clinics are scheduled, or being scheduled, throughout Riley County beginning Monday, November 23, and continuing through the middle of December.

The vaccination process at health department clinics will be much quicker for you, if you arrive with completed paperwork. Each person should have a consent form, a HIPAA form, and (if you have insurance) a health insurance form. These forms can be downloaded from www.rileycountyks.gov. Also please bring a copy of your insurance card (front and back) with you. This is necessary even if we have your insurance information on file because H1N1 data is entered into a separate computer system. H1N1 vaccine is free.  Fees for administration of the vaccine will be billed to insurance.  Only insurance will be billed, not individuals.

We are very grateful to all of our staff and to the volunteers who are helping us hold the flu clinics. We will be receiving ongoing shipments of vaccine and will continue to offer regular clinics as supply allows. Sometimes a clinic may deplete the supply, but we anticipate ongoing shipments. Watch www.rileycountyks.gov  for changes in vaccine availability or call 776-4779 extension 297.